Sepsis, hypernatremia, and fluid resuscitation

[Raryn]

I've seen angioedema and coughs with ACE inhibitors, but never hyperkalemia. I've seen Pts on an Ace and spironolactone, which you probably shouldn't mix. Lisinopril and amlodipine are free here.

Eh. I mix ACEI+spironolactone - just need to keep an eye on things. Both are good drugs.

Shouldn't mix ACEI+ARB though.

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[GeneralVeers]

I give them 25 mg HCTZ and tell them to follow-up with their doctor. We really don't benefit these patients by starting therapy for a couple weeks and then they run out. Most are never going to follow up with a PCP.

 

[aafisahar]

bp control in general

ace/arb first -> ccb (nifedipine>amlodipine) -> sprio vs thiazide depending on how i feel -> vasodilatory bb (coreg, nevibilol) -> hydralazine -> minoxidil

we get referred a **** ton of resistant hypertension and that cascade works 7-8/10 times. 2-3/10 because they aren't taking their meds.

 

[Splenda88]

bp control in general

ace/arb first -> ccb (nifedipine>amlodipine) -> sprio vs thiazide depending on how i feel -> vasodilatory bb (coreg, nevibilol) -> hydralazine -> minoxidil

we get referred a **** ton of resistant hypertension and that cascade works 7-8/10 times. 2-3/10 because they aren't taking their meds.

Are you a nephrologist? Why would they refer to you resistant HTN?

 

[aafisahar]

Are you a nephrologist? Why would they refer to you resistant HTN?

Cards, dunno why we get the resistant hypertensives instead of renal, but that's the culture here.

 

[Raryn]

Cards, dunno why we get the resistant hypertensives instead of renal, but that's the culture here.

Cards vs renal vs endocrine getting resistant htn is a crapshoot. I think locally to me more cardiologists do it.

 

[Splenda88]

Cards, dunno why we get the resistant hypertensives instead of renal, but that's the culture here.

Interesting! Cards would laugh where I am if some internist or FM doc refer for resistant HTN.