pharmaceuticals affected by dehydration?

[franksolich]

Is anyone aware of how pharmaceuticals are affected by dehydration, and what ameliorative steps one can take, to ease it?

It's very hot out here in the Sandhills of Nebraska, and no, air-conditioning is not an option in this place, not even a small window unit.  The place has never had air-conditioning, and from what I can tell of the wiring, the refrigerator is about the most powerful electrical appliance that should be in use here.

The wiring is modern, but one has to remember the house was inhabited until the late 1980s by a woman born in 1897, in this house, who naturally used electricity only very modestly.  After she died, the place was essentially left alone until I came here the autumn of 2005.  It's reasonable to assume that after the cats and I leave here, the house will be torn down, and a more modern one built, by one of the sons or grandsons of the ancient elderly gentleman who used to mow the lawn here, whose property this now is.

So air conditioning is not an option.  That of course is eased somewhat by that the house is circa 60% windows, all in operating order and all with good screens, on all four sides, and I do have four large electric fans.

I sweat a lot; of course, to me, 65 degrees is a heat wave.

This is complicated by that the dermatologist, my principal physician, strongly advises me to stay out of the sun as long as I'm on these two drugs.  Being out in the sun of the Sandhills more than twenty minutes causes problems, but with these drugs, I'm really not supposed to be out in the sun, period.  So instead I'm in this great big enormous airy house, fans rotating, most of the time.....and sweating like a pig.

Since I was nervous about being on drugs, from the start, I decided to monitor everything closely, very closely.  The drugs have been working, but way below expectations.  I wonder if constant dehydration is a factor here.

As mentioned, since Sunday night, I've monitored.  One of the things I've watched closely is food-and-drink consumption.  My food consumption has been practically nil, probably not even 500-600 calories a day, and while I can get away with that for a bit, it can't become a lifetime habit.  The usual fibers, no sugar (which had never been a part of the diet anyway), and for the time being, no salt, which probably goes a long way in explaining no food, because food without salt is poison.

I watch consumption of liquids by using a glass only one time during a day, sticking or lining it up on the counter, and counting every 24 hours.  The twenty-four hours from 12:01 a.m Thursday until 11:59 p.m. the same day, showed a consumption of half a gallon of pure orange juice, two 32-ounce glasses of non-caffeinated fountain sodas from convenience stores, 11 32-ounce glasses of plain ordinary water (no ice), and three 16-ounce glasses of ordinary water.

Am I sweating the pharmaceuticals out of the system before they can do their work?

If so, what are some things I can do to retard that?  I take two pills in the morning, one pill in the evening, which might, or might not, be my main source of calories at the moment.

[Chris_]

Coach, most pharmaceuticals are metabolized in the liver, and your exposure to high temperatures will not generally affect how they work......depending on the drug.  Your daily fluid intake will not generally affect the rate of metabolism either, however, you should read the fine print and contraindications that are generally provided by the pharmacy for the drug that you take to determine for sure......you do need to remain properly hydrated or unforseen consequences might develop, which may or may not be related to the drugs.

For example, I take a lipid medication that doesn't react well with either exposure to direct sunlight, and cannot be taken if I drink grapefruit juice, so reading the data sheets from the pharmacy is where you will find your answers.

If for some reason you no longer have the data sheets from the pharmacy, you can go to the library and look the drug up in the PDR (Physician's Desk Reference)  which will give you all of the requisite data on any medication available, albeit,, not generally in laymans terms.....

doc

[MrsSmith]

I don't know about the medications, but do have some suggestions for reducing the heat.  When my mother first came here from Austria, the 100+ temps nearly killed her...literally.  She did end up in the hospital a couple times.  Her doctor advised her to take frequent cool baths, lay down in front of a fan with a wet towel or sheet over her, and, as you are already doing, drink lots of liquids.

Your lack of salt intake may be causing problems, salt helps your body retain liquid.  I think moderate intake could actually help in the heat.  (As the vast majority of people now have A/C, healthcare personnel may not consider the problems caused by zero salt intake.  Just as they demonize fat, despite the fact that fat is a dietary neccesity, they also demonize salt, which is also necessary)

[franksolich]

If for some reason you no longer have the data sheets from the pharmacy, you can go to the library and look the drug up in the PDR (Physician's Desk Reference)  which will give you all of the requisite data on any medication available, albeit,, not generally in laymans terms.....

