Should Bokey Be Stopped Before Cardiac Catheterization? - Internal Medicine

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When preparing for cardiac catheterization, the question of whether to discontinue medications such as Bokey (a beta-blocker) is a common concern, especially for patients with underlying health issues. In the case of your father, who is 70 years old and has been taking Bokey long-term, it is essential to consult with his cardiologist for personalized advice. However, I can provide some general insights based on medical knowledge.

Bokey, which contains the active ingredient bisoprolol, is a beta-blocker commonly prescribed for conditions like hypertension and heart failure. These medications help manage heart rate and blood pressure, which can be particularly important for patients undergoing procedures like cardiac catheterization. The decision to stop or continue beta-blockers before such procedures often depends on the individual patient's health status and the specific circumstances surrounding the catheterization.

In many cases, it is not necessary to stop beta-blockers before cardiac catheterization. In fact, continuing beta-blockers may help stabilize the patient's heart rate and blood pressure during the procedure, potentially reducing the risk of complications. However, if the catheterization is being performed to assess coronary artery disease or to treat a specific heart condition, the cardiologist may have specific protocols regarding medication management.

Regarding your father's kidney issues (Minimal Change Glomerulonephritis, MGN), it is crucial to consider the potential for renal toxicity from contrast agents used during the catheterization. Certain contrast agents can pose a risk to kidney function, especially in patients with pre-existing renal conditions. Therefore, it is vital to inform the cardiologist about your father's kidney status. They may choose a contrast agent that is less nephrotoxic or implement strategies to protect kidney function, such as hydration protocols before and after the procedure.

As for the duration of stopping Bokey, if the cardiologist decides it is necessary to discontinue the medication, they will provide specific guidance on how long before the procedure it should be stopped. Typically, if a medication needs to be paused, it might be stopped a few days prior to the procedure, but this varies based on the medication and the patient's condition.

In terms of alternative contrast agents, there are newer options available that are designed to be less harmful to the kidneys. These agents may be more expensive, but they can significantly reduce the risk of contrast-induced nephropathy. Discussing these options with the cardiologist will help determine the best approach for your father.

In summary, it is essential to have a thorough discussion with your father's cardiologist regarding the use of Bokey before cardiac catheterization, especially considering his age and kidney condition. The cardiologist will assess the risks and benefits of continuing or stopping the medication and will choose the most appropriate contrast agent for the procedure. Regular follow-up and monitoring are crucial to ensure your father's safety and well-being during this process.