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74 years old, had pneumonia. Take inhaler with other medication. How to get relief from coughing?

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Cardiologist, Interventional
Practicing since : 1998
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My father is an indian, Doctor my father aged 74, had a pneuomonia( hospitalised and cured 2010), fell down in 2009 , CT SCAN REVEALED cerbral atrophy left side, ecg left axis deviation, Doctors treatment Enace 10 at night , Dytor 5 mg at 8 am, Angizem CD 120 at 10 : 00 am,and inhalers(Avessa & Combimist) 3 times daily, PAN 40 MRNING DAILY. His sweeling has reduced now, BP at present 140/80.

Na 134 K -5 , Hb 10.5 , Crarinine 1.9 , Slight albumin in Urine. Lipid Normal , Thyroid Normal after taking dytor 5 ESR is 40 1 hr.


His past history is smoking, skin sometimes gets redish patches if presssed, leg muscles are weak. . after consulting with nephrologist and cardiologist general medicine doctor has decided the combination of medicines as described above now.
He has standing up problem from sitting at bottom , this is extremely diffciult, left lumbar spine weak
From the General geriatic medicine side what medicines to take, the present medicnes how to alter and kidney function keep normal.
He has early parkinsonism.
Please advise medicines , whether bp medicines he is taking are ok in combination? creatinine how to make alright. whether dytor can be taken regularly without affeting eletolyte imbalance? then waht to do?

At present he is Taking MDOPA 250 -1-0-1
Dytor 5 mg 1-0-0
Angizem CD 120 0-0-1
Due to his high BP 160/80 today 05/01/13 , and slight chest discomfort and controlled coughing in winter with inhaler pranayam and baska leave , dr suggested to us e anti cholestorel medicine Stator 10 mg ( 001) in addition to the above medicines.
What anti cold medicines are required sometimes long spell of coughing is coming.
My question is it a right approach for treatment. Pl suggest us by today.

Posted Sat, 26 Jan 2013 in Lung and Chest disorders
 
 
Answered by Dr. Prabhakar C Koregol 53 minutes later
Hi,

Thanks for detailed history. But I am a bit confused regarding the medicines he is taking. You have described particular drug in the beginning and another one at the end. Which all medicines are he taking?

Knowing that his serum creatinine levels are high, he needs to be on a class of medicines called ARB (Angiotensin Receptor Blockers). Whenever a patient is on diuretic medicines such as dytor, electolyte problems are always a possibility. This needs to be monitored regularly. If it is long standing, his kidney abnormality may not be reversible but we can prevent further progression.

Also I would like to know what his ultrasound abdomen and urine examination showed.


Regards
Above answer was peer-reviewed by
 
Follow-up: 74 years old, had pneumonia. Take inhaler with other medication. How to get relief from coughing? 41 minutes later
Dr

At present he is Taking MDOPA 250 -1-0-1
Dytor 5 mg 1-0-0
Angizem CD 120 0-0-1
Due to his high BP 160/80 today 05/01/13 , and slight chest discomfort and controlled coughing in winter with inhaler pranayam and baska leave , dr suggested to us e anti cholestorel medicine Stator 10 mg ( 001) in addition to the above medicines.
What anti cold medicines are required sometimes long spell of coughing is coming.
My question is it a right approach for treatment. Pl suggest us by today.
 
 
Answered by Dr. Prabhakar C Koregol 35 hours later
Thanks for clarifying. The following are my comments:

1. His medicine regimen is acceptable though there are better alternatives.

2. If cough is recurring it may be due to diastolic heart failure rather than cold. Discuss about this possibility during his next follow-up with his doctor. In such case we need to optimise hypertension treatment - that might include increasing dytor to 10mg/day.

3. If cough is due to cold then he can be benefitted by night intake of cetrizine; but it has to be done after making sure diagnosis.

4. As he falls in high risk and has pain, it's better to on statin.

5. What does his ECG show and has it been done after pain - If yes, let me know the report / if no, please get it done when he has pain.

Hope this answers your query. Let me know if you need further clarifications.

Best Wishes
Above answer was peer-reviewed by
 
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