![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 29. This is the beginning of the thread.
Posted by okydoky on October 28, 2008, at 13:52:44
What are the best medications/suppliments to take for opiate tolerance?
oky
Posted by Phillipa on October 28, 2008, at 16:18:01
In reply to What for opiate tolerance?, posted by okydoky on October 28, 2008, at 13:52:44
Oky did they stop working did you try bupe? Love Phillipa
Posted by yxibow on October 29, 2008, at 0:46:32
In reply to What for opiate tolerance?, posted by okydoky on October 28, 2008, at 13:52:44
> What are the best medications/suppliments to take for opiate tolerance?
>
> okyGetting off the opiates before the situation becomes even worse.
Its contrite, but that's basically the case, if you've been on a trial of bupenorphine I guess, which itself is used to get off opiates and become dependent, there's really only the choice of going away from them.
Basically it's really bad for about a week or two and its gone, at least for some. And you may need help such as possibly a low dose benzo for anxiety if it gets really bad and definitely medications for GI effects (which themselves are opiates, lomotil or Imodium).I'm not sure what else to suggest that would be more reassuring
-- Jay
Posted by Sigismund on October 29, 2008, at 2:50:20
In reply to Re: What for opiate tolerance? » okydoky, posted by yxibow on October 29, 2008, at 0:46:32
Memantine?
Posted by okydoky on October 29, 2008, at 9:23:50
In reply to Re: What for opiate tolerance?, posted by Sigismund on October 29, 2008, at 2:50:20
Thanks Sigismund. That is what I'd been looking at. It a down side for me. I alkalize my urine all day with buffered sodium bicarb. I had never read too much about taking memantine until yesterday. This is quite serious for me as the alkalization generally allows me to take less opiate pain medication. Perhaps I will have to weigh out the pros and cons:-) I was looking forward to it helping some with the cognitive problems I have too.
Thanks all but I do need to take these pain meds for my whole life I believe for a bladder disease.
The Suboxone did not work well enough for my pain or depression.oky
Posted by ricker on October 29, 2008, at 12:29:19
In reply to Re: What for opiate tolerance? » Sigismund, posted by okydoky on October 29, 2008, at 9:23:50
> Thanks all but I do need to take these pain meds for my whole life I believe for a bladder disease.I can relate somewhat as my wife is diagnosed with Interstitial cystitis. She has been using morphine and valium to manage her pain. Her Dr. has most recently prescribed Tramadol. As one suffering many years with depression, the furthest thing from my mind was the likelihood of her being treated for depression. This past year has been extremely difficult for her as far as pain management.
Antidepressant meds are now part of her daily prescription, along with a hosts of other meds to help manage the I/C.
I wish you well and hope you experience many days of enjoyment.Regards, Rick
Posted by okydoky on October 29, 2008, at 13:36:31
In reply to Re: What for opiate tolerance?, posted by ricker on October 29, 2008, at 12:29:19
Thank you so much for your candor and well wishes. I hope she and you do well also.
There are many different types of treatments to try for I.C.,I also take valium as a muscle relaer for it. This is what I suffer with also. I hope she is aware of and can benefit from some that might help beyond pain medications.
I had a preexisting trd for many years before I was diagnosed with it. I know many or perhaps most with I.C. end up needing to be treated for depression. I have been unable to take most antidepressants because in my case the medications bring on flares of the I.C.
I am glad to hear she is able to take some and find some relief with it I hope. If she would like to correspond with me please feel free to provide with my email:
gm3342@gmail.comoky
Posted by yxibow on October 29, 2008, at 18:51:17
In reply to Re: What for opiate tolerance? » Sigismund, posted by okydoky on October 29, 2008, at 9:23:50
> Thanks Sigismund. That is what I'd been looking at. It a down side for me. I alkalize my urine all day with buffered sodium bicarb. I had never read too much about taking memantine until yesterday. This is quite serious for me as the alkalization generally allows me to take less opiate pain medication. Perhaps I will have to weigh out the pros and cons:-) I was looking forward to it helping some with the cognitive problems I have too.
