A list of meds taken after heart attack(s). And the alcohol warnings

[BleedingHeartPatriot]

that come with them.

1. First, beta blockers, which are given to patients after heart attacks, although if he has Congestive Heart Failure, they aren't recommended.

While on beta-blockers, you should also avoid eating or drinking products that have caffeine or taking over-the-counter cough and cold medicines, antihistamines, and antacids that contain aluminum. You should also avoid drinking alcohol, because it can decrease the effects of beta-blockers.

http://www.tmc.edu/thi/betameds.html

2. He's probably on some kind of diuretic, for BP control and to remove extra fluids.

The dizziness, light-headedness, or fainting is also more likely to occur if you drink alcohol, stand for long periods of time, exercise, or if the weather is hot. Drinking alcoholic beverages may also make the drowsiness worse. While you are taking this medicine, be careful in the amount of alcohol you drink. Also, use extra care during exercise or hot weather or if you must stand for long periods of time.

http://www.nlm.nih.gov/medlineplus/druginfo/uspdi/202360.html

3. An ace inhibitor is generally prescribed, especially if Congestive Heart Failure is present.

Also, do not drink alcohol until you have talked about it with your doctor. Alcohol can increase the low blood pressure effects of ACE inhibitors, making it more likely that you may become dizzy or faint.

http://www.tmc.edu/thi/acemeds.html

4. Post MI (heart attack) patients are always on an anti-coagulant of sorts.

Currently, I believe, Plavix is currently recommended, based on the most current clinical evidence.

If you drink alcohol, faintness or dizziness may be worse.

http://www.medsafe.govt.nz/consumers/cmi/p/Plavix.htm

5. An anti-hypercholestermic (for cholesterol) is also usually prescribed for patients at risk for CAD (Coronary Artery Disease)

Also, do not drink alcohol and take statins until you have talked about it with your doctor.

http://www.tmc.edu/thi/cholmed.html

I don't know how up to date this list is. I've been a nurse manager for a couple of years ago, so I'm not keeping up with all the latest evidence based recommendations.

In general, these medications can increase the effects of alcohol.MKJ

[DS1]

1. Cheney. Long day outside in the sun. Not used to carrying anything

on his own, let alone a gun at shoulder level.

He got dizzy, fell over, blasted the guy. Waited to concoct "inter-species mistaken identity" story.

[BleedingHeartPatriot]

3. I don't believe he was aiming at any birds. I personally believe he was

carrying the shotgun and it discharged.

The cover-up is that vice fired unexpectedly, without warning. It's plausible that it was because he wasn't feeling well physically. MKJ

[Warren Stupidity]

22. Gun would not have been at face/chest level.

If he was just carrying the gun, even given that he is a complete asshat, and even if he were drunk, it would have been pointed at the ground. He was tracking a bird that was low to the ground and he tracked it right back into his own hunting party where he pulled the trigger and blew his friend's face off. Given just how stupid that is, he was likely impaired on something.

[SillyGoose]

2. This is important. They don't want to remind people about all the meds

this guy is on and how they can interact with booze.

K & R

[BleedingHeartPatriot]

4. He is reckless with his health, just like he's reckless with the country.

MKJ

[SillyGoose]

6. Yes, it indicates very poor judgement. nt

[BleedingHeartPatriot]

5. Self promoting kick,

'Cause I put some work into the OP!:) MKJ

[Marnieworld]

15. Bravo

:applause: :woohoo:

[BleedingHeartPatriot]

7. Changed title on OP.

Edited out my comment about being "compliant". MKJ

[onenote]

8. do any of you have experience with heart attacks? Are you Cheney's Dr?

"Suffice it to say he really shouldn't be drinking" -- are you his doctor?


I have two friends who have had heart attacks and in both instances, they have checked with their cardiologists and they are permitted to drink alcohol "in moderation". Meaning that when they come over to watch a game, they sometimes have a beer. Or if we go out to dinner, they'll have a glass of wine.

The assumptions made about whether Cheney should or shouldn't have had a beer (and at the moment we have nothing but utter speculation that he had more than that) by people who don't know what medications he's on, what his doctors have told him he can or can't do, is positively Fristian. Lots of folks who have had heart attacks have an occasional drink and carrying on as if Cheney is some wack job for doing so just looks foolish to folks with first hand knowledge of the issue.

onenote

[BleedingHeartPatriot]

9. I'm just listing the medications which are prescribed based on national

clinical evidence practices, for post MI patients. (of which he is one).

And you're right, I will edit out the comment you pointed out. I worked in CCU and then in Cardiology before moving to Primary Care, where I work with internists who are dealing with post MI patients routinely, and the medications are fairly standardized.

Would you mind if I said that he looks overweight?

MKJ

on edit: I changed the comment, thanks for pointing it out. I was being too judgemental, kind of like calling someone "Fristian" :) MKJ

2nd edit: I edited another post. Alcohol "in moderation" can be a struggle for heavy drinkers who have MI's. We in the medical field walk a fine line in advising patients about alcohol consumption, since alcohol actually has beneficial effects on health, if taken, again, in moderation.

