medication questions

[kate38]

Hi,
I had a cath preformed in Oct and had a spasm in one of the arteries while having the procedure done.I'm scheduled to go back in mid-Dec to discuss the medications I'm taking for blood pressure and possibly stopping some of them (metoprolol,
diltiazem,minoxidil,traim/hctz,diovan and clonidin and wel chol)blood pressure is currently running in the(140's/70-80's)cholesterol,(done on 10/23) tri-365 tot-321 LDL-195 HDL-53 chol/HDLC-6.06 unable to take statins.
Quetions:
Are spasms somthing I should be concerned about, what causes them, a little info please?

In the process of having the spasm,for which I did feel, the heart monitor showed a really weird rhythm to it,should I be concerned?

Which calcium channel blockers work best and will I require life long treatment for this condition?

What other treatment options are available other than calcium channel blockers,what adverse effects come from long term use of calcium channel blockers?  

How do you decide which medication to stop first when dealing with blood pressure that won't cooperate?

If required to continue on all of the above medications,What kind of long term problems should I expect to have from all of them?
What long term effects could I expect if I chose to not take anything at all?

With the new guidlines for blood pessure being what they are,am I still at risk for long term problems,even though I'm taking all the above meds,if my blood pressure continues to stay were it's at? (upper 140's/70-80's)

Thanks
K :-)
Have a wonderful day!!!
Merry Christmas everyone

[Mikeyb17]

I think I'll jump in here. I'm new here so- 51 YO Male, MI 11 yrs ago(LAD then threw a clot in RCA on Cath table). Given 6 months to live. Well here I still am ! Started with spasms about 6 years ago. I realized, with research, that I had Prinzmetal's angina. 2 years ago Dr.'s finally saw it during a Cath. Tried all the Calcium Channel blockers to no avail, causes a lot of fluid retention though. Have episodes every 3-7 months - Dr's know me so well at the ER that all agree with my cardiologist. 6mg Morphine followed by Tridil (Nitro) IV drip. 3 hours later all ok, takes 6 hours without the morphine. All blood tests ok CPK elevated slightly-CKMB fine/Troponin I fine. There is a rhythm to the attacks. Mag level a little low each time a attack occurs but taking Mag Ox has not helped. I wonder about the absorption of Mag in a pill form.
Mikey

[mommof2]

YOu said you went off Atenolol due to asthma? I thought Toprol and Atenolol were both the same type of med? I had to go off atenolol due to a consistent cough. Doc put me on Digoxin(lanoxin). My rate is up and down, I hate it. Before I ever went on a beta blocker, I was diag w/hyperthyroid which caused my rate to go up. Then palps started due to MVP. Well, thyroid levels are now normal, but rate is 90-136.

Anyone on a med they are pleased with? It's ironic, it took a long time for me to finally "admit" I needed a beta blocker. Now I totally rely on meds and wish I could still be on Atenolol.

Thanx,
Mommof2

[kate38]

Bryan,


Thanks for the info,I really appreciate it.




Happy Holidays to you and your family.


:)
K

[bryan56]

Heyya KAte,

As I said I also take Diltiazim and Imdur. I have had spasms now for about 3 1/2 years and I think they have tried just about every kind of pill combonation known to man. I was having a heart cath when they found out it was spasms and the artery were so small that the Doctors were afraid to insert the catheter for fear that the artey would stick to it and that they wouldn't be able to get the catheter out. I mainly take Nitro under the tongue when this happens as most of the medications I am taking do not keep the artteries open on a regular basis. I average a trip to the Emergency Room about every 8 - 10 weeks, then they put me on a Nitro drip to fully open them. After that I seem to be fine for about 3 weeks and the entire process starts again.

I seem to have a problem with potassium loss, they haven't decided yet where it is going, but everytime I end up in the ER my potassium is low. So to combat that they have me taking 6 K-Dur potassium pills a day. Also I mentioned the L-Arginine supplement that I take. My other pills are Aldactone, to assist the potassium pills, Lipitor, and Prilosec, Magnesium, Folic Acid and 325 mg. Aspirin. All in all I take a total of 30 pills per day...I kind of feel like Ozzy Osburne...hehehe

I just tried a trial of a new drug that I had to get from India called Nicorandil, but it didn't seem to work either. I have a cupboard full of medications that haven't worked. I took Procardia XL in 30, 60 and 90 mg., Theodur, Isordil, Lopressor, Nizoral, Norvasc, Clonidine, Bepridil, Probanthine, Nadolol, Maxide, and Persantine. That was in the past two years, all of the other medications I tried before that I have thrown out.