>
> Thanks all but I do need to take these pain meds for my whole life I believe for a bladder disease.
> The Suboxone did not work well enough for my pain or depression.
>I didn't realize it was for a medical condition -- I'm sorry you have that and I'm sure you've investigated all options including surgery and had tests and biopsies.
I'd be careful with Namenda though, its not innocuous and can bring some people into the psychosis spectrum. Just monitor it if you want to take it, I had assumed there would be a suggestion for that.
-- best wishes
Jay
Posted by Sigismund on October 30, 2008, at 2:20:49
In reply to Re: What for opiate tolerance? » okydoky, posted by yxibow on October 29, 2008, at 18:51:17
Is there evidence for memantine minimising opiate tolerance?
There must be some, but maybe not as much for amphetamine?
Memantine at 5mg/d is no big deal though it (like almost anything useful) aggravates my insomnia.
Someone here said he felt it was (at that dose) like Ritalin though only a *little* for me.
When you get up to higher doses it would be different, more dissociative but not more stimulating perhaps?
There are reports (not necessarily of therapeutic use) on Erowid.com
It has a very long half life.
Posted by okydoky on October 30, 2008, at 11:54:58
In reply to Re: What for opiate tolerance?, posted by Sigismund on October 30, 2008, at 2:20:49
I had read quite a bit in the past about it minimizing opiate tolerance. Some here for sure and probably on sites like Eroid, the good drug guide, blue light etc... I cannot recall if it was by evidence or by anecdotal evidence. I am sure I got mixed up and it does nothing for amphetamine. Thanks for gently showing me my inaccuracies. It is kind and helpful. I had a slight memory of reading there were other possibilities to minimize opiate tolerance. I guess I did not want to search them out again only with a possibility of forgetting it soon after I read it. Sorry if I am inconveniencing people here.
I am having trouble with the stimulating effects of medications that used to help.
Amineptine for one. I started Parnate today and have been so anxious I took several klonopin and 4mg of perphenazine. I found I could almost not move for a couple of hours the anxiety was so high. Perhaps memantime is after all not a suitable route?
I have always had too much stimulation from Parnate. Perhaps my mood and such has been so low I had trouble dealing with the abrupt change?
As I have finally started the Parnate unless there is convincing evidence that I should be better helped by trying the meantime first I believe I should continue?
I have been trying to evaluate my mother on memantime. It is difficult as she cannot remember from day to day what she was like. It was obvious at first her confusion was worsened. Now she is on a full dose ( I cannot get her to tell me as she does not seem to understand) but I believe 10mg twice a day it seems like maybe she is having some improvement. I was hoping for some improvement in mood which I have not seen. I have recently read that this medications advantages might only be seen with chronic use.
I do not assume that opiates should not be tried for depression. Perhaps as last resort but I do not believe in suffereng for sufferings sake alone.
oky
Posted by Sigismund on October 30, 2008, at 17:02:17
In reply to Re: What for opiate tolerance?, posted by okydoky on October 30, 2008, at 11:54:58
Hello Oky
You might be interested in this.
http://www.drgeorgedavidson.com/ebixa_getting_off_methadone.htm
I find it difficult to believe that anything could help much with methadone, so if this is true it's remarkable, but that is from memory....I haven't read it this time round.
Sig
Posted by okydoky on November 2, 2008, at 10:48:51
In reply to Re: What for opiate tolerance? » okydoky, posted by Sigismund on October 30, 2008, at 17:02:17
Thanks. Interesting. I am looking at long term opiate use and possible help with cognitive problems. I think "dopaminergic" has posted a lot about it. Cumulative has posted a lot of informative information. I found some interesting reading at the following post in the included link: http://www.dr-bob.org/babble/20081016/msgs/858542.html , even if I need to read it all again for both memory and lack of a good understanding. It was suggested on the thread that one stop taking the Ritalin before trying the meantime. I am worried now I read one needs to keep ones urine acid. I spend a great deal of time and energy every day alkalizing my urine and obtain a lot of relief from doing so.
oky
Posted by JadeKelly on November 3, 2008, at 23:21:23
In reply to Re: What for opiate tolerance? » Sigismund, posted by okydoky on November 2, 2008, at 10:48:51
Hi Oky,
Sorry to hear of the seriousness of your condition. I can only offer my experience with several years of pain meds after a car accident. I too would become tolerant and was afraid of addiction. What I ended up doing was alternating 3 pain meds and that seemed to work pretty well.