[marions ghost]

11. Cheney has a history of alcohol abuse

that makes it different. It only takes a small amount of alcohol to cause spacing out or worse problems in such individuals. No, we don't know what limitations he has medically, but it is appropriate to speculate that ANY alcohol may have been a factor, given his profile. It's a fair line of questioning.

[onenote]

17. link?

he had two duis 40 years ago when he was in college. Is there something more recent?

[marions ghost]

18. References

John Nichols's book The Rise and Rise of Richard B. Cheney: Unlocking the Mysteries of the Most Powerful Vice President in American History (The New Press) is available nationwide at independent bookstores and at www.amazon.com. Publisher's Weekly describes it as "a Fahrenheit 9/11 for Cheney" and Esquire magazine says it "reveals the inner Cheney." (published Nov 2005)

This is a recent article: "Cheney, "A Beer or Two" and a Gun"

http://news.yahoo.com/s/thenation/20060215/cm_thenation/160212
John Nichols Wed Feb 15, 12:16 PM ET

The Nation -- Vice President Dick Cheney, who was forced to leave Yale University because his penchant for late-night beer drinking exceeded his devotion to his studies, and who is one of the small number of Americans who can count two drunk driving busts on his record, was doing more than hunting quail on the day that he shot a Texas lawyer in the face. The vice president has admitted that he was drinking on the afternoon of the incident. He claims it was only a beer, according to the transcript of an interview with Fox New Wednesday. But the whole discussion about how much drinking took place on the day of the fateful hunt has been evolving rapidly since Katherine Armstrong, the wealthy Republican lobbyist who is a member of the politically connected family that owns the ranch where Cheney blasted his hunting partner, initially claimed that no one was imbibing before the incident.

Armstrong later acknowledged to a reporter from the NBC investigative unit that alcohol may have been served at a picnic Saturday afternoon on the dude ranch where Cheney shot Harry Whittington.(snip)
(snip)

Cheney's admission that he was drinking, along with Armstrong's clumsy attempts to downplay the alcohol issue raises more questions than it answers about an incident involving a Vice President who, like George W. Bush, was a heavy drinker in his youth, but who, unlike Bush, never swore off the bottle.

As with her over-the-top efforts to blame Whittington, the victim, for getting in the way of Cheney's birdshot blast, Armstrong's line on liquor smells a little more like an attempt to cover for the Vice President than full disclosure. This is where the hunting accident "incident" becomes a serious matter. The role played by the Secret Service in preventing questioning of Cheney on the evening of the shooting takes on new significance when drinking is at issue. If Cheney was in any way impaired at the time of the shooting, it was certainly to the Vice President's advantage to put off the official investigation until the next morning.
(more at link)

[onenote]

19. in other words --- nothing

We do ourselves no good when we throw around baseless charges, such as the accusation that Cheney has an ongoing drinking problem -- the only basis for which is the fact that more than 40 years ago he drank heavily in college and got popped twice for DUI. Sorry, but to the average person, that is hardly evidence of anything and if it was, it would cast suspicion the behavior of millions of people.

onenote

[marions ghost]

20. read the book

no I can't get a daily blood alcohol reading on Cheney, but the signs point to a level of consumption that may be a problem. We are talking about a socially acceptable drug consumption, so of course any outside assessment will be interpreted as "baseless charges." As I'm sure you are aware, denial about alcoholism is huge in this country. Even doctors can be reluctant to recognize signs of alcoholism and have been known to cover up for their alcoholic patients.

It's fair to say that Cheney has a history of alcohol abuse and that puts him at high risk for a dependency right about now, especially as the stresses of his situation mount. We know for a fact that he drank twice on the day of the shooting. The biographer obviously suspects it is the reason for the delay and obstruction of investigation into the hunting incident. All I'm saying it that it's a reasonable line of questioning, given Cheney's profile...especially when unexpected shooting accidents happen and procedures are not followed.

[Warren Stupidity]

24. Oh you are arguing with another of our

misguided DUers who think it improper to speculate at all about our political opponents without evidence that would stand up in court.

A person with two DUIs under his belt is very likely to be a chronic alcoholic. By his own admission we know he was drinking and fooling around with guns. Sheesh.

[marions ghost]

26. yeah thanks for that comment

I realize now it's a :banghead: futile exchange

you're right -- it's the old "you don't have any proof"--(in the legal sense) argument--which is usually intended to block investigation. Investigation of any kind always begins with informed speculation.

[onenote]

27. If drinking enough to get two duis 40 years ago

makes it likely that you're a chronic alcholic, then almost everyone I went to college with 35 years ago is a chronic alcoholic.

onenote

[BleedingHeartPatriot]

13. Yes, I have 25 years experience with MI (heart attack) patients. n/t

MKJ

[Warren Stupidity]

23. My assumption is that if you are using guns you

should not be drinking. End of story. No doctorate required. If you are drinking and using guns and you blow your friends face off you ought to go to jail.

