Re: Lee's post on atenolol digoix cardizem...

[Guest guest]

>atenolol is a betablocker - I don't really know as much as I would

> like about these but I think they basically block sympathetic tone

> (by competing with catecholamines?) - hence the slow rate and

> calming affect.

Here's what I recollect my docs telling me about beta blockers,

filtered thru my hazy understanding and not having asked enough

questions when this first was freaking me out:

first cardiologist: it shields the heart somewhat from adrenaline.

(I certainly noticed when I has taking a high enough dose of toprol

xl that it acted somewhat like a tranquilizer.)

some doc: it increases the time that that node that transmits

electrical impulses from the atria to the ventricles has before it

can respond to another impulse from the atria, hence the ventricles

are " rate controlled " even though the atria are going fast.

current cardiologist: has been about to explain to me how beta

blockers help prevent extra beats, but we didn't finish the

discussion at my previous appointment. She did say it was not thru

the response time thing I mentioned immediately above.

p.s. In a previous message someone said something about my working

on a glossary, nope, not me.

Trudy

[Guest guest]

> Having said all that - I think my AF is predominantly vagal and I'm

taking a

> beta blocker, bisoprolol (doh!). The only reason I'm taking it is

to keep my

> rate down when I'm in AF. On my next visit to the cardiologist I

want to ask him

> if I can come off of it and only take something when I pop into AF -

in the hope

> that a faster heart rate in NSR will increase the gap between

attacks. I'm not

> entirely sure there is a drug out there that acts fast enough for

this though

> but we shall see (I suspect my heart rate will go too high in the

first hour of

> AF before most drugs get a chance to do their magic).

, that is just what my cardio has said I should do with toprol,

take it when something happens. I don't know how long it takes to

really take effect, but when I was taking it, I could feel the

tranquilizing effect in about ten minutes.

I feel so much better off it in terms of increased tolerance for

physical activity and fewre posture effects (the stuff about bend

over, heart does a little thing is almost copletely gone), even

though I can still have episodes of frequent extra beats that I am

working on, that for me it is worthwhile. She also said to take it

if the extra beat stuff gets out of hand.

Trudy

[Guest guest]

:

Thanks so much for your response to my post, and for your effort to

explain in plain English the action of the various meds.

I think one reason I feel so well on my beta blocker is that it takes

care of whatever part adrenaline-induced AF plays in my story. So,

even if it might be good for the vagally-induced portion of my AF, I

guess I'm not willing to give up the overall symptom reduction it

produces me. I will be very interested in your experiment with

finding a med to take only when you go into AF. I don't think I would

feel well enough with no atenolol or digoxin to do it that way, but

I'm always open to new ideas. And wouldn't it be great if each of us

could find just the right chemical balance to keep us out of AF!

Again, thanks.

Lee

> Hi Lee,

> thanks for your recent post on digoxin,atenolol and diltiazem

(cardizem).

> I'm currently trying to understand this strange balancing act that

goes on...

>

> as I understand it (please don't take this as truth - I'm still

learning)....

> digoxin inhibits the sodium-potassium (Na-K) pump and leads to a

higher

> concentration of Na in the cell (intracellular). This high

concentration of

> intracellular sodium leads to a higher sodium-calcium exchange so

you end up

> with higher concentration of intracellular Ca. It slows the

conduction rate of

> the AV node down but sympathetic stimulation easily overrides this

(which is why

> verapamil & diltiazem are often used in preference to digoxin these

days)

>

> diltiazem is a calcium channel blocker and it inhibits the influx of

> extracellar Ca across heart cells. (I think you end up with less Ca

in the

> cells). It also slows the conduction rate of the AV node but I

believe this slow

> conduction still happens when sympathetic tone is increased.

>

> atenolol is a betablocker - I don't really know as much as I would

like about

> these but I think they basically block sympathetic tone (by

competing with

> catecholamines?) - hence the slow rate and calming affect.

>

> I can't stress enough that I don't know enough about all of this

but if I were

> doing a test to see if I had vagal AF I would have picked on the

atenolol.