1.Vicoprofen (Vicoden if you prefer tylenol). I couldn't take codiene and Hydrocodone worked well.
2.Ultram (tramodal) a little milder
3.Toradol (no "high" but really works on pain) This med is hard on the stomach, and can only be used for a short time.I was taking ritalin and Klonopin at the time I started these meds. I think they augmented, and if pain got really bad I took an extra Klonopin.
Have no idea if this helps you or not, just my experience. Also, not sure if any of these can be taken with Parnate.
Good luck to you-hope you find a solution soon.
Jade
Posted by okydoky on November 4, 2008, at 0:00:10
In reply to Re: What for opiate tolerance? » okydoky, posted by JadeKelly on November 3, 2008, at 23:21:23
I hope you continue to do well on this regimen if you are still on it. Do you still need to take it? I will most likly end up alternating morphine with oxycontin and it was suggested methadaone. Not there yet.
I have some literature which tells me what narcotics I can take with Parnate.
I take Ritalin Valium and Klonopin. Benso's I believe potentiate the opiates.
oky
Posted by JadeKelly on November 4, 2008, at 1:36:10
In reply to Re: What for opiate tolerance? » JadeKelly, posted by okydoky on November 4, 2008, at 0:00:10
> I hope you continue to do well on this regimen if you are still on it. Do you still need to take it? I will most likly end up alternating morphine with oxycontin and it was suggested methadaone. Not there yet.
>
> I have some literature which tells me what narcotics I can take with Parnate.
>
> I take Ritalin Valium and Klonopin. Benso's I believe potentiate the opiates.
>
> oky
Hi Oky,
seems you are a night owl as am I? Actually just getting thru those first days of Parnate insomnia...tired but can't sleep!It seems we have some meds in common. Actually tho, I haven't taken any pain meds for years. But I also DID take them for years. Like you, I had no choice. Anyway you've got the klonopin and ritalin, those were helpful at that time. Sounds like you need stronger pain meds than I did. So, right now I take Parnate, the antidote for Parnate, and Klonopin. That's it.
I dropped the ritalin a while ago. PDoc said not with Parnate. But I was taking 30mg daily.
So your doc lets you take ritalin with the Parnate? I geuss some people are getting along ok with small doses. Lucky.Well, I'm rambling. Sounds like your on the right path with meds. Sorry it had to be so frustrating :(
Btw-I would be interested to know what pain meds can safely be taken with Parnate. I don't need it very often, but when I do I'm not going to feel like goin to my GP, i can tell you that.I didn't look into that cause my Pdoc said Advil only.
Oh, you might want to get this antidote for Parnate if you haven't (Nifedipine). Sounds like you'll be able to handle the headache ok, but not the hypertension part. Its great for piece of mind.
May we both live long, parnate happy , pain free lives! (sometime in the near future).
Good night-Jade
Posted by okydoky on November 4, 2008, at 14:35:28
In reply to Re: What for opiate tolerance?, posted by JadeKelly on November 4, 2008, at 1:36:10
I have the antidote from the last time my retired pdoc tried Parnate with me in 2005. He got things confused and I find myself with Nifedipine 30mg extended release tablets. I do not know if I chew them if they would work like the gel caps ? I always used 10mg gel caps. I would prick it with a pin and squirt it under my tongue as instructed. It is a great piece of mind!
How much Parnate are you taking and at what intervals?
