Diving and medication in general (spin off from beta blocker thread)

[violamama]

I was reading this thread: Beta Blockers and Pulmonary Edema , and now I have a questions about medication and diving.

As a musician, I take beta blockers occasionally and in extremely low doses (1/4 pill, rarely 1/2). This is a fairly common practice for musicians, particularly when taking auditions or playing in high stress situations. For me, I use them probably once every 8 weeks in single micro doses.

I hadn't thought of this as a risk. I don't take any other medication of any kind unless you count caffeine addiction, am in good health and have never had any kind of heart problem. I understand from the thread that there is not an empirically proven connection between beta blockers and diving injuries, but still I would like to know the answer to these more general questions:

1. Is there a way to look up the half-life of a medication in the body (besides paying for an appointment to ask that)?

2. If certain medication fundamentally changes the way a body works (which some of the things stated here about beta blockers seem to imply in terms of blood volume per heart beat), how can a patient best determine risk? How do they estimate how much they have to have taken and for how long in order to raise their risk factor?

3. If any of you have specific thoughts on my use of beta blockers in relation to diving, I'm all ears.

 

[TSandM]

I Googled "metoprolol half-life" and got a ton of hits that immediately gave the information that the half-life is 3 to 7 hours. I would assume you could do this with any medication you were considering taking.

In addition, pharmacists are actually quite good sources of information about medications. If you don't understand what your medication is actually doing to your physiology, having a chat with your pharmacist may clarify a great deal. So will doing some Wikipedia reading.

There is not a great deal of good information on the effects of medications on divers. Often, medical advice has to be given based on an understanding of the physiological effect of the drug, and the effects of diving, and an educated guess as to how the two will interact. In the case of IPE and beta blockers, a modest correlation between a rare malady and a common medication is appearing to show up, but correlation does not necessarily imply causality, and it may be the underlying conditions for which the drug is given that are actually at fault, or an interaction between the condition and the medication. At this point in what we know, nobody can quantitate the risks of diving while taking blood pressure medication at all, let alone any particular medication.

Taking it in very small doses and very sporadically probably isn't a significant risk, but unless we studied a population who did that, we really couldn't say for sure.

 

[violamama]

So what you're saying is, in order to provide an adequate population for study more high-strung performing artists should be diving?

Seriously, though, thank you for the response. I really appreciate it.

 

[TSandM]

Yup -- I can see the fun in trying to recruit for THAT study!

In today's litigation-prone world, you are always going to have trouble getting a doctor to say anything is SAFE, unless there are studies to support that position. We're all going to hedge -- "ought to be", "probably is", "issues are unlikely" -- but none of us is going to draw a line and say something is okay. How willing you are to stick your neck out and advise someone to go ahead and do something has a lot to do with your basic risk tolerance, and whether you've ever been in any kind of legal trouble.

 

[diverdoug1]

If you have a concern about a medication with respect to diving risks, the safest course of action is to discuss it with a physician who is a specifically trained and certified diving medicine specialist.:doctor:

In general, if a person chooses to dive and is otherwise healthy but has hypertension which is well controlled by a moderate dose of a beta blocker, I will clear them to dive. I would recommend continued home bp monitoring as well as patient education re: warning signs for bp spikes and stroke.