Consultation

Mohammed x.man
Active Member
Active Member
Posts: 85
Joined: 20 Nov 2011, 21:19
University & College: OIU, MBBS
Country & City: Omdurman
Graduation Year: 2008
Plan \ Working On: MRCP
Speciality: General Medicine
Job Title (other): SHO
Work Place: Khartoum
Has thanked: 13 times
Been thanked: 5 times
Contact:

Consultation

Unread post by Mohammed x.man »

hi every one ....just wondering if someone give me consultation .. i has a patient with HTN and DM he also had stroke before ..any how he is on Lisinopril 10 mg BID and amilodpine 10 mg OD and daonil OD and glucophage OD... now his BP is 160/90 ..
according to last NICE guidlines we should offer him Thiazide but i concern about his blood glucose ?!? what can i add to control his BP ?!?
NB: his blood sugar are control to the normal limit !!!
einas
Contributor
Contributor
Posts: 117
Joined: 09 Jan 2012, 01:51
University: Omdurman Ahlia University
Degree (College): MBBS
Graduation Year: 2005
Plan \ Working On: MRCP
Speciality: General Medicine
Job Title: SHO (Medical or Resident)
Work Place: Burjeel hospital-Abudhabi-UAE
Has thanked: 17 times
Been thanked: 21 times
Contact:

Re: Consultation

Unread post by einas »

Dr Mohammed what about increasing the dose of lisinopril to 20 mg ( some literature may allow 40 mg ) if cough is a problem change it to losartan ,I think if the blood pressure doesnt controlled after the maximum dose of losartan you should go for a thiazide-like diuretic, such as chlortalidoneor indapamide in preference to a thiazide diuretic such as bendroflumethiazide or hydrochlorothiazide it may become a little bit harder to control the blood sugar.but it may not happen at all ,another important point is to make sure that his or her renal function is normal other wise you should stop dounil and start insulin .
These users thanked the author einas for the post (total 2):
SudaMediCabessa
Post Reply

Return to “General Discussions”