I never could sleep on it no matter how I took it. I forgot once again but someone on this site had a suggestion for this. Perhaps one of us could find it:-)I took Parnate for several years at 30mgs for quite some time before I needed to increase it. I had severe hypotention on both Parnate and Marplan. I used to pass out all the time. It was because of this that I was prescribed the Ritalin. (Not time released and it did nothing for me but made my mood fluctuate drastically) I arranged with a reputable pdoc (who was not treating me in "practice" ) to prescribe 20mg time release Ritalin and I had no further problems with hypotention or the mood swings. I had several spontaneous hypertensive episodes on Parnate and was in the ER so many times that my next pdoc prescribed the Procardia at my bidding.
After two or three years the Parnate started to pooped out. I used to go on holiday and go on Marplan, then on Moclobimide (which did not work so well) then back to Parnate. I soon was taking 60mg and more of Parnate along with Ritalin ,depakote,xanax,klonopin,.. I remember at the end I was taking many different medications each day. Some of them to potentiate the Parnate and some of them for all the side effects of so much Parnate. It along with Marplan were the only medications that ever truly worked for me for any length of time. Since I stopped the Parnate in 1995, at about he same time I was diagnosed with interstitial cystitis I have never regained any meaningful capacity to function.
The articles I had on my computer about Parnate with opiates: http://bja.oxfordjournals.org/cgi/reprint/95/4/434.pdf
http://www.psychotropical.com/8_st_maois_opiate_analgesics.shtml
There is an over the counter fix for the hypotention but I loath to print it as it is dangerous.
Let me know how you are doing,
oky
Posted by JadeKelly on November 4, 2008, at 18:30:57
In reply to Re: What for opiate tolerance? » JadeKelly, posted by okydoky on November 4, 2008, at 14:35:28
Hi Oky, I posted (tried) earlier and lost it. I'm having that problem with posts and emails. I'm starting to think this thing is past its prime. I'll try to find it and resend. Don't worry, it was stuff about some interactions I'm having. Very boring:) would like your opinion re: some Parnate stuff. Oh, get the 10mg capsules Nifedipine if you can. Not sure the tabs will work fast enough. Maybe ask pharm?
Repost again later, hope u r feeling well- Jade
Posted by okydoky on November 4, 2008, at 22:04:11
In reply to Re: What for opiate tolerance? » okydoky, posted by JadeKelly on November 4, 2008, at 18:30:57
Hope everything is okay. If you are having some reaction and you are unsure please be viligent and get help promptly.
again hope all is well,
oky
Posted by JadeKelly on November 5, 2008, at 10:01:18
In reply to Re: What for opiate tolerance? » JadeKelly, posted by okydoky on November 4, 2008, at 22:04:11
> Hope everything is okay. If you are having some reaction and you are unsure please be viligent and get help promptly.
>
> again hope all is well,
>
> okyHi Oky, No all is well today. All these BP fluctuations, then last few days, low BP but rapid pulse. I read about it and they make it sound like I'm headed for heart attack, when really just side effects of Nifedipine. Most don't take it daily so not problem.
Anyway, in researching that, I found that the tablets are NOT to be broken or crushed in any way. In fact, slow release in stomach I believe. Probably wouldn't do you much good in emergency. I'd get the capsules if I were you. Don't take them daily as they cause bunch of nasty sides!.
Actually, Oky, just spoke to my pharmacist as did not want to give out bad info, so here it is: According to him they don't prescribe the capsules that you bite into or prick with pin anymore. He siad even my capsules are made to swallow for fast delivery. Don't know why. He said may be other antidotes to put under tongue, but PDoc would know about that, one would hope!
Lets see what our Pdocs prescibe and share notes. I see mine on Monday. Thats when I'll know if I can even take Parnate anymore! If not, what has worked best for you after Parnate? (can't take ssri's).
Hope you are feeling well today! Jade
Posted by okydoky on November 5, 2008, at 12:14:48
In reply to Re: Parnate and Nifedipine » okydoky, posted by JadeKelly on November 5, 2008, at 10:01:18
How long have you been taking Parnate? Why would the pdoc tell you no to take Parnate anymore?
