Concluded Case

BPH with Hypertension

A 70 year old retired male reported to OPD on 30.12.2020 as well on 03.01.2021 Chief Complaints 30.12.2020 - Increased frequency of urination both day and night 3.01.2021 - Increased frequency of urination both day and night, mild relief than before, but not that much Vitals BP on 30 Dec as well as today was 179/90, 170/90 Pulse was 54/min and today it was 60/min Investigations USG KUB(PVRU and Prostate Size) reveals Mild BPH Management I had started him on 30.12.2020 on - Tab. Telista CL OD Tab. Urimax D HS Today I changed his BP medicines too - Tab. Cilnidipine 10+ Telmisartan 40 + CH 12.5 OD Tab. Cilnidipine 10mg OD Tab Urimax D HS Tab Levoflox 750mg OD Kindly give your valuable comments on line of management esp. for BP in BPH patients? After how many days of Urimax D or Silodosin D patient feel some improvement in urine issues?

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So the patient reported for follow up visit today and his BP is well controlled and pulse is wnl too BP- 128/78 mmHg Pulse - 76/min So I have kept him on same combination of Telmisartan 40 + Cilnidipine 10 + CH 12.5 in morning and Cilnidipine 10mg after dinner, Urimax D at bedtime and Levofloxacin 750mg( for 7 days total) Meawhile, advised him for double voiding, restricting fluid/water intake after 8 pm and avoiding tea/coffee at night

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Hypertensive pt of BPH Wait for desired effect in one month I shell prefer silodosyn+dutasteride Rest continue Order for bsl and hba1c to r/o diabetes

Thanx dr Kute Ankush
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IT'S A..CASE OF.. BPH..WITH HT.. NEED'S.. TO CONTINUE WITH.. ANTIHYPERTENSIVE MEDICATIONS..&.. URIMAX-D .. INVESTIGATE WITH..SOS.. BSR HBA1C.. PSA..

Tnx Dr Shivraj Agarwal sir
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Dx-HT (systolic hypertension) Mild BPH. Rx-1-Mild BPH-no need of surgical intervention. Cap urimax D o.4mg 1hs continue for 1yr. Response will be within 15 to 3o days. 2-Tab Telmisartan 40 mg 1od continue.

BPH patients with symptoms, shows improvement almost immediately after starting Tamsulosin or Silodosin

Thank you doctor
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SUGGESTIVE. OF SYSTEMIC . HYPERTENSION WITH ...B .P. H NICELY. ..DISCUSSED BY. THE. RESPECTED .DOCTORS THANKS...

In my opinion we can add tb arkamine .1 mg tds for BP controll as it is beneficial in BPH c HTN.

Pulse is on a lower side sir, still can give??
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Hi sir, I agree with your treatment... And we should wait for atleast 1 month for the expected result in BPH... And I also agree with your antihypertensive treatment... I would like to suggest two things 1. Chlothalidone in elderly patient can give rise to hyponatremia associated syndrome.. and 2. We must preserve Levofloxacin for kochs patient only..

Valuable opinion
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HTN with BPH Treatment is fine Require month to resolve Assess patient on regular interval Check BP and Pulse USG KUB for residual urine if high or retention then think for surgery

So the patient reported for follow up visit today and his BP is well controlled and pulse is wnl too BP- 128/78 mmHg Pulse - 76/min So I have kept him on same combination of Telmisartan 40 + Cilnidipine 10 + CH 12.5 in morning and Cilnidipine 10mg after dinner, Urimax D at bedtime and Levofloxacin 750mg( for 7 days total) Meawhile, advised him for double voiding, restricting fluid/water intake after 8 pm and avoiding tea/coffee at night

After Three months patient will feel improvement in his Urine problem

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