♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi Brad Heineck, physical therapist.
- Hi I'm Chris the pharmacist.
- And today we're gonna talk about Losartan
for high blood pressure, what are the side effects
and the risks that you need to know.
Chris is gonna go through this in detail,
he's gonna answer all your questions.
But before we go any further,
we have a little business to take care of.
- All right.
- And if you're new to Bob and Brad
or if you're not, you know this.
bobandbrad.com, go to there for the giveaway.
We have an incredible giveaway today.
We've got six exercise strengthening products
with our name on 'em, we love 'em.
Or you can go to Facebook,
it's pinned to the top of the page.
Or if you want the 62nd version, you can go
to Twitter, Instagram or to the infamous TikTok.
Anyways, let's get rid of this.
- All right.
- What are the giveaway?
So if you sign up for the giveaway,
you can win all these in one package.
We have the grip strengthener which we in, well not we,
but we had a rock climber invent this, it's a great way
to strengthen your grip. - I love that thing.
- Look at this, this whole box comes
with five straps like this with nice red handles.
We got our name on those as well.
We use those on a regular basis, we love 'em.
And we just started using the six or the large loop.
Have you used loops yet?
- I have not.
- But I have a feeling you're gonna get into 'em.
- Actually I'm gonna buy some cause, I like 'em.
- Your son, he's a hockey player,
it's gonna be real beneficial for him.
They all come in a nice box like this.
And this is the loop that goes around the waist
for hip abduction workout,
much, much better than the typical latex one,
much more comfortable, works great.
And... - Your favorite.
- The suspension straps.
This is one of my newest and more favorite workout devices.
Everything I do fits right at my wall.
I can get an incredible workout,
but let's get on with Losartan.
Chris, have a seat.
- All right.
- So, I'm gonna pretend that I just came from the doctor,
the doctor said you got high blood pressure, hypertension
and I'm already like, oh no.
And he says, you're gonna have to take this medication.
And he went through some of the rigor on how to take it
but I was so kinda nervous about, I kinda forgot.
I'm gonna go to the pharmacist and figure out
if I can get this squared out
and feel more comfortable about it.
Now, I didn't know this until a few years ago.
Chris is a pharmacist, I've known him from years,
but I actually went to where he distributes his medications.
And he does an outstanding job
on making his customers feel like they're knowledgeable
about the product, that medication they're gonna take.
And so that's the approach we're gonna take.
So, Chris can you talk a little bit about how people come
to, come for Losartan?
- Yeah, I sure can.
- And they're a little nervous sometimes,
or they're mad or what is this?
- I think there's a lot of emotions,
I mean, anytime somebody tells you
that something's wrong with you,
I think we somehow naturally kinda get
a defensive mechanism.
Oh my gosh, this is awful.
And I think a lot of times when you're not feeling well,
or in the case, like Losartan,
we're gonna, is a medication for blood pressure.
I'll bet it can be also used for a couple of other things.
But I mean, we'll just for simplicity.
- Is Losartan the name of it is that a generic name?
- No, generic name is Losartan, brand name is Cozaar.
It's the first angiotensin receptor blocker
that was out in the market, ARB for short.
- So what does that mean?
- That's how it works.
It's just all these drugs have their own little categories
and so they can have, you know, calcium channel blockers.
- So does that work with the heart directly
or does it work with--
- Actually indirectly, it's gonna work
on the blood vessels itself.
So, you know, if you were to come up
and hi Brad, this is a prescription for Losartan today.
It looks like it's gonna be a 50 milligram tablet daily.
Did your doctor spend a little time talking
to you about the medication?
- Yeah but I can't remember anything he said.
- No and you probably went through a lot
and it's a lot to hear in a lot process.
So why your doctor chose this,
he didn't like how he saw your blood pressure developing.
So he thought it was probably a little elevated
in all likelihood.
Does that sound like something
you guys may have talked about?
- Yeah and he said something about,
maybe what raised my risk for a stroke
or something like that, which is pretty scary.
- Well actually, it's gonna help to prevent strokes.
So by lowering the blood pressure, so.
- But a high blood pressure.
- High blood pressure can increase your risk for a stroke.
- Okay. - So, yup.
So by lowering it, so basically it relaxes, you know,
what it does in your body is it just gonna relax the vessels
in your heart and all around the heart
so the heart doesn't have to work so hard.
- So you would say vessels, you mean like arteries?
- Arteries, arterials.
- So they get, they relax and they get bigger?
- Yeah they have little receptors.
And so if you think of it as a hose,
so when things are--
- Garden hose?
- Garden hose, so well, yeah.
And so when it's wide open, you know,
water is flowing right through that garden hose.
When it gets cramped down, it comes through a lot harder
but there's a lot more resistance to squeeze
that water through that tiny hole.