If you have any more questions email me at ***@****

[kate38]

Bryan,
What medication are you taking for your vasospasms?Do you feel like the combination is working? The cardio who preformed my cath,not the one that put me on all the meds,suggested Procardia. I currently take Tiazac,tazetia,I guess it's a form of diltiazem,it can be increased up to 540mg,if needed.Could you tell me a little bit about your experience with these vasospasms,if you don't mind.



Have a wonderful day!!!

K :)

[kate38]

Hankstar,

I totally agree with you and the doctor.But I'm kind of in a pickle.Thats how I ended up at this site,looking for answers.I have had trouble in the past with the ACE inhibitors,side effects and beta blocker are a killer on my asthma.So far I seem to be doing ok at 100mg of metoprolol,but bump it up and I'm toasted.The first cardio indicated that the reason I'm on the combination I am is sensitivity to medications.He even mentioned checking with one of the University Medical Center to see if maybe they had any experimental drugs available,I think he just gave up and did'nt want to deal with it anymore,can't blame him,it has been complicated. If you have any ideas please let me know. I think I'm at the point of calling it quits on the pills.
Hankstar I understand you are not a doctor,but sure are a great person to talk to.

Thanks so much!!!!
K :-)

[bryan56]

I too have spasms and I am on many of the same medications you are on. I also take 240mg of Diltiazim daily along with 240 mg of Imdur. The doctor I see also has me taking nine grams of L-Arginine to try and strengthen the artery walls to make them stay open. You may want to ask your Doctor abour this.
Hope it helps and try to have happy holidays,
Bryan

[DottyCece]

What is the relationship of the BNP (B-Type Natriuretic Peptide) value to the severity of CHF?

If there there is moderate to severe tricuspid regurgitation with normal RV function, enlarged atria, EF of 50%, would a tricuspid repair improve the symptoms of ight heart failure (peripheral edema, JVD, mild pulmonary hypertension.?

[kate38]

Hi,
The dosages I currently take of each med is metoprolol 50mg twice a day,clonidin .1mg three times a day,minoxidil 5mg once a day,diovan 160mg twice a day,diltiazem increased to 240mg twice a day traim/HCTZ 37.5/25mg once a day.And most secondary causes have been ruled out. I was told by frist cardio i would be on this combination probably for the rest of my life. The second cardio did the cath and pretty much said the same thing as you some of them need to go.I have only be on this combination for a little while. Every attempt made previously to stop one of the meds,the blood pressure would increase. I have been on a roller coaster ride with these medications and  side effects, some I think are worse then taking nothing at all. I'm now at a point were I'm able to deal with the side effects, and the previous symptoms before medication are gone.I'm aware of the side effects of the minoxidil. I have been on that one pretty much the whole time.
I was told that it was probably the one keeping the blood pressure down.

I'm very sorry about the long list,I really appreciate you answering my questions.

Have a Merry Christmas

Thank U
K

[kate38]

Hello,

Would you happen to know which of the medication I'm taking
(previously posted) are used for vasospasms.


Hope you and your family are doing well,
Have a Merry Chirstmas.

K :-)

[DottyCece]

What is the relationship of the BNP (B-Type Natriuretic Peptide) value to the severity of CHF?

If there there is moderate to severe tricuspid regurgitation with normal RV function, enlarged atria, EF of 50%, would a tricuspid repair improve the symptoms of ight heart failure (peripheral edema, JVD, mild pulmonary hypertension.?

[Cleveland Clinic]

kate,

you are taking too many blood pressure medications. If you truly are on maximal doses of all of them, then you should be evaluated for secondary causes of hypertension. Too frequently however, people are on submaximal doses of alot of medications.

given your spasm, you should certainly be ona maximal dose of a calcium channle blocker. There are theoretical differences between calcium channel blockers so if one isnt working another, such as amlodipine or verapamil may be more helpful in controlling your syptoms.

Spasms usually are self limiting, but some people can have severe enough spasm to actually cause heart attacks. The best preventions is to be maximum agents like calcium channel blockers and nitrates.

Im unsure of what rhythm you had and cannot commment.

As far as stopping medicines, I would keep you on ones that help your vasospasm and try to maximize those doses. I would alsot try to get you off minoxidil and clonidine, as I dont frequently use them. clonidine must be titrated off or else you can get a rebound effect on your hypertension.

Side effects of out of control hypertension include myocardial infarction, stroke and heart failure. Not taking medicine or trying to control your blood pressure should not be an option.
Side effects of the medicines are available on medincine sheets from your pharmacy and are too numerous to list. Most often the side effects are rare.

Yes. There is a direct relationship with level of blood pressure and stroke and mi. Get it under control.

good luck. hope this is a start.