Managing Medication Concerns for Elderly Patients with Lung and Heart Issues

Q: Managing Medication Concerns for Elderly Patients with Lung and Heart Issues

Hello Jun： This hospitalization may be related to infection or heart failure. <br>In principle, the attending physician will determine the medication based on the severity and urgency of the condition. <br>Some medications that are usually taken may affect heart rate or blood pre

Consult a physician?

Dr.
Yang: My father, who is 83 years old, was hospitalized two days ago due to pneumonia caused by pleural effusion.
He has a history of chronic obstructive pulmonary disease (COPD) and asthma, and he was cured of tuberculosis over forty years ago.
He uses an oxygen concentrator at home and has a pacemaker.
He also has benign prostatic hyperplasia and is on long-term medication.
Upon admission, the physician discontinued all of his usual medications for his lungs, heart, and prostate enlargement, and only administered anti-inflammatory medication via intravenous injection three times a day, without any substitute medications.
My father has started experiencing frequent urination.
When I asked the physician about this, he stated that the primary focus is on treating the lungs.
I am very concerned about whether this could lead to heart and prostate issues for my father and what I should do in response.
Below are the medications my father usually takes for his lungs: Astomin tab 10mg (dimemorfan) 1 tab, Xanthium cap 200mg (theophylline-SR) 1 cap, Combivent MDI 200 puffs 10mg (Ipratropium 20mcg + salbutamol 120) 1 aerosol, Flixotide accuhaler 250ug/d, 60 (Fluticasone) 1 aerosol, Duspatalin tab 100mg (Mebeverine) 1 tab, Bisolvon tab 8mg (Bromhexine) 1 tab, Meptin-mini tab 25mcg (Procaterol) 1 tab, Denosin tab 5mg (Desloratadine) 1 tab.
For heart and prostate medications: Cardizem retard 90 mg (Diltiazem) 1 tab, Lanoxin tab 0.25 mg (Digoxin) 0.5 tab, Spirotone tab 25mg (Spironolactone, Aldactone) 1 tab, Tamsulosin HCL D tab 0.2mg (Harnalidge D tab 0.2mg (Tamsulosin HCL)).
Thank you, Dr.
Yang.

jun, 40~49 year old female. Ask Date: 2010/10/12

Dr. Yang Wenda reply Pulmonology

Hello Jun: This hospitalization may be related to infection or heart failure.
In principle, the attending physician will determine the medication based on the severity and urgency of the condition.
Some medications that are usually taken may affect heart rate or blood pressure, which could pose risks to the current condition, so the physician will temporarily discontinue them.
Essentially, we still respect the attending physician's decisions.
You can also consult the attending physician about your concerns; he should be willing to explain.
Wishing your father a speedy recovery.

Reply Date: 2010/10/12

More Info

Managing medication concerns for elderly patients with multiple health issues, such as lung and heart problems, requires a careful and nuanced approach. In the case of your father, who is 83 years old and has a complex medical history including chronic obstructive pulmonary disease (COPD), asthma, a history of tuberculosis, and cardiac issues, it is crucial to balance the treatment of his acute condition with the management of his chronic diseases.

Understanding the Situation
Your father's recent hospitalization due to pulmonary edema and infection necessitated a reevaluation of his medications. The physician's decision to stop all his regular medications and focus on intravenous antibiotics is likely based on the immediate need to address the lung infection. However, this approach raises valid concerns regarding the potential impact on his heart condition and prostate issues.

Importance of Medication Management
1. Medication Interactions and Side Effects: Elderly patients often take multiple medications, which can lead to drug interactions and side effects. In your father's case, medications for COPD, heart conditions, and prostate enlargement may interact in ways that could exacerbate his symptoms or lead to new problems. For instance, certain bronchodilators can increase heart rate, while diuretics can lead to electrolyte imbalances, affecting heart function.

2. Monitoring and Adjusting Medications: It is essential for healthcare providers to monitor elderly patients closely when they are hospitalized, especially when medications are changed or stopped. The physician should assess your father's heart function and prostate symptoms regularly to determine if and when to reintroduce his chronic medications.

3. Communication with Healthcare Providers: As a family member, it is important to maintain open lines of communication with your father's healthcare team. Express your concerns about his heart and prostate health, and ask for clarification on the rationale behind stopping his medications. Inquire about the plan for re-evaluating his condition and when it might be appropriate to resume his regular medications.

Recommendations for Family Caregivers
1. Keep a Detailed Medication List: Maintain a comprehensive list of all medications your father has been prescribed, including dosages and schedules. This can help healthcare providers make informed decisions about his treatment.

2. Monitor Symptoms: Keep track of any new or worsening symptoms your father experiences, such as increased frequency of urination, chest pain, or difficulty breathing. This information can be invaluable for his healthcare team in making treatment decisions.

3. Advocate for Comprehensive Care: If you feel that your father's heart and prostate issues are not being adequately addressed, consider advocating for a multidisciplinary approach. This might involve consulting with a cardiologist or a urologist to ensure that all aspects of his health are being considered.

4. Educate Yourself: Understanding your father's conditions and the medications he takes can empower you to make informed decisions and engage in meaningful discussions with his healthcare providers.

Conclusion
Managing the health of elderly patients with multiple comorbidities is a complex task that requires careful consideration of the risks and benefits of medication changes. While the immediate focus may be on treating the acute lung condition, it is equally important to ensure that your father's heart and prostate health are monitored and managed appropriately. By staying informed, communicating effectively with healthcare providers, and advocating for comprehensive care, you can help ensure that your father receives the best possible treatment during this challenging time.

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