BP control

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BP control

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12 Posts

doc4mindia
Forum Guru

Topics: 134
Posts: 243

05/23/04 - 09:22 AM

A 57-year-old man presents to his physician for a preoperative evaluation. He has been a long-time patient in this office and has been treated for hypertension and gastritis. He has been scheduled for an elective open cholecystectomy in 2 days. He currently takes omeprazole for his gastritis and thiazide for his hypertension daily. He smokes two packs of cigarettes per day. His home blood pressure log shows that his systolic pressures range from 150 to 190 mm Hg, and his diastolic pressures range from 80 to 105 mm Hg, indicating that his blood pressure may be not adequately controlled for the surgical procedure. Which of the following medications is most appropriate in the perioperative period for added blood pressure control?
A. Captopril
B. Clonidine
C. Metoprolol
D. Nifedipine
E. Prazosin

xmihaela
Forum Junior

Topics: 1
Posts: 51

05/23/04 - 12:53 PM

I am not very sure, but I think the ans is Metoprolol :?:

bobby
Forum Guru

Topics: 136
Posts: 569

06/07/04 - 03:09 PM

doc4mindia, can u tell us the correct ans, please.
the ques is interesting, if possible explain why that ans is correct

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Idiopathic
Forum Guru

Topics: 19
Posts: 641

06/07/04 - 04:38 PM

I say nifedipine...CCB are effective here.

Healer4life
Forum Newbie

Topics: 4
Posts: 20

07/12/04 - 02:38 PM

Hello,

Great question here, please let us know the correct answer!! I say A because Ace Inhibitors are proven to decrease mortality in Diabetic nephropathy/hypertention.

daira
Forum Senior

Topics: 29
Posts: 138

07/12/04 - 03:16 PM

My answer is Metoprolol.

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dimps
Forum Guru

Topics: 63
Posts: 446

07/12/04 - 03:46 PM

even i go in favour of metoprolol

hey doc4mindia dont create mystery tell us the ans

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Healer4life
Forum Newbie

Topics: 4
Posts: 20

07/12/04 - 03:54 PM

"dimps" wrote:
even i go in favour of metoprolol

hey doc4mindia dont create mystery tell us the ans

This question was posted a very long time ago, so let's try to reason this out amongst ourselves !! grin

Beta Blockers are contraindicated in Diabetics because they mask the hypoglycemic effects of diabetes(sympathetic effects like sweating, etc.), so I said no to Metoprolol.

Why do you two say Metoprolol?

dimps
Forum Guru

Topics: 63
Posts: 446

07/12/04 - 05:46 PM

he does not write pt has diabetics,Q says pt is hypertensive and has gastritis

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Healer4life
Forum Newbie

Topics: 4
Posts: 20

07/12/04 - 06:05 PM

#10

"dimps" wrote:
he does not write pt has diabetics,Q says pt is hypertensive and has gastritis

OOPS!!! You are absolutely correct!! In that case I'm not sure, why would you say Beta Blocker and not the other choices? Please give me your reasoning as to why you would eliminate the other choices.

daira
Forum Senior

Topics: 29
Posts: 138

07/13/04 - 06:43 AM

#11

My reasoning for a BB choice is:

In general first line Rx for hypertension is diuretics and if not controlled adequately, BB are added.

Specifically for this pt., we have a time limit for two days, so BB would be a good choice. ACE will take longer. CaB, I think wouldnt make a good combination with a thiazide plus it wont be a good choice for a pt undergoing GA

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Healer4life
Forum Newbie

Topics: 4
Posts: 20

07/13/04 - 02:51 PM

#12

Thanks Qalandar!! grin

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