Trust me, doc, sir, I am so leery of these things I have all paperwork associated with them.  In my opinion, or perception, or observation based upon past experiences with others, this is dynamite here--necessary dynamite--and needs to be handled with as much caution and care possible.  Knowledge is power.

But none of the instruction sheets deal with dehydration.

I'm going to play a primitive here, and boast about the specific pharmaceuticals; it's no hair off my ass anyway, because the plan is, after stabilization, to work to get off of these things.  Especially, as my primary physician, the dermatologist, says, I'm in really bad trouble if I go out into the sun too much with this in me.  I'm in enough trouble as it is, without these chemicals in me.

At the hospital, in the emergency room, the physician was going to prescribe me a whole array of drugs, including pain-killers (even though I was in no pain), until I made noise about it, and told her we needed to go mild, as mild as possible, on this.

So we talked about it, and she tore everything up, and ordered me only Metoprolol Tartate 50 mg, one tablet two times a day.

That was Sunday night; Monday early afternoon, another physician said no, that wasn't nearly enough, that wasn't going to cut it.  He started writing down a whole lot of things, to which I said, whoa-ho, mild it down.  My body has a history of healing on its own, and even if it takes longer, I'd just as soon heal naturally as much as is possible.

So he tore everything up, and ordered me only Lisinopril-HCTZ 12.5 mg, one tablet one time a day.

In my whole adult life, other than occasional penicillin, these are the only pharmaceutical drugs I've ever taken.  Every time I've broken bones, physicians have prescribed pain-killers, but those pieces of paper went into the wastebasket upon leaving the hospital, or arriving home.

I some days ago read all the small print regarding the two pharmaceuticals, whose primary side-effects appear to be loose bowels, which has not happened in six days, since I first started taking them.  But then and again, not being a primitive, too-loose or too-tight bowels has never been a problem.  As Sigmund Freud reminds us, excepting in the case of women bearing infants, bowel disorders are a result of malfunctioning attitudes about people and life.

[franksolich]

Your lack of salt intake may be causing problems, salt helps your body retain liquid.  I think moderate intake could actually help in the heat.  (As the vast majority of people now have A/C, healthcare personnel may not consider the problems caused by zero salt intake.  Just as they demonize fat, despite the fact that fat is a dietary neccesity, they also demonize salt, which is also necessary)

Yeah, here's sort of a problem, but I'm sure it'll get straightened out.

I love salt; I love salt with an ardor and a passion that surpasses BadCat's love for beautiful women.  I love salt with all my heart and being.  I would crawl ten miles on my bare knees over broken glass, for salt.

But abruptly late Sunday night, I immediately went to zero salt.

Sooner or later, this must inevitably cause problems, but for right now and probably the next few days, until I see a physician again, I'm just leaving it alone, no salt.  I see BadCat's suggestion, Gatorade (the neighbor brought over a case of it about noon), has a little bit of sodium, and I'm hoping that's enough to hold me until I learn more from the next physician, on Tuesday.

[Chris_]

Yeah, here's sort of a problem, but I'm sure it'll get straightened out.

I love salt; I love salt with an ardor and a passion that surpasses BadCat's love for beautiful women.  I love salt with all my heart and being.  I would crawl ten miles on my bare knees over broken glass, for salt.

But abruptly late Sunday night, I immediately went to zero salt.

Sooner or later, this must inevitably cause problems, but for right now and probably the next few days, until I see a physician again, I'm just leaving it alone, no salt.  I see BadCat's suggestion, Gatorade (the neighbor brought over a case of it about noon), has a little bit of sodium, and I'm hoping that's enough to hold me until I learn more from the next physician, on Tuesday.

