Hello doctor,
My father has developed a hypertension crisis, BP not less than 180/120 mmHg, for a month. He has weakness on the left side and slurred speech. He also cannot control his emotions, such as crying and smiling. There is no total paralysis as he can still walk on assistance. MRI shows small vessel ischemia. I have attached the report.
He is currently on Amlopidine 10g BD, Hydralazine 25 mg BD, Telmisartan 80 mg BD, Bisoprol fumarate 10 mg OD, and Repace H OD. He also has high cholesterol of 6.44. He does not have diabetes. Please advise.
Hello,
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What is the RFT of the patient? We need to give Arkamin to the patient, and this will help. The main problem is we need to rule out a stroke. Please get an NCCT (non-contrast computerized tomography) head done and let us know and start Arkamin 0.1 mg thrice daily.
Thank you doctor,
We have done MRI already. I went for NCCT they rejected to perform as the MRI is already done. I have attached the MRI report and RFT results as well. Should we also stop all other prescriptions and proceed with Arkamin alone or take it in combination with all other prescribed medicines?
Hi,
Welcome back to icliniq.com.
I saw the MRI report (attachment removed to protect patient identity), and his urea creatinine is unfortunately raised. Please do not stop other medicines. We need to add Arkamin and reduce other medicines. We cannot give Telmisartan, and Repace H has to be stopped. So stop Repace H and start Arkamin. Check his BP three to four times a day. Reduce the salt intake. You have to get an ultrasound abdomen done and urine routine analysis.
Thank you doctor,
So any intervention on high urea?
Hello,
Welcome back to icliniq.com.
Yes, you need to get the urine routine examination and ultrasound abdomen done and a repeat renal function after two weeks.
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