Posted by Vincent_QC on September 15, 2010, at 15:18:03
In reply to Hypertensive emergency drugs while on Nardil, posted by proudfoot on September 7, 2010, at 10:17:14
> Doing lots of reading about what is used by folks as their "emergency pill" should a blood pressure elevation develop unexpectedly while taking an MAOI. I'm seeing my pdoc next week and was hoping to get others' feedback before seeing him. Was prescribed nifedipine 10 mg with my initial Nardil Rx, but have been reading that it's not the best choice and can in fact pose problems with other drugs commonly used in the ER (specifically phentolamine) for this problem.
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> I'm most intrigued by the use of chlorpromazine (Thorazine) 50 to 100 mg. I know it is of great value in managing the migraine-like symptoms of a vascular headache, but how potent is it as a BP reducer? Is that dose significant enough in someone who doesn't take Thorazine regularly to induce a hypotensive response that will be helpful without making the BP bottom out?
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> Clonidine, too is an interesting choice, working centrally as it does as an alpha blocker. It's potency is well established, and it can be dosed serially and frequently to reduce BP. Of the two options listed above, my pdoc seemed most open to the idea of the clonidine when I emailed him.
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> And what about sublingual nitroglycerine (NTG)? It is a potent vasodilator and obviously doesn't pose any cardiovascular risks like nifedipine does when used to lower BP acutely. Has anyone's doc prescribed this to carry with you in case of emergency? The little vials of NTG would need to be replaced frequently, as its shelf life is very short to maintain potency. Might NTG be the safest option, albeit the least convenient one?**********************************************
When I was on the Nardil I never had any hypertensives crisis, had severe hypotension but nothing else.
While I was on the Parnate it was a nightmare. Had severals hypertensives crisis, I had to go to the emergency to treat some of them and almost die...
The PDoc RX nifepidine 10 mg in case of hypertensives crisis...
Had also severe hypotension at night so I had a RX for a med that I can't recall, but it was mainly to keep the salt, potassium, magnesium more longer in my system...something like that... it was not very good also since I had severe hypotension almost every night...
To be honnest the Nifepidine was not very helpful also, it was not working fast to decrease the blood pressure, it had weak effect on me... At the hospital they have more powerfull meds to decrease the blood pressure in emergency case, but don't remember the name of them, but it was quick...
For the Clonidide that's seem a good choice, but I used it when I was not on a MAOI...
poster:Vincent_QC
thread:961554
URL: http://www.dr-bob.org/babble/20100908/msgs/962485.html