- So the pressure goes up?
- Yeah, so if you think of your heart is the pump,
it has to work a lot harder to get
that water through the, well,
in this case, your blood, through your body.
- So it just relaxes the vessels, allows the blood
to flow through more easily with less pressure involved.
So then the heart, blood pressure goes down.
- Heart's not working so hard again,
so it works so pretty slick. - That's not so bad,
so I just take it twice a day?
- Once a day.
Well, no, your doctor's got you taking this once a day.
And actually the newer study is actually showing
it came about last year.
It might be better to take blood pressure medication,
most blood pressure medications at bedtime.
Diuretics gotta take the morning,
that's a different discussion.
- Okay.
- But we'll talk about for this one,
probably gonna do better at night.
Actually may be a 50% reduction in heart attack and stroke,
but you're taking your blood pressure
at the same time every day at night.
So the big thing to make any medication work well
is to take it consistently.
So it's important for you to take it
the same time every day or within a small window.
So if you're taking it at bedtime,
just take it approximately the same time every day,
that's critical for you.
- Okay.
Do I need to take it with food.
- This one doesn't matter, so, which is good.
- Doesn't matter, just water?
- Yeah a big glass of water.
So like eight ounces of water,
about six to eight ounces of water.
Some people don't like to drink a lot before bed
but you do wanna be hydrated.
- What if I, you know, football game or whatever I,
like a beer? - Beer?
No, well, the one thing that's kinda interesting,
that's a good point that you bring up.
You know, I mean, being from Wisconsin you know,
there's a lot of people that do probably enjoy a beer.
- Well Saturday night football before you go to bed.
- Exactly and so blood pressure, when you have a beer
or a glass of wine,
it is gonna naturally bring your blood pressure down.
So you could get lightheaded or dizzy,
which kinda leads us into some of the side effects
with Losartan.
So drinking alcohol--
- So I get lightheaded or dizzy
from the alcohol or the beer?
- The alcohol and the drug,
it's the combination of the two together.
Can, your blood pressure's here
and it can bring it down even further.
So let's say you're sitting down and watching the game,
you took your medication cause you got an hour to go
and then you stood up too quick.
All of a sudden you get really lightheaded or dizzy.
That's called orthostasis
and it's a fancy term that just says you're dizzy.
But some people can be so severe.
You know, you could hit your head on the coffee table and--
- So, it gets so dizzy, you fall.
- Yeah, so you wanna be real careful with that.
And as we age, you know sometimes our muscles don't work
as well as one another.
And this is probably a lot more in detail
what I would give to a patient,
but it's something to be aware of.
You know, we don't want you to take a tumble
because you could get hurt.
- That's right.
- So we have to be careful with that.
And actually it's so the first five days
while you're on drugs like Losartan,
it takes your body about that long
to start to begin to see that blood pressure lowering.
And then it takes about three to six weeks
for that maximum response to occur.
So you might have to go back and see your doctor
to see how things are going
and maybe they'll adjust as necessary.
- So I've got a lot of things going on here, how to take,
I feel a little bit better about it now
but there's some things, the side-effects.
What I've heard there's some side effects
that are, may not be good for this.
- Yeah, you know and it's kinda--
I mean all drugs have a ton of side effects
and if we listed--
- You're not making me feel good Chris.
- I know.
So basically we wanna focus on the major three.
Most side effects in general from all medications,
very, very uncommon across the board.
Now everybody's gonna have a story
of, well my uncle took this and it was horrible.
I mean, it can happen, we have genetic predisposition,
so certain drugs our race can dictate what drug
is actually better for us versus others.
So there's a--
- So we need to really depend
on our doctor. - Your doctor.
- He has made the--
- Your doctor did the homework,
your doctor prescribed this for a very specific reason.
And unfortunately, anytime we get a new prescription,
we're all lab rats.
You don't know what that first dose
is gonna do until you try it.
And sometimes it takes our bodies a few days
to get used to it.
So we wanna be real mindful of that.
So in case of the blood pressure medication, like I said,
takes about five days to start to kick in,
three to six weeks for that next response.
What we're gonna see is your blood pressures here
and it's gonna gradually come down.
It's not gonna come down like you're coming off a cliff.
If it did that, you could have some pretty serious problems
and that orthostasis we mentioned earlier, could be--
- But you're you're gonna feel some symptoms.
- You would.
- Light headed, dizziness.
- So lightheaded and dizziness are the primary things
that we always warn people about.
So how do you prevent that?
Well, you know, when you get outta bed in the morning,
don't just jump out of bed and walk across the room,
just sit up slowly, you know,
that's one thing that I find very important.
Let's say you wanted to tie your shoes
and you just popped right back up,
stand up slowly for the first couple of days.
Your body will naturally adjust.
But after about the first five days
you just take a little bit easier then.
