Reducing Meds Question?

Question

My husband had a bad night. His fever was 102.2 and he vomited from 6 til 1 this morning missing his riba dose.  He couldn't hold water.  His appt. Thursday with the Nurse practioner wasn't a great one. His blood dropped enough for him to get an aronesp shot and she will be giving that to him every other week.  She has suggested him getting off the treatment but he doesn't want to even tho it's making his arthritis act up like crazy. Can barely walk.  Very weak and can't eat much at all. She suggested reducing his meds but was unclear as to how this will affect SVR. May or may not. He's genotype 1a, UND at week 7 or before even since they had taken a test at week 2 and VL went down from 600,000 to 350,000. 5' 9", lost 20 pounds and is now at 150.  Started out with Riba 1200 mgs, and Peg 120 MCGs. Is now on 800 Riba and 120 Peg. She suggested reducing Riba to 400 mg and cut the Peg in 1/2.  He doesn't want to do that but after last night he's thinking about it. What will this do to his SVR status?????

ALT is 45 holding steady but his AST is 94 and last time it was 83 so it seems to be climbing again. His platelets are flucuating from 95 to 78 this time.  I'm scared and worried.  He can't eat much at all. He's trying. He's wasting away  and I'm feeling helpless. We are caught between a rock and a hard place. I need some input.
Thank you all,
D

sldb · Answer

If the phenergan is not working call the doc and get a script for ZOFRAN, its more expensive but it works  when phenergan doesnt. Zofran does not make you sleepy like phenergan.  Phenergan has a nasty side effect of lowering  peoples blood pressure.

Andiamo1 · Answer

From his viral load response, he sounds like a good candidate for SVR.  The fever and vomiting are probably from some bad food.  We are more susceptible to that, since interferon lowers neutraphils.  Try and stick to the full dose for a few days more.  Most likely the fever and vomiting will go away quickly.  If it doesn't then you need to have a serious meeting with the doctor, not the NP, very quickly.

Good luck with this and I hope he feels better soon.
Eric

hitherdither · Answer

He has phenergan he takes for nausea. It helps but makes him sleep all the time. Also noticed that his arthritis is worse after he takes it. We think it's dehydrating him more. If he takes it at night he wakes up and can't move and hurts. He's been drinking gatorade. If I could just get him to eat.....! It's easy for me to say eat but I'm not nauseas. Hope today goes better.

sldb · Answer

Call the on call dr and get them to call in phenergan or zofran for his nausea vomiting. you need to get some food in him. Get him to try and hold down some gatorade in the meantime, this will help with dehydration.