Can You Stop Heart Medication After One Day of Breathing Issues?

If you have been taking heart medication for a day and are experiencing shortness of breath, should you stop the medication? Or how can you improve the situation?

My mother is 83 years old and has asthma and hypertension.
For the past three years, she has been using a bronchodilator (4.5 mcg) once in the morning and a coated tablet for hypertension (10 mg).
This year, she has been experiencing increased shortness of breath when climbing stairs, and in the past two weeks, she has developed leg edema (redness, slightly raised bumps, and pain).
The doctor prescribed a diuretic, but it has not been effective.
An electrocardiogram and blood and urine tests showed that her liver and kidneys are functioning well.
On August 16, the doctor added the following medications: 1.
Kankun (1.25 mg) once in the morning and once in the evening, half a tablet each time; 2.
Long-acting heart medication (0.25 mg) once daily, half a tablet (my mother takes this after breakfast); 3.
Furidean (2 mg) once daily, one tablet (my mother takes this after breakfast).

On August 17, at 8:00 AM, she took the three newly prescribed medications for the first time.
After 1.5 hours, she experienced severe shortness of breath.
I measured her blood oxygen saturation with a fingertip oximeter, which showed a heart rate fluctuating between 80 and 120 BPM.
After another 0.5 hours, her condition improved.
Later that evening, at 7:00 PM, she took half a tablet of Kankun after dinner, and from 8:00 PM until the next morning at 7:30 AM, she struggled to breathe, with her fingertip oximeter showing a heart rate fluctuating between 55 and 160 BPM, accompanied by wheezing.

On August 18, at 7:30 AM, after finishing breakfast, she used the bronchodilator but was hesitant to take the newly prescribed medications.
She is currently trying to catch up on sleep and plans to take the coated tablet for hypertension after waking up.
I would like to ask the doctor if it is okay to stop the new medications after just one day of use due to her shortness of breath, or how to improve her situation.
The doctor is on leave today, August 18, and we have to wait until next Wednesday, August 23, to schedule an appointment for her.
My mother has been wanting to lie down and rest all night but has been unable to do so because of her breathing difficulties, so she has had to sit up all night.
Additionally, she has been coughing with phlegm this week, which she mentioned to the doctor, but no medication was prescribed.

Joann, 40~49 year old female. Ask Date: 2017/08/18

Dr. He Dongjin reply Cardiology

Hello, you can stop the medication for now and discuss any adjustments with your physician during the outpatient visit.
It appears that there are episodes of arrhythmia, but it seems more like a change in your condition.
Due to your orthopnea, it is advisable to return for an earlier consultation.
The original attending physician is unavailable, but you can consult another cardiologist for immediate care.
Changhua Hospital is concerned about your well-being.

Reply Date: 2017/08/18

More Info

It sounds like your mother is experiencing significant distress and discomfort due to her recent medication changes and underlying health conditions. Given her age and medical history, it's crucial to approach this situation with care and attention.

Firstly, regarding the question of whether it is okay to stop the newly prescribed medications after just one day of experiencing breathing issues: it is generally not advisable to abruptly stop any prescribed medication without consulting a healthcare professional. Medications like KanKen (Carvedilol), Longxin (Bisoprolol), and Furosemide (the diuretic) can have important effects on heart function and blood pressure regulation. Stopping them suddenly could potentially lead to worsening of her heart condition or other complications.

However, your mother's immediate symptoms of shortness of breath and fluctuating heart rates are concerning. It is essential to monitor her closely. If she is experiencing severe breathing difficulties, it may be necessary to seek emergency medical attention rather than waiting for her scheduled appointment. In cases of acute respiratory distress, it is better to err on the side of caution.

In the meantime, here are some steps you can take to help manage her symptoms:
1. Positioning: Encourage her to sit upright or in a position that eases her breathing. Sometimes, leaning slightly forward can help alleviate the sensation of breathlessness.

2. Oxygen Monitoring: Continue to monitor her oxygen saturation levels with the pulse oximeter. If her oxygen levels drop below 90%, it is advisable to seek medical help immediately.

3. Avoid Triggers: Identify and avoid any potential triggers that could exacerbate her asthma or breathing issues, such as allergens, smoke, or strong odors.

4. Medication Management: If she is hesitant to take the new medications due to her symptoms, document her experiences and prepare to discuss them with her doctor. It may be possible to adjust dosages or switch to alternative medications that could be better tolerated.

5. Hydration and Diet: Ensure she stays well-hydrated and maintains a balanced diet. Sometimes, fluid retention can be exacerbated by dietary factors, so reducing salt intake may help with her swelling.

6. Follow-Up: Since her doctor is unavailable until next week, consider reaching out to another healthcare provider or an urgent care facility if her symptoms worsen. It is important to keep her healthcare team informed about her condition.

7. Cough Management: If she is experiencing a cough with phlegm, it may be beneficial to discuss this with her doctor as well. There are medications that can help manage cough and clear mucus.

In summary, while it may be tempting to stop the medications due to her immediate discomfort, it is crucial to consult with a healthcare professional before making any changes. Monitoring her symptoms closely and ensuring she is in a safe and comfortable position can help until she can be seen by her doctor. If her condition worsens, do not hesitate to seek emergency care. Your mother's health and safety are the top priority.

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It is advisable for you to discuss the above situation further with your attending physician. Thank you, and wishing you good health!