Aging may require change in dosage
Q. After using a particular medication for a long period of time, the side effects may increase, especially in older adults. This has happened to me. How and where do you report these side effects?
A. The problem you experienced is not so much in the medication as it is a function of age. Senior citizens undergo striking metabolic changes as they age. One of these changes is the decreasing ability to detoxify many medications. When this occurs, the patient may need a dosage adjustment or even a change in the medication itself. I've also observed that if a patient has been on more than one medication for an extended period of time with apparent success, metabolic changes occur that can result in adverse effects.
I urge my elderly readers to report any suspected drug reaction to his or her physician.
Another option is to review the situation with a pharmacist, who can offer further advice.
Q. I'm in my late 50s, a type A personality and have been overweight my entire life. I lead an active lifestyle with weight training and walking. I've been practicing some deep breathing to calm down before going to bed because I tend to be on the go physically and mentally throughout the day, and it is hard to sleep.
My blood pressure had always been around 120/80. Starting last summer, it was in the 130s and 140s. My doctor put me on atenolol, which gave me a feeling of pressure in my chest. My doctor indicated the possibility of this side effect, so I was somewhat prepared. The good news was that my blood pressure dropped to the 90s and low 100s while I remained on the atenolol. Because of the pressure, however, I had a stress test done, and everything was normal. My doctor took me off the medication.
Now my blood pressure is usually around 110-120/80. After exercise, it rises to the 150s or 160s and stays there for several hours. My pulse rate is in the 90s.
Is there always such variation in a person's blood pressure, and at what point should I go back on the hypertensive medication? Is there another drug that could be taken without giving chest pressure?
A. Blood pressure varies a lot. This is normal, especially after physical exercise. In order for a blood pressure to cause health problems, it has to be in an abnormal range consistently. The preferred pressure for adults is about 120/80.
Stay away from medication unless your blood pressure consistently rises above the limit. Should that occur, speak with your physician regarding another drug in the same category as atenolol that doesn't carry such unpleasant side effects. Physicians often receive a variety of medication samples. Ask your doctor to give you enough samples to last a week or two as a trial. In this way, you won't feel committed to purchasing a month's supply of medication that could be inappropriate for you.
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