Why do you take the Procardia on a daily basis? Are you taking it for angina or high blood pressure unrelated to Parnate?. Is it is causing you to have high blood pressure constantly?
I did not remember but the fact that it is no longer prescribed as gel caps explains why I had tablets. I would assume he would have told me to chew the tablets for a hypertensive crisis, but I will not go by assumptions about things I do not remember. I was given the gel caps in the hospital several times as I described and told by my pdoc at the time take it under the tongue. The tablets I currently have are slow release and I do not think this is advisable for a hypertensive crisis. I will have to further research it.
Currently I have no pdoc. I have not had one since 2005 when mine retired. I am not saying I do not need one. I have been unable to find one on my own. When I looked before he retired I was told that my case was too complicated by several I had interviews with. I have been treated by many pdocs through the years, usually in the hospital. I have also worked as a social worker of sorts. From these experiences I have learned to have little respect for the pdocs where I live and I also have some awkwardness as I was a provider at one time in the area and fairly well known. It is not only pride but my informed opinion that most of these doctors have little regard for their patients and are not educated or knowledgeable to help me, as evidenced by some very capable ones honesty telling me so.
Things are different now though as I have had to go off all my medications so that complication is no more. My indecisiveness, caused by my severe depression and my physical problems have further complicated my ability to choose a pdoc where I live now (its been over ten years).
Now I have gone on and on.
Let me know how things are going,
oky
Posted by JadeKelly on November 5, 2008, at 16:26:37
In reply to Re: Parnate and Nifedipine » JadeKelly, posted by okydoky on November 5, 2008, at 12:14:48
Hi Oky
> How long have you been taking Parnate? Why would the pdoc tell you no to take Parnate anymore?
I've been taking Parnate since Oct. 11th. 4th or 5th day had great response, I was really excited! Then, on Oct 21, after nothing but low BP (managable) woke up 6am to a nasty hypertensive crisis. I scoured my kitchen to see what the culprit could've been and found protien bars made with soy. PDoc and I decided that was probly it.
Every day after had spike in BP (185-190). I got tired of that pretty quick and called PDoc. He said I could take Nifedipine daily till I see him on Monday. Nifedipine is not a daily option long term (for me anyway) for several reasons.
So, unless he has something else to offer, I can't be having HT crisis every day. This will stink if I have to get off Parnate.
>
> Why do you take the Procardia on a daily basis? Are you taking it for angina or high blood pressure unrelated to Parnate?. Is it is causing you to have high blood pressure constantly?No, low BP still, but now regularly high resting heart rate. Thats new. Also, lethargic beyond belief. Seems paradoxical to me but its in my books and on line.
>
> I did not remember but the fact that it is no longer prescribed as gel caps explains why I had tablets. I would assume he would have told me to chew the tablets for a hypertensive crisis, but I will not go by assumptions about things I do not remember. I was given the gel caps in the hospital several times as I described and told by my pdoc at the time take it under the tongue. The tablets I currently have are slow release and I do not think this is advisable for a hypertensive crisis. I will have to further research it.My pharm said he thinks there is something you can put under tongue available, I'll ask PDoc on Monday.
>
>
Currently I have no pdoc. I have not had one since 2005 when mine retired. I am not saying I do not need one. I have been unable to find one on my own. When I looked before he retired I was told that my case was too complicated by several I had interviews with. I have been treated by many pdocs through the years, usually in the hospital. I have also worked as a social worker of sorts. From these experiences I have learned to have little respect for the pdocs where I live and I also have some awkwardness as I was a provider at one time in the area and fairly well known. It is not only pride but my informed opinion that most of these doctors have little regard for their patients and are not educated or knowledgeable to help me, as evidenced by some very capable ones honesty telling me so.I geuss its nice yours were honest, I just plain don't like or understand any of them. I've personally only had one, but the others I've met (for family), they seem cold, want you out in 15 minutes, not a second more. I probably could have avoided Hospital if mine had taken an extra five minutes to explain, God forbid. I'm gonna find a new one. I need someone that will explain things enough so that I know whats normal and what isn't in terms of s/e's, dangers, etc.