> Actually, since digoxin is not very good when the heart starts

racing I would

> have been tempted to come off both and try a drug that would at

least keep the

> rate down in AF. (no idea which one though!)

>

> I know there can be problems with abruptly stopping atenolol - I

wonder if this

> was the cause of your attacks when you forgot to take a dose?

>

> Having said all that - I think my AF is predominantly vagal and I'm

taking a

> beta blocker, bisoprolol (doh!). The only reason I'm taking it is

to keep my

> rate down when I'm in AF. On my next visit to the cardiologist I

want to ask him

> if I can come off of it and only take something when I pop into AF -

in the hope

> that a faster heart rate in NSR will increase the gap between

attacks. I'm not

> entirely sure there is a drug out there that acts fast enough for

this though

> but we shall see (I suspect my heart rate will go too high in the

first hour of

> AF before most drugs get a chance to do their magic).

>

>

> The balancing act that goes on between the ions inside and outside

of cells is

> probably a crucial piece of the jigsaw but I'm not sure anybody

knows enough

> about it - or how to test the various concentrations. Somebody

please tell me

> I'm wrong

>

> cheers

> --

> D

[Guest guest]

Hello! I'm new and today is the first day I've been researching this online. I

noticed you mentioned that

Toprol has a tranquillizing effect. That was added to my meds on Thurs night, a

few days ago and I've

noticed a muscle fatigue that's been quite alarming. Does anyone know if that's

possibly due to the

Toprol, or is it something connected with my Lone Atrial Fibrillation?

I have very high blood pressure, diagnosed about four months ago. In the course

of managing that, my

Internist, a Cardiologist, found the afib a week and a half ago. I'm currently

taking the following meds

for this:

40 mg Accupril BID for the bp,

One coated aspirin a day with food,

Tiazac 300 mg once a day,

Toprol-XL 50 mg BID.

I'd been taking 300 mcg of Synthroid for a long time and while my Thyroid level

was testing a little

high, not high enough to account for the Lone Atrial Fibrillation, according to

the Internist/

Cardiologist I've been seeing. I have probably had this LAF for a while, not

knowing what it was, but

I'm now wondering what other problems may be associated with it, and also how to

get rid of it, of

course.

I've had a urinary problem for a while: a lot of pressure sometime incontinence,

on small amounts of

urine. I do get very tired sometimes. Today I was really knocked out and I'm

wondering if the meds are

causing this now, though it did happen before at times. He already told me " no

caffiene in any form "

and he wants me to rest and avoid stress. He says I'm not likely to have a

stroke or die but he's

obviously worried about this and I'm not sure why. This muscular exhaustion is

very worrisome now,

as is the general fatigue.

He took me entirely off the Synthroid 300 mcg for several days but after being

back on a lower dosage

of Synthroid 200 mcg for two days when I was in his office I was again in afib

and I could tell that

time. I can't always tell, but I felt bad then, and very " rushed " in the chest

area. He took me off

Synthroid again. He's not letting me work out and I'm starting to feel like an

invalid. My

echocardiogram was normal, chest x-ray showed normal size heart but when I wore

a 24 hour heart

monitor I was in and out of afib. I'll be having a stress echocardiogram next

week and he'll want me to

wear the 24 hour heart monitor again.

Any comments and suggestions are welcome!

> > Having said all that - I think my AF is predominantly vagal and I'm

> taking a

> > beta blocker, bisoprolol (doh!). The only reason I'm taking it is

> to keep my

> > rate down when I'm in AF. On my next visit to the cardiologist I

> want to ask him

> > if I can come off of it and only take something when I pop into AF -

> in the hope

> > that a faster heart rate in NSR will increase the gap between

> attacks. I'm not

> > entirely sure there is a drug out there that acts fast enough for

> this though

> > but we shall see (I suspect my heart rate will go too high in the

> first hour of

> > AF before most drugs get a chance to do their magic).

