Adverse Drug Reactions and Other Delights

For problems that tend to persist

Take a look at what’s on the drug list

     Symptoms varied and strange;

     A small patch of the mange?

Find a drug we can stop, I insist.

I enjoy making people feel better.  Finding the problem and improving the patient before they leave brings a wonderful feeling.  Occasionally I get a doctor’s moment, when my strengths come together, I ask the right questions, and heal with words; it doesn’t happen often.

Every year or two I cure a man’s headache by moving the wallet to a front pocket.  Once or twice a year I fix a woman’s headache by reducing the load in her purse; more often by getting her to either loosen her hairstyle or cut a couple of feet off her hair.

I really enjoy watching people get better when I stop drugs rather than starting them.

The three top drugs I love to hate are nicotine, alcohol, and caffeine, in that order.  True, I get more than half my business from them, but I’m at a phase in my career when I want to slow down anyway.

The top prescription drugs I love to stop are the statins, like Lipitor, Crestor, and Pravachol and others.  If a person comes in with otherwise inexplicable bone, joint, or muscle pain, I judiciously ask them to stop the statin (if they’re on one) and come back in a week or two.  More than half the time the pain is gone and the patient is grinning.  Then I start the hard process of getting the cholesterol under control either with a statin plus coenzyme Q 10, or by turning to other agents.

Many a patient came in with a dry, hacky cough and no other symptoms, and asks if it might be the lisinopril (or other angiotensin converting enzyme= ACE inhibitor) prescribed for high blood pressure.  Of course it could be, I said.  In fact, it probably is, so stop that drug (the entire class can give such a cough) and start this other drug, an angiotensin receptor blocker, or ARB.  And come back in a week or two and we’ll see how you’re doing.  The shift from an ACE to an ARB is pretty straightforward.

If a person takes a drug and the drug is distributed throughout the body, one would think that an allergic skin reaction would be throughout the body’s covering.  Very difficult to diagnose is the fixed drug eruption, where a small part of the body, less than six square inches, reacts to a medication; it is well described in the medical literature.

There are at least two case reports of people who had a rash in reaction to tap water.  Now if a person can have a rash in response to water, then any person can have any reaction to any drug. 

Thus we get to one of my governing first principles, ABCD: Always Blame the Cottonpickin’ Drug.


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5 Responses to “Adverse Drug Reactions and Other Delights”

  1. John Brooks Says:

    As a statin-induced myopathy sufferer I can wholeheartedly confirm the case of statins’ adverse effects; they are (or can be) heartbreaking indeed. Drug manufacturers should be horsewhipped for pursuing their commercial interests regardless of “collateral damage”.

  2. Lori Jessen Says:

    It seems to me that on some of the prescription drug commercials on TV that the list of side effects appear to be almost as bothersome as the condition they are treating.

  3. thenonconformer Says:

    Medicare in Canada, Quebec is too often a joke.. One day at the Hospital. 1/3 of the employees times is on lunch, supper, coffee, rest breaks. A hospital is not a place for employees to have a good time, to socialize on the job with their friends and to visit the other medical staff. Doctors even often make false assumptions about the patient’s sickness that are not scientifically based, personal opinions explain why you can see 5 doctors and receive 5 different diagnosis too often now too. Nurses themselves often to me do admit they do not read in detail patient’s charts, files nor do they follow all the medical prescription schedules as well.. Managers and Ombudsman tend to be a pretentious service. I told one nursing manager to stop playing around and get back to work and she said she was going to file a grievance report against me, I rightfully repeated my request to her.. stop playing and get back to work. It is not my duty is a common excuse why things now also are not being done.. Very sick Patients diapers are changed when the staff feel like it too often.

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