>
> Things are different now though as I have had to go off all my medications so that complication is no more. My indecisiveness, caused by my severe depression and my physical problems have further complicated my ability to choose a pdoc where I live now (its been over ten years).That must be frustrating. Hard enough to find one you can work with, harder still when you feel lousy. Won't you start new pain med soon? Maybe then you'll be up for the task?I hope so!
>
> Now I have gone on and on.I think it I who have gone on and on!!!
>
> Let me know how things are going,You too, Oky, I'd like to hear about your experiences with Parnate sometime when your up for it. I posted today with a bunch of Parnate questions in it. Hope to get some good answers. I'll pass on anything of interest if you like.
Talk to you soon! Jade
>
> oky
>
Posted by okydoky on November 5, 2008, at 18:56:44
In reply to Re: Parnate and Nifedipine and stuff :) » okydoky, posted by JadeKelly on November 5, 2008, at 16:26:37
The lethargy is probably caused or contributed to by having a low bp.
I understand there are several drugs to take for hypertensive crisis. There was an online discussion about it not long ago. I dont understand that your doctor did not discontinue the Parnate, at least as a temporary measure until you bp is normalized? I just read two or three online informational sites on Parnate and every one says to immediately stop the Parnate. I remember I did not stop, or at least not for more than a day but after treatment for HT my bp always stayed normal with the Parnate, you continue to have high bp. I dont get it. When do you see him
I wont be changing pain meds any time soon. I am currently on Morphine.It is strange that you are having a HC every day. My old pdoc would describe it as something else, not as a HC. I found the following at: http://amc.edu/Amr/archives/200705/Prashant%20Mehta.html
Overview
Hypertensive crisis is typically defined as a blood pressure reading greater than or equal to 180/120 mmHg and is divided into two categories: hypertensive urgency and hypertensive emergency.1 Hypertensive urgency is defined as severe hypertension without signs of end-organ damage and hypertensive emergency includes severe hypertension with end-organ dysfunction.
Epidemiology
Hypertensive crisis cases account for nearly one-fourth of all cases of hypertension seen by the emergency department yearly. It is seen in less than one percent of Americans suffering from hypertension. It typically affects more males than females, and is mostly seen in the 60 to 70 year old age group. Hypertensive crisis is seen most commonly in individuals with diagnosed hypertension, who are either under-treated or noncompliant with medication. It may also present as a consequence of renovascular disease, renal parenchymal disease, adenomas, eclampsia, pheochromocytoma, and head trauma.
I hope you get some answers to the questions you posed online. I have not seen them.
oky
Posted by Phillipa on November 5, 2008, at 19:47:59
In reply to Re: Parnate and Nifedipine and stuff :) » JadeKelly, posted by okydoky on November 5, 2008, at 18:56:44
Oky found one specific to parnate. Hope it helps Jade. Love Phillipa
Posted by JadeKelly on November 5, 2008, at 21:36:33
In reply to Re: Parnate and Nifedipine and stuff :) » JadeKelly, posted by okydoky on November 5, 2008, at 18:56:44
Hi Oky!
> The lethargy is probably caused or contributed to by having a low bp.
Contributed to def. But quadrupled since start of daily Nifedipine.
> I understand there are several drugs to take for hypertensive crisis. There was an online discussion about it not long ago. I dont understand that your doctor did not discontinue the Parnate, at least as a temporary measure until you bp is normalized
I d/c'd Parnate for day or 2 to give my brain a break, but then started again as I thought Hypertensive crisis was from energy bar (with Soy). At restart, for couple days, I had jump from low BP to high (180-190sys) within 30 minutes after taking Parnate, unprovoked. Same symtoms, terrible allover headache, pounding in the back of my neck, etc. Its a "syndrome" you don't soon forget.I had IV in hospital, but I think it was to check out my blood. They gave me shot of torodol for headache (finally). I just layed there till BP went down and headache was gone. Whole thing took about 3 hours. Well the next couple of times had HT, I stayed at home and layed in my own bed for couple of hours took advil and klonopin, finally all went back to normal.(not fun)
I just read two or three online informational sites on Parnate and every one says to immediately stop the Parnate. I remember I did not stop, or at least not for more than a day but after treatment for HT my bp always stayed normal with the Parnate, you continue to have high bp. I dont get it. When do you see him.
