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Re: Beta blockers » ed_uk

Posted by SLS on October 30, 2005, at 15:40:24

In reply to Re: Beta blockers » SLS, posted by ed_uk on October 30, 2005, at 14:59:49

Hi Ed.

> Celecoxib is generally contra-indicated in heart failure,

At age 96, we're not worried about theoretical long-term effects. Celecoxib is contra-indicated for almost anyone with a cardiovascular disease. It is hard to get my grandmother to try anything new. I don't blame her. I would rather she take Advil with a proton-pump inhibitor.

> especially in patients with renal impairment. Celecoxib has been associated with fluid retention, renal impairment, hypertension and thrombo-embolic events.

Yes. We follow-up with a nephrologist to guage her kidney function while she takes these drugs.

> For what condition is she taking celecoxib?

Severe osteoarthritis.

> >We will probably have to discontinue the Cozaar.
>
> If she suffers from edema, despite her current treatment, perhaps an increased dose of furosemide would eliminate the excess potassium.

Actually, she suffers from very little edema at this point. She takes 40mg on a regular basis and 80mg on days where edema appears. Her lungs are quite clear. I am disappointed that her cardiologist defines HF as being congestive. There are presentations of HF that do not display much fluid retention, but for which exertion breathlessness and fatigue manifest. Her ejection fraction is too low and she has hypertrophy of the left ventricle. Sometimes, doctors really...

My grandmother has a hint of emphysema and perhaps other contributors to pulmonary insufficiency. It is really not too big a deal though - not compared to the HF - although her cardiologist would like to think otherwise. Along with the other antihypertensives, the higher dosages of Coreg and Cozaar very much remedied her exertion breathlessness. Too much potassium. Her case is a bit complicated.

Just to add a psychiatric point of interest:

My grandmother has no history of depression. However, she became very much depressed when she was given clonidine to treat hypertension.


- Scott

 

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