Frank, the drug that you are taking is a combination of two compounds, one is an ACE inhibitor, which reduces blood pressure by relaxing the blood vessels, allowing them to expand.  The second is a diuretic, which reduces the level of fluid in your body, hence the necessity for you to drink plenty of fluids to remain hydrated, as the medication is removing them from your body more quickly than normal.

The only contraindication that I read in the PDR is a caution against consuming anything containing high levels of potassium, as doing so with this drug can lead to kidney failure........now I don't know what is in Gatorade, but I seem to remember that it contains electrolytes, which would suggest that it includes potassium, which you need to avoid.....I would stick to juice or water for now, and read the labels on those things that you do consume carefully.  Sodium does not appear to be a problem for this med, so consuming moderate amounts of salt would likely be fine.

doc

[franksolich]

Got you, sir; I'll add whatever pure fruit drinks I find at the grocery store this morning (cranberry and somesuch) that have little or no potassium, and drink the remaining Gatorade half diluted with plain ordinary water, as I assume I must have potassium, at least a little bit of it.

As for hard foods, the day before yesterday, I went to Subway in town, and by sheer coincidence--I had no idea; I only learned it later--ordered the "best" thing on the menu, which was whole wheat bread, white turkey, lettuce, cucumber slices, nothing else on it.

I had no idea; it was just by sheer chance and luck I had ordered it that way.

That was the only solid food I've had since last Sunday morning.  It might not be good, and it might be less than what I need, but until advised by a medical professional in real life to do something different, as I really don't feel like eating (the very hot weather, and the general lassitude), I'll let the body dictate if I need something more solid.

It's temporary, and while I'm no Fat Che or gigantic primitive or subway cat--oh God no, far from it--it's not like I'm threatened with emaciation.

If one's not sure what he's doing, better to underdo than overdo.

[Chris_]

Got you, sir; I'll add whatever pure fruit drinks I find at the grocery store this morning (cranberry and somesuch) that have little or no potassium, and drink the remaining Gatorade half diluted with plain ordinary water, as I assume I must have potassium, at least a little bit of it.

As for hard foods, the day before yesterday, I went to Subway in town, and by sheer coincidence--I had no idea; I only learned it later--ordered the "best" thing on the menu, which was whole wheat bread, white turkey, lettuce, cucumber slices, nothing else on it.

I had no idea; it was just by sheer chance and luck I had ordered it that way.

That was the only solid food I've had since last Sunday morning.  It might not be good, and it might be less than what I need, but until advised by a medical professional in real life to do something different, as I really don't feel like eating (the very hot weather, and the general lassitude), I'll let the body dictate if I need something more solid.

It's temporary, and while I'm no Fat Che or gigantic primitive or subway cat--oh God no, far from it--it's not like I'm threatened with emaciation.

If one's not sure what he's doing, better to underdo than overdo.

I noticed that one of the side effects of this drug is general weakness in the muscles, so the lassitude that you are experiencing is likely the high heat, combined with the effects of the med.  As you continue to take it, the side effects will likely moderate.....

An ocasional bowl of cereal or the like wouldn't hurt though, to give your body some carbs to burn.

doc

[delilahmused]

frank I think as long as you drink enough fluids you should be fine. If you feel you need some extra calories or vitamins you could add Ensure or Boost to your diet.

Cindie

[Wineslob]

Frank, I came to this "bonfire' a tad bit late. Sounds like you are taking a calcium blocker/booster(?) along with a diuretic, as said before. I'm on what is the "opposite" of what you are taking. Mine (Diovan) is a potassium booster along with the HCTZ, (which makes you lose potassium, so I eat bannanas) and has very few side effects.
If the one you are on stops working, and trust me, you might end up spending a year finding what works, stay away from Lotrel, the abdominal bloating was awful, plus it made me depressed/sluggish. Really crappy stuff.
Watch your salt intake! It sounds like you "love" it too much, but with the HCTZ you still need to keep it at reasonable levels.

[RobJohnson]

I would suggest a window a/c unit. At least you would have one or two rooms you could cool down in.

The portable a/c units also work good, they simply use a dryer type vent for the hot air exhaust. It will also reduce the humidity.

I can't imagine spending much time in the midwest humidity with no a/c, it can't be healthy.