[Lone_Star_Dem]

10. Thank you!

I had a call in to a friend and was waiting for them to provide me with something similar.

Now to begin spreading this around. :)

[BleedingHeartPatriot]

12. You're welcome.

:) MKJ

[tishaLA]

14. Wrong about beta blockers, for starters

beta blockers are indeed recommended for CHF--Coreg (Carvedilol) specifically. It's the standard of care med for CHF. (Trust me. I know.)

Lasix (diuretic) won't really increase drowsiness/drunkenness symptoms. It's just a silly precaution. ACE inhibitors, on the other hand, do.

I'd also imagine he's taking a statin.

He probably also takes colchacine (for gout when it's active) and Allopurinal when it's not.

[BleedingHeartPatriot]

16. Thanks for the update. I have a question...I thought the older generation

Beta Blockers (Atenolol, for instance) were recommended to decrease cardiac workload, post MI, if there weren't further complications. I'm not familiar with Coreg, though...geez, two years out of the clinical side may as well be two decades!

I was thinking Maxide(for potassium sparing action) more than Lasix. Forgot about the colchicine (and gout), good call! MKJ

edited to add: you're right about beta blockers and CHF.(I thought you were saying wrong for post MI) I know if someone has sigificant peripheral edema,(which can be secondary to CHF) beta blockers are contraindicated. Again, thanks so much for the update. MKJ -hy

BTW, I did list a statin, just by the old term, anti-hypercholesteremic. :) MKJ

[Virginian]

21. Is Maxide like Spironolactizide?

(Brand name Aldactizide)
It is also potassium sparing.

[BleedingHeartPatriot]

30. Maxide is Triamterene/HCTZ

HCTZ=(hydrochlorothiazide)

I think another trade name may be Dyazide.

It is a combination of two diuretics, with slightly different actions and of which the Triamterene is potassium sparing.

I believe Triamterene and Aldactizide are fairly close in medication action. MKJ

[Caretha]

25. I can vouch for this information

My SO has congestive heart failure and also has an implanted Medtronic devise. In fact it used to be the exact same model as Cheney's until it was replaced with an updated version called InSync by Medtronics.

He is on diuretics, beta blockers and several other heart medications. He will not take a sip of alcohol, and he wasn't by any means ever a "tea totaler" before, but his desire to remain alive is much greater than his desire to drink.

His doctor has informed him that alchohol is possibly one of the worst things he can do for his condition. Every time he has a doctor's examine, same doctor for 6 years, his doctor asks him if he has had any alchohol. That's how seriously his heart doctor thinks imbibing while taking these medications are.

All I can say is I hope Cheney delights in drinking and does more of it.

[arikara]

29. My SO is also on all those meds

and will hopefully soon have a device implanted. He never takes a drink anymore either, but a couple weeks ago stopped by a friend's and had a glass of wine. When he phoned I could tell by his voice that he'd been drinking and made him sleep it off before he drove home.

That was only one glass of wine. If Cheney had even one beer in combination with those meds he shouldn't have been shooting a gun.

[Mabus]

28. I found the letter from his doctor in 2000 listing Cheney's ailments

It is summed by the sentence that says "Mr. Cheney takes a long list of medications which are monitored closely by myself and Dr. Reiner."

Mr. Richard B. Cheney has received his care at The George Washington University Medical Center since 1985; I have been his primary care physician since 1995. At this time, Mr. Cheney is in excellent health. His major medical problems include:

* Coronary artery disease: Mr. Cheney has had several prior heart attacks and has undergone one bypass surgery (in 1988). He is followed closely at GW. His heart disease is treated with medication and is followed closely by myself and Dr. Jonathan Reiner, head of our Cardiac Invasive Laboratory. A most recent update of Mr. Cheney's cardiac history is attached in a letter written by Dr. Reiner. His vigorous lifestyle and exercise tolerance are excellent.

* Hyperlipidemia: Mr. Cheney has had a long history of elevated cholesterol. This has been vigorously and successfully treated with medication.

* Skin cancer: Mr. Cheney has been treated for skin cancer. He continues to be monitored closely for any recurrences.

* Knee injuries: Years ago, Mr. Cheney underwent successful surgical therapy of his right knee for old athletic injuries. There has been no recurrence.

* Gout: Mr. Cheney has had several minor episodes of gout of the foot. I monitor this closely.

* Allergy: Pomegranates (anaphylaxis).

* Cancer screening: Mr. Cheney is up to date with his colon cancer and prostate cancer screening. His last PSA (prostate specific antigen blood test) and colonoscopy were normal.

* Medications: Mr. Cheney takes a long list of medications which are monitored closely by myself and Dr. Reiner. He has shown no side effects of any of these medications which would alter intellectual performance or impair his judgment. http://www.doctorzebra.com/prez/a_cheney2000.htm

edited to correct formatting.

[BleedingHeartPatriot]

31. Great find! This should be an OP...LOL at the "vigorous lifestyle".

MKJ

[Mabus]

32. I thought it was a good listing of his ailments

to help us figure out what/how many meds he is on. I'll see if I can find anything a little more current.