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Suggest Treatment For Swelling On The Ankles And Rashes On The Hands
Question: Respected Sir,
My father facing problem with swelling on ankles as well hands and rashes in skin from last month previously he used to use BP tables every day as per doctor advised from 2010
Prolomet XM 50 mg - daily once
Nicardia retard - 20 mg - daily twice
Telmisat - H 40 mg - daily one.
After arising the current probelm we have under gone all the tests and attaching reports here for review after seeing all the reports doctor advised below medicines however we have seen only small improvement.
Prolomet XM 100 mg - daily once
Isolazime 20 mg - daily two
Telmisat - 40 mg - daily one.
Nefrosave - Daily once
Febutaz 40 mg- Daily once
Doctor further addvsed ULTRASOUND for Abdomen test after seeing report doctor suggested following medicines
a) Zytanix -5mg tab twice a day
b) Percin - 600mg tab once a day
Can you please review the reports and let us know your suggesations to reduce swelling on his ankles as well hands.
My father facing problem with swelling on ankles as well hands and rashes in skin from last month previously he used to use BP tables every day as per doctor advised from 2010
Prolomet XM 50 mg - daily once
Nicardia retard - 20 mg - daily twice
Telmisat - H 40 mg - daily one.
After arising the current probelm we have under gone all the tests and attaching reports here for review after seeing all the reports doctor advised below medicines however we have seen only small improvement.
Prolomet XM 100 mg - daily once
Isolazime 20 mg - daily two
Telmisat - 40 mg - daily one.
Nefrosave - Daily once
Febutaz 40 mg- Daily once
Doctor further addvsed ULTRASOUND for Abdomen test after seeing report doctor suggested following medicines
a) Zytanix -5mg tab twice a day
b) Percin - 600mg tab once a day
Can you please review the reports and let us know your suggesations to reduce swelling on his ankles as well hands.
Brief Answer:
Calcium channel blocker(Nicardia) related swelling.
Detailed Answer:
Hello Dear.
Have gone through all the reports attached by you.
Clinically all the parameters are normal.
2d echo renal function etc all are normal. Swelling is not related to organ dysfunction.
Creatinine is mildly elevated and most likely was related to intake of telmisartan and diuretic.
Once he is off these drugs things will settle down to normal.
So don't worry too much about creatinine it will return back to normal as he is off Telma H now.
As all tests are normal swelling is related to calcium channel blocker intake (Telma).
As calcium channel blocker has been stopped now it will soon settle down.
Zytanix will further increase the level of creatinine by dehydrating the body.
I don't think he needs zytanix.
As telma is stopped creatine should return to normal in a week.
Regards!
Calcium channel blocker(Nicardia) related swelling.
Detailed Answer:
Hello Dear.
Have gone through all the reports attached by you.
Clinically all the parameters are normal.
2d echo renal function etc all are normal. Swelling is not related to organ dysfunction.
Creatinine is mildly elevated and most likely was related to intake of telmisartan and diuretic.
Once he is off these drugs things will settle down to normal.
So don't worry too much about creatinine it will return back to normal as he is off Telma H now.
As all tests are normal swelling is related to calcium channel blocker intake (Telma).
As calcium channel blocker has been stopped now it will soon settle down.
Zytanix will further increase the level of creatinine by dehydrating the body.
I don't think he needs zytanix.
As telma is stopped creatine should return to normal in a week.
Regards!
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks for your advise
As per your advise we have stopped (Nicardia retard - 20 mg - daily twice) from last 4 days and using (Isolazime 20 mg - daily two) as well Telmisat - 40 mg - daily one and
Prolomet XM 100 mg - daily once. However my father feeling some un-easy XXXXXXX Prolomet XM 100 mg previously he used to use Prolomet XM 50 mg and we don't have any issues.
apart of those medicines we are using
a) Zytanix -5mg tab twice a day
b) Percin - 600mg tab once a day
c) Dytor -10mg tab twice a day
Do we need to meet any general physician for further related to ULTRASOUND for Abdomen report.
As per your advise we have stopped (Nicardia retard - 20 mg - daily twice) from last 4 days and using (Isolazime 20 mg - daily two) as well Telmisat - 40 mg - daily one and
Prolomet XM 100 mg - daily once. However my father feeling some un-easy XXXXXXX Prolomet XM 100 mg previously he used to use Prolomet XM 50 mg and we don't have any issues.
apart of those medicines we are using
a) Zytanix -5mg tab twice a day
b) Percin - 600mg tab once a day
c) Dytor -10mg tab twice a day
Do we need to meet any general physician for further related to ULTRASOUND for Abdomen report.
Brief Answer:
Follow up advice.
Detailed Answer:
Hello.
Thanks for query again 2d echo of your father is normal and his creatinine are elevated.
Kindly change your doctor.
There is no rationale of adding Dytor and Zytanix(Zytanix is usually added to potentiate the diuretic effect of Dytor in patients suffering from refractory congestive cardiac failure.)
Your fathers heart is perfectly normal.There is no sense of adding Zytanix and Dytor( will further dehydrate him and would further derange is kidney functions)
Percin is an antibiotic.why is your doctor giving him antibiotic?
Swelling in ankle is because of Nicardia and will subside in a week or two.It's not a case of congestive cardiac failure so none of these medicines are required.
Telma should also be stopped.AT 1 antagonists are contraindicated in deranged kidney function tests.
Medicines that should be given are-
Tab Metolar XR 50 mg twice daily.
Tab Isolazine once a day.
Tab Clinidipine 10mg once a day(no ankle edema).
Blood pressure should be checked every 3rd day.
Increase and decrease in doses should be done according to response of body.
Using 2 diuretics,1 AT1 antagonist with Very high dose betablopcker with potassium channel opener with nitrate(6 anti hypertensives at a time).
I really doubt the expertise of your cardiologist and would seriously advice you to change him/her.
Whats the need of ultrasound?
Change your physician and at a time maximum four medicines that's all i would suggest.
Follow up advice.
Detailed Answer:
Hello.
Thanks for query again 2d echo of your father is normal and his creatinine are elevated.
Kindly change your doctor.
There is no rationale of adding Dytor and Zytanix(Zytanix is usually added to potentiate the diuretic effect of Dytor in patients suffering from refractory congestive cardiac failure.)
Your fathers heart is perfectly normal.There is no sense of adding Zytanix and Dytor( will further dehydrate him and would further derange is kidney functions)
Percin is an antibiotic.why is your doctor giving him antibiotic?
Swelling in ankle is because of Nicardia and will subside in a week or two.It's not a case of congestive cardiac failure so none of these medicines are required.
Telma should also be stopped.AT 1 antagonists are contraindicated in deranged kidney function tests.
Medicines that should be given are-
Tab Metolar XR 50 mg twice daily.
Tab Isolazine once a day.
Tab Clinidipine 10mg once a day(no ankle edema).
Blood pressure should be checked every 3rd day.
Increase and decrease in doses should be done according to response of body.
Using 2 diuretics,1 AT1 antagonist with Very high dose betablopcker with potassium channel opener with nitrate(6 anti hypertensives at a time).
I really doubt the expertise of your cardiologist and would seriously advice you to change him/her.
Whats the need of ultrasound?
Change your physician and at a time maximum four medicines that's all i would suggest.
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
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