Antihypertensives

60yr/F with elevated renal parameters urea - 60 creat - 2.2 on Olmesartan medoxomil 20mg OD , T.nefrosave OD complaining of on/off decreased micturition releaved by taking T.nefrosave Not a diabetic SHT on Olmesartan for 5 yrs Dyslipidemic on Atorvas 20mg Is this safe to continue ACE/ARB in elevated renal parameters? She can't afford Olmesart as it costs 10/tablet I suggested her to start Amlodipine 10mg OD Is this suggestable?

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? RENAL PATHOLOGY.. WITH.. ELEVATED LEVELS OF.. SR .. UREA .. 60 .. SR.. CREATININE.. 2.2 .. BETTER TO GIVE.. PRAZOSIN .. MINIPRESS XL ..AND .. AMLODIPINE ..

She can't afford minipress xl sir Can I give Amlodipine + Atenolol
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In case of renal impairement acr/arb are c/i better to give Amlong and minipress xl

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Prefer betablokers Alfa blockers CCB. Avoid ACE ARB

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Yes it’s safe no problem

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Ace inhibitors & ARBs should not be used in patients with baseline hyperkalemia. So, you can start with Amlodipine + atenolol combination.

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Try to use of Vasa swarasa or churna with Ghee , vasaghruta. I think here we should consider the Raktapitta samprapti (tiryakgata).

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