Behram’s Pharmacy advises hypertensive patients to be cautious when buying over-the-counter medicines | 16 November 2020
In the following interview, Zarine Udwadia-Durup, pharmacist at Behram’s Plaisance Pharmacy, explains why she is urging patients with hypertension to be careful when buying over-the-counter medicines, in particular cold and flu medicines, which can potentially lead to a ‘hypertensive crisis’.
Seychelles NATION: You mentioned that you wanted to raise awareness about patients with chronic conditions and their use of over-the-counter medicines; tell us more about this.
Zarine Udwadia-Durup: We get so many patients coming in with chronic conditions. Probably the most common condition that we see is high blood pressure, also known as hypertension.
A person is classed as a hypertensive patient if their blood pressure measurement is 140/90 mmHg or higher. A ‘normal’ blood pressure reading is 120/80 mmHg but this can vary slightly from person to person. Anything above 120/80mmHg but below 140/90mmHg means that a person is at risk of developing high blood pressure if they do not take steps to keep it under control. Basic lifestyle measures that can be taken to reduce the risk of developing hypertension include:
- weight control
- reducing your daily salt intake
- doing exercise
- reducing the intake of alcohol and caffeine-based drinks such as coffee, tea and RedBull
- stop smoking
Whenever someone comes into the pharmacy to buy a medicine, our first question is always ‘do you have high blood pressure?’ Medicines that hypertensive patients have to be careful with, or preferably avoid, are mainly cold-flu remedies which contain pseudoephedrine, ephedrine, phenylephrine, oxymetazoline, xylometazoline or even caffeine. In addition, medicines that dissolve in water (effervescents) also need to be avoided or used with caution.
Seychelles NATION: Can you explain why hypertensive patients need to be careful with cold/flu medicines?
Zarine Udwadia-Durup: Cold and flu medicines come in several forms: tablets, syrup, powders or nasal sprays. Such products generally contain ingredients called decongestants. These decongestants work to reduce the symptoms of blocked or stuffy noses by making the blood vessels in the nose narrower which reduces the amount of blood flowing through them. This reduces inflammation and swelling, thus allowing more air to flow through and the mucus to drain.
The problem with this in patients with high blood pressure is that this constriction is not specific to the nose. It affects blood vessels all over the body. The smaller the vessels, the less space there is for blood to flow through. Think of a garden hose: when you place your finger but leave a small gap over the end where the water comes out, the water comes out with a higher pressure. The same thing applies to your blood vessels.
While the effect of decongestants can be minimal, there is always a risk of sudden increased blood pressure in patients with uncontrolled high blood pressure. We call this a ‘hypertensive crisis’. This can result in stroke, heart attack, loss of consciousness, kidney damage or even aortic dissection.
As previously mentioned, products that dissolve in water can also increase blood pressure due to their salt (sodium chloride) content. It is possible that just one dose of some products can contain more than a whole day’s allowance!
People with high blood pressure should adopt a low sodium diet. The reason for why salt increases blood pressure is not completely understood, but it’s thought that it does so by increasing the amount of water in your blood. This means that the amount of blood and water going through your blood vessels is increased which in turn puts pressure on the walls of the blood vessels, and hence, an increased blood pressure.
Seychelles NATION: What is your advice to these patients?
- Always tell the pharmacist and pharmacy staff that you are a hypertensive patient
- Always read the medicine label or patient information leaflet before taking any medicines
- Choose tablets that you swallow instead of those that dissolve in water, unless they state that they have a ‘low sodium’ content
- Try to avoid caffeine-containing medicines
- If you’re suffering from a cold or blocked nose, always choose products that contain antihistamines such as Piriton (chlorpheniramine) or similar, use saline nasal drops/sprays, do steam inhalation or use chest rubs such as mentholatum.
For more information, contact Behram’s Plaisance Pharmacy:
- Telephone: 4 345 783
- Email: email@example.com