- Sure.
- After that, you know, the side effects
are really becoming inconsequential with this drug.
I mean, the one thing that we wanna watch for
and if this is the only drug you're on,
it's not gonna be a big issue.
But sometimes people that have blood pressure issues
may take multiple medications.
This is a drug that is known to raise our potassium levels
and potassium, you know, this is gonna be a sidebar here.
But for the most part, we have to make sure
that we're not eating more potassium than we should.
A normal healthy diet where you having some bananas,
cantaloupe, potatoes, broccoli, those types of things,
are certainly fine, you just don't wanna--
- Those are foods that are high in potassium.
- High in potassium, oranges, orange juice,
those types of things.
So, you know you don't wanna have tons of it,
but I still think it's important to have a wide variety
of food in your diet.
So when you heard me say diet, diet's very very important
when people have blood pressure issues.
I mean, one of the coolest things
that most patients aren't aware of when they hear
the bad news that they have hypertension,
we can get you off these medications
with lifestyle changes in a lot of cases.
So if you're willing to put the work in
and exercise and you're willing to put the work in
and eat a healthy balanced diet
and you're willing to get some good rest and hydrate well,
we may be able to naturally,
with the weight loss that you can create,
you may actually get off of the blood pressure medicine.
And all it can be like 10 pounds,
might be enough depending upon where that level is,
you know, genetic factors withstanding.
So again, your doctor would probably tell you this,
but again, it's pretty overwhelming.
But here's something that you have hypertension,
I mean, do you think you're gonna have a stroke?
Do you think you're gonna have a heart attack?
Do you think you're gonna die?
It can be a terrifying experience for a lot of patients.
- So the biggest side effect I have to worry about
is monitor that I'm not getting lightheaded or dizzy
and if that's not happening, I trust my doctor.
He gave me the right one in combination
with the other medications I'm taking.
Also another pharmacist, you will be aware
of the other medications that patient's taking.
- Yup, we're gonna be looking at that exclusively.
- So you double check it?
- Yeah, we are, anal retentive to a fault.
I mean, we're gonna sit there and look
at that profile and make sure
that there's nothing cross-reactivity type-wise.
Cause people could come in for Losartan
and there could be another drug called,
like elekenese nedralyglose, lisinopril.
This is a total sidebar again.
We see, why are you getting this today?
Oh, I got a cough.
What's a primary side effect of that drug?
Well, discontinue that and we'll start this
cause too much together, all that potassium problem
could be an issue, light head, dizziness.
There's a lot of things that could go on there.
- So between the physician and the pharmacist,
you guys double check each other to make sure your--
- Oh yeah, there's phone calls, faxing, emails,
we communicate pretty readily with the nurse staff.
Usually we ended up with the nurse staff.
Double check with the doctor
and they really get back to us.
But we're looking for those things very hard.
Actually it's 90% of my job.
- Sure.
Well I feel a lot better so I can take it,
I know the side effects and if I want to take the effort
and change my diet, my exercise and my liquid intake, water,
you're saying I can get rid of these.
- It's very possible, very possible.
You gotta put the work in.
And it might take a little bit of time, but you know,
working with your doctor and knowing
that you've got a plan to work ahead,
I mean, you can live a healthier lifestyle.
But I will point out, you know,
all drugs do have side effects, even the positive effects
of the drug are a side effect.
We just learned that that was the good part of it.
So, if something bad happens
or let's say you're losing consciousness,
you're really dizzy, you don't feel right,
you're nauseous, just thinking your heart's racing.
Just something's, I mean,
when we take many different medications, you know,
if it's weird, reach out to your pharmacist, reach out
to your doctor right away.
Because if you don't feel right, it could be a possibility
that there's something going on.
And the other thing we didn't touch on, if you're pregnant
or thinking about being pregnant,
Losartan is not a good drug for you.
- Oh, that's good to know.
- So it's tradagenic, which means--
- Well not for me personally?
- Not for you personally, but we'll say Liz, you know,
but anybody that has a childbearing age,
it's important to have probably a backup plan
if we're trying to avoid pregnancy.
Or, you know, maybe we have to try
and find a different medication
if that's the family plannings in the future.
- Okay, well good.
And, this is, I feel a lot better about it now, Chris.
- All right.
- And hopefully that same experience you will feel
after you see your doctor, your pharmacist.
And you know, I didn't realize it,
but that is, one of the jobs of the pharmacist,
is to help you understand what you're taking.
- Yup, that's what we hope to do for everybody.
- That's right.
Very good, can you do anything for a broken heart, Chris?
- I can fix a lot of different things
but I can't fix a broken heart, I'm sorry.
- Well then you're not gonna be able
to help Bob and I on that quest.
(laughs) But anyways,
carry on.
- Have a great day guys.