I see him Monday and the only reason I'm still on Parnate is because I take Nefedipine DAILY. No more High BP, none. Only high resting pulse on and off around 120-125, thats with LOW BP. Its a Nifedipine side effect. You can see why its got to go. So thats my problem, one of the unlucky few who gets spontaneous HT from Parnate. And my research tells me that Parnate is the worst for that. So, maybe back to Emsam Patch, or maybe Nardil. Don't know. Maybe he'll surprise me and have daily antidote that doesn't wipe out Parnate's effects like this Nifedipine. Good for once in a while, def not good daily.Not sure what you thought was going on, just simple case of incompatability with Parnate:(
> I wont be changing pain meds any time soon.
I am currently on Morphine.
>
> It is strange that you are having a HC every day.No, not any more! But I would without daily Nifedipine, which I hate.
Just first couple when resumed Parnate with out Nifedipine on board. I haven't had one in a while.
My old pdoc would describe it as something else, not as a HC. I found the following at: http://amc.edu/Amr/archives/200705/Prashant%20Mehta.html
> Overview
> Hypertensive crisis is typically defined as a blood pressure reading greater than or equal to 180/120 mmHg and is divided into two categories: hypertensive urgency and hypertensive emergency.1 Hypertensive urgency is defined as severe hypertension without signs of end-organ damage and hypertensive emergency includes severe hypertension with end-organ dysfunction.There better not be any organ damage!! You've had a hypertensive crisis, right? Its not the kind of head pain, etc. you'd mistake for something else. At least I don't think so. The latest thinking in a lot of ER's is that if BP Spike is going down slowly on its own by time you get there, which most are, they just watch you, as risk of heart attack if they lower BP at an undesirable pace with meds. Makes sense I geuss. Be nice if they would get up off their *ss*s and treat headache a little sooner!!!!
> Epidemiology
> Hypertensive crisis cases account for nearly one-fourth of all cases of hypertension seen by the emergency department yearly. It is seen in less than one percent of Americans suffering from hypertension. It typically affects more males than females, and is mostly seen in the 60 to 70 year old age group. Hypertensive crisis is seen most commonly in individuals with diagnosed hypertension, who are either under-treated or noncompliant with medication. It may also present as a consequence of renovascular disease, renal parenchymal disease, adenomas, eclampsia, pheochromocytoma, and head trauma.
No head trauma here! just crazy fatigue from that Nifedipine.OK, no more whining from me.As for you, Oky, glad you have pain med on board, is that recent? Will you alternate with others so no tolerance? I hope so. Then you'll feel like taking care of stuff like finding good PDoc! Are you still on that Parnate or are you waiting to get new from Doc?
Hope your having a good evening!
Jade
>
>
>
> I hope you get some answers to the questions you posed online. I have not seen them.(me too!)
>
>
> oky
Posted by JadeKelly on November 5, 2008, at 23:33:13
In reply to Re: Parnate and Nifedipine and stuff :) » okydoky, posted by JadeKelly on November 5, 2008, at 21:36:33
Hey guys, as you know I have my Pdoc appt on Monday and have no idea what I will walk away with. Very kind of you to help me out with research!
You were right Oky, Parnate is supposed to be d/c'd immediately upon suspicion of hypertention. I bet most of us on this board that responded did not quit!!! Alas, I may have no choice:( Also, I see why this med would not suit you Phillipa, ANXIETY, major side effect. In fact, it has alot of side effects. I really might have to switch. How frustrating right when u find "The One". Anyway thanks again both, I'll be better armed on monday. Ugh, parnate insomnia again! Strange mix this drug!! Jade
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