>

>

> , that is just what my cardio has said I should do with toprol,

> take it when something happens. I don't know how long it takes to

> really take effect, but when I was taking it, I could feel the

> tranquilizing effect in about ten minutes.

>

> I feel so much better off it in terms of increased tolerance for

> physical activity and fewre posture effects (the stuff about bend

> over, heart does a little thing is almost copletely gone), even

> though I can still have episodes of frequent extra beats that I am

> working on, that for me it is worthwhile. She also said to take it

> if the extra beat stuff gets out of hand.

>

> Trudy

[Guest guest]

Hi, ,

I was on 50 mg of toprol for a while and it absolutely flattened me.

I did much better on 20 mg a day (I had to carve the pills down with

the razor blade on a pill cutter.) There is a 25 mg size pill. It

may be that your blood pressure and pulse are getting very low on

that dose. You can buy a blood pressure machine at a pharmacy for

$60 to $100 or so. Well worth it. Even at 20 MG, I was tired.

Eventually as things calmed down from the mess I started in, my doc

took me off toprol altogether. I tapered off over three weeks.

I am wonderting if you need the Accupril since toprol lowers blood

pressure. A common problem is docs over medicate.

For the urinary stuff, I suggest drinking cranberry juice. They have

now proven that it helps that both by changing the ph to kill off

bacteria(?) and does something else, maybe coating the urinary tract.

The reason your doc is worried about the afib is if you are in it for

1 to 2 days and the go into sinus (normal) rhythm, there is a

possible blood clot problem. During afib the blood stagnates it the

atria as they are inefficient, and can form clots, and when you go

into sinus the clots can shoot out of the heart. The aspirin is to

help prevent that as it thins the blood or soemthing.

It is very good news that your echocardiogram and xray show a normal

heart. So you are in the class of folk who have the best chance to

cntrolling the afib.

Trudy

[Guest guest]

Trudy! Thanks so much for your response about this. I just figured out how to

read the messages here:

the messages were appearing with the most recent at the bottom and I thought

there was nothing

new.

I'm so relieved that this feeling is probably due to the Toprol. I'll leave him

a message asking if I can

cut this pills in half. I have a little pill cutter that should be able to do

that fairly accurately.

The problem in regard to the blood pressure is that it was very high, he

gradually raised the Accupril

from 20 mg a day to 40 twice a day and it was when I came in to test the results

of that, the bp was

normal for the first time but the afib was present. He added one drug that I

couldn't seem to manage

to take QID, and then instead of that, added the Tiazac. It was on those that I

was back into a rather

bad afib on Thursday, and also had a very high bp reading. He wanted me to bed

rest and I really

wouldn't, so I'm wondering if he gave me so much Toprol partly to knock me out.

It certainly has! I see

him again Monday evening, and he wanted me off Synthroid and on these till then

but I'll leave him a

phone message asking if I can reduce the Toprol.

I already have a bp machine, which I picked up after the hypertension was

diagnosed about four

months ago. I'm not sure it's that accurate. He says they aren't. Is there any

way to tell if you're in

afib? Any machine you can buy?

I'm upset and frightened by the fact he isn't letting me work out OR diet! I was

working out regularly

and I really need to diet. This scares me enough that I got ready to start a

really serious diet and I

asked him about it because it's severe and could stress the heart. He said not

to diet at all, so he's

really afraid of rocking the boat.

With Lone Atrial Fibrillation there's not supposed to be that much risk of

stroke and he said I didn't

need Coumadin, but I guess there is some risk or he wouldn't be keeping me on

the aspirin.

You could be right that he's panicking a bit, seeing the afib come back after we

reduced the Synthroid

worried him. It worries me, too!

I know about cranberry but I haven't been bothering with it lately. I have caps

and I'll start taking

them again. I'm taking a lot of vitamins and supplements! I'm wondering if

there's a relation between

the urinary problems and the afib.

Thank you again. It's great to have found this forum.

> Hi, ,

>

> I was on 50 mg of toprol for a while and it absolutely flattened me.

