Any nurses advise me on elderly mum?

[LadySSofD]

Hi any nurses out there! I wonder if you could help me. My mum has been on various tablets for her high blood pressure and all of them have given her a really bad cough and flu like symptoms. The cough is really bad and it's wearing her out. She's had it about 4 months, since starting high blood pressure tablets. The doctor has tried her on different ones, but she can't shift the cough. She is 78. Do you know of any other way of managing high blood pressure at her age instead of medication? I think she'd try anything, this cough is getting her very down. Obviously she need to keep her blood pressure at a normal limit, can anyone suggest anything?

Thanks for any replies!

bump

hi

i know the tablet you mean, but cant remember the name

if the dr has taken her off the tablet, it should stop almost immediately. maybe she could try again?

did he take her off the correct one?

im not sure but i think there is a tablet you can take to stop the cough, although not many do as they would rather put up with a cough than take yet another tablet

there are countless meds for high BP, but unfortunately most of them are tablet form

hope your mum feels better soon, if you want my opinion, she should go back to the dr and explain again about the cough, asking for a change of medication, as i say there are lots of different meds she could take (although obviously i dont know your mums medical history)

hope she feels better soon

hi nailpolish, she has changed her blood pressure tablets a couple of times but she's still got the bad cough. She's going to ask the doctor to change them again - when she can get an appointment!! Sh'e had this awful dry cough and sore throat for ages and she's really sick of it, she's talking about cutting down her tablets, maybe taking one every couple of days? I don't know what to advise her, the doctor keeps changing her tablets but the side effects so far are a dry cough so she's not getting anywhere

Wish I could help her, she's feeling rotten over this.

bump anyone?

Mum is really not well.

Please can anyone advise, I'm at my wits end

Do you know the names of the tablets she's tried?

is her bp her only problem? does she have any related factors? have you made an appt with the dr yet? has she been referred to the hospital?

If you are very worried about her the best way is to take her to the docs. If we don't know the names of the meds or any other medical histroy we can't say alot! And almost anything we do say will involve going to the docs anyway. Are you sure the meds are the cause of her cough? Has any other testing been done to rule things out (xray etc).

hi floss

Hi, how are you? Are you still in the pub? Things going well? Can you help me with my babies bowels thread I've just started? 20 questions!

working in the pub, that is. It's a bit worrying if you were still in the pub at this time (unless you're queing up to get in )

Sorry LadySSofD

I've just checked on the BNF (British National Formulary) and the side effects you describe are linked with a class of antihypertensive called ACE inhibitors (persistent dry cough, upper respiratory-tract symptoms such as sinusitis, rhinitis and sore throat are listed as possible side effects). Examples of ACE inhibitors are captopril, lisinopril, and enalapril maleate (these are generic names, and there are lots of others).

So it could be that, in which case a change to a different class of drug (e.g. beta blockers) could be the answer.

If you can tell us what she's been on I could say if they were ACE inhibitors. The doctor may have been trying different types from the same class to see if any suit her better before trying something else. This might be because there is some reason in her case why a different class of drug is unsuitable (e.g. interactions with some other medicine she takes). So, you do really need to consult her GP.

HTH.

Thanks for answering.

She's got an appointment with her doctor next Tuesday to see if we can change her tablets again, so we'll see.

She was told she had high bloodpressure on May of this year and started to take coversil and bendrofluazide each once a day. This lead to her getting a terrible dry hacking cough. So about 1 month ago the coversil was changed to micardis 10mg x 1 a day as well as the bendrofluazide. But sh'e still got the dry hacking cough. She recently had a chest x-ray which was clear. The doctor told her she doesn't need an inhaler. So we're going back on Tue to try to change the tablets agin to get something that doesn't give her cold like symptoms and this awful cough. Her bp is 145/70, doc says it's fine. So the tablets are controlling her bp but making her feel rotten with the cough........

Hope this is clear, anyone advising would be really appreciated. Have to pop out, will be back later.Thanks again, just feel rotten for my poor old mum, she never complains but this cough is sapping her strength.

Thanks gingernut, also she takes tablets for chlorestrol, they are rosuvastatin 10 mg and ezetrol 10 mg both are 1 a day. Her chlorestrol is fine now and sh'e still taking them.Thanks. Do you know if these tablets would interfear with beta blockers?

It could be the bendrofluazide. Looked it up in my BNF (race you GN!! ) and it says a side effect of this drug is pneumonitus. Did she start this drugat the same time as her cough? It is a hypersensitivity reaction so IMO ought to be swapped off it for something else when she sees the doc. Ask him to look it up and see what he thinks. (only thing being it should normally be visable on a chest xray)

you 2 are making me miss nursing STOP STOP!

Come back NP, come back, we miss you! Do you really miss it?

not a jot

Well, Micardis isn't an ACE inhibitor, it's an angiotensin II receptor antagonist. The BNF and the actual ptoduct information for this drug do not mention side effects like your mother has been experiencing, and neither does the bendrofluazide, so I'm a bit stumped.

WRT the cholesterol-lowering drugs I can't find any mention about interactions with beta blockers at the moment but I'm not sure.

A lot of this information would be in the leaflets that should come with her pills. I think you need to check them before you go back to the docs, and ask about beta blockers if you can't see any reason why she shouldn't swap.

HTH.

Ah, did wonder about the pneumonitis.

I am quite demoralised now actually. Have had a couple of crappy shifts. Keep getting quite sick patients and feel out of my depth! Also know that I will be leaving next year, so don't feel so committed atm if that makes any sense.

Does this make any sense

Hi girls, read what you linked to FPF and the symptoms sound similiar but is that a reaction to the medicine or allergens? I was a bit confused. Also you said something about it showing on her x ray, do you mean an allergy? Sorry to sound daft! I've asked my friend about this too and she's stumped, we'll see the doctor next week. I've read her leaflets that come with the medicine she's on but they seem to all produce the cough she's on so I'm confused further. GN, do you mean she's not on an ace tablet or a beta blocker tablet, can you explain a bit the sort she's on? Thanks!

GN, what's pneumonitis? And is that linked to the bendrofluazide rather than the micardis?

Could she making be taking too much tablets for BP, would one of them do eg. the bendrofluazide or the micardis? Don't worry, I'm just asking your opinion, we'll change things after seeing her GP. I'm just trying to find out things to try and help her.

Hi LadySSofD, really sorry to confuse matters but further searching on my part has resulted in me finding a reference to cough' and influenza-like symptoms' on the product info for Micardis so that is the likely culprit IMO. The drug she was on before is in the same class so would prob have similar side effect profile. Sorry I missed that earlier - shouldn't post when in a hurry! (but then I always am).

Pneumonitis is listed as a possible hypersensitivity reaction to bendrofluazide (i.e. it is an allergic reaction to the drug). I think Floss means there would be physical effects on the lungs which would be visible on an X-ray. So unlikely to be that IMO since she has had a clear X-ray.

I think it's quite common to give bendrofluzide in combination with another antihypertensive, but I'm not a medical doctor so don't really know. I used to work for a pharma co, that's why I know how to find out about side effects and interactions etc. I think usually a patient is started on a `typical' dose and the effects on BP are monitored to see if the dose is sufficient.

Re the type of drug she's on, it's not an ACE inhibitor. It's an Angiotensin-II receptor antagonist (or blocker) which is a newer class of antihypertensive agents. Cough is supposed to be less common with these than with ACE inhibitors.

Hope the GP is helpful.