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This is a case study.
The patient is a 62 y/o man complaining of decreased exercise tolerance. He suffered an MI 2 years ago for which he received PCI and a bare metal stent.. He has DM type II, COPD, and hyperlipidemia. Pertinent meds are verapamil ER 240mg daily, ISDN 30mg daily. He also takes NPH insulin for DM and albuterol and ipratropium for COPD. Also he is on aspirin 81mg daily.
His current ejection fraction is 30% and BP is 118/86. HR is 74 bpm, Scr is 1.4. BUN is 24 and Na and K are in normal limits.
I think the verapamil should be discontinued and replaced with carvedilol since it has been studied more in heart failure, but I’m worried about it affecting his COPD status. Can you tell me what suggestions you have? Please include references (or links) if you are using web resources.
Serious answers only please. Thank You!
Mike_T says:
I know exactly how you feel, I was in a very similar situation. I remember that I was so nervous at that time and I took it out on everyone around me. I didnt know what could I do until, thanks god, I found Smoke Deter. Now I can look back and laugh on myself and in the same time I remember how helpless I was. I hope that I'll never be in the same situation again
The correct answer seems to be yes and no.Coreg is contraindicated for asthma, however research indicates beta blockers do not have to be avoided in COPD patients.I would think Toprol xl would be the better choice to replace Verapamil.
Check this website for information on carvedilol. As you can see, it is not recommended for people with asthma, bronchitis, or emphysema. Since your case study has COPD, it may not be a good idea. Hope this helps.
http://www.drugs.com/MTM/carvedilol.html
Many patients with advanced lung disease require supplemental oxygen in order to tolerate exercise. Perhaps something as simple as O2 during exercise could benefit him more than a change to this type of beta blocker.
My drug reference shows that it should not be used with someone that has been diagnosed with COPD.