> I did much better on 20 mg a day (I had to carve the pills down with

> the razor blade on a pill cutter.) There is a 25 mg size pill. It

> may be that your blood pressure and pulse are getting very low on

> that dose. You can buy a blood pressure machine at a pharmacy for

> $60 to $100 or so. Well worth it. Even at 20 MG, I was tired.

> Eventually as things calmed down from the mess I started in, my doc

> took me off toprol altogether. I tapered off over three weeks.

>

> I am wonderting if you need the Accupril since toprol lowers blood

> pressure. A common problem is docs over medicate.

>

> For the urinary stuff, I suggest drinking cranberry juice. They have

> now proven that it helps that both by changing the ph to kill off

> bacteria(?) and does something else, maybe coating the urinary tract.

>

> The reason your doc is worried about the afib is if you are in it for

> 1 to 2 days and the go into sinus (normal) rhythm, there is a

> possible blood clot problem. During afib the blood stagnates it the

> atria as they are inefficient, and can form clots, and when you go

> into sinus the clots can shoot out of the heart. The aspirin is to

> help prevent that as it thins the blood or soemthing.

>

> It is very good news that your echocardiogram and xray show a normal

> heart. So you are in the class of folk who have the best chance to

> cntrolling the afib.

>

> Trudy

[Guest guest]

>Is there any way to tell if you're in

> afib? Any machine you can buy?

>

> I'm upset and frightened by the fact he isn't letting me work out

OR diet! I was working out regularly

> and I really need to diet. This scares me enough that I got ready

to start a really serious diet and I

> asked him about it because it's severe and could stress the heart.

He said not to diet at all, so he's

> really afraid of rocking the boat.

, just IMHO, but -

If your doc says you can reduce the dose of toprol, br sure to ask

him about how to taper it down.

I dunno about the accuracy of home bp machines, mine seems at least

consistent.

If you take your pulse you should be able to tell if it is regular or

not. I am no good at telling afib from other irregularities, but I

feel fairly confident that I can at least tell regular or not.

Yikes, don't put more stress on yor heart with exercise or a severe

diet until he has you stabilized and okays them. IMHO, I would work

on stress reduction techniques first.

Trudy

[Guest guest]

Lee: I bought a bunch of the L's on Friday, actually 1000 mgm of the

L-Carnitine, I think. I was going to

add it to my already big Vitamin/Supplement regimen, and now I'll add it with

more enthusiasm. My

friend, who is almost 95, told me not to take the L's with food, so that threw

me off with starting

them. She's been going to the Atkins Clinic for years and a lot of her

alternative info comes from that

source.

Trudy: Thanks again for that info. Since adding the Toprol my home bp machine is

giving me normal to

low readings in general. I didn't try taking my pulse. I used to take it when I

ran, years ago, so I can do

that and try to notice if it's irregular. I know it was very very high when the

AFIB was first found.

I feel better knowing the muscle fatigue is probably due to the Toprol. I

thought I was developing

some sort of hideously debilitating muscular disease. I'll call him at around

10AM today about

reducing the dosage. Thanks SO much! You've been so helpful!

> >Is there any way to tell if you're in

> > afib? Any machine you can buy?

> >

> > I'm upset and frightened by the fact he isn't letting me work out

> OR diet! I was working out regularly

> > and I really need to diet. This scares me enough that I got ready

> to start a really serious diet and I

> > asked him about it because it's severe and could stress the heart.

> He said not to diet at all, so he's

> > really afraid of rocking the boat.

>

> , just IMHO, but -

>

> If your doc says you can reduce the dose of toprol, br sure to ask

> him about how to taper it down.

>

> I dunno about the accuracy of home bp machines, mine seems at least

> consistent.

>

> If you take your pulse you should be able to tell if it is regular or

> not. I am no good at telling afib from other irregularities, but I

> feel fairly confident that I can at least tell regular or not.

>

> Yikes, don't put more stress on yor heart with exercise or a severe

> diet until he has you stabilized and okays them. IMHO, I would work

> on stress reduction techniques first.

>

> Trudy