Wonder drugs!

Here’s a riddle for you (and me actually). Four people, four different conditions, but only one medication to cure them all, what is the medication? I’ll elaborate and give you the conditions:

  • 25 year old girl with packet-a-day smoking habit has had chronic bronchitis for over 2 months.
  • 27 year old girl has sudden and very intense hormonal problems with nausea,  lumps in the breasts and fatigue for 3 weeks out of 4.
  • 27 year old boy has severe allergic reaction to god knows what, breaks out in hives, has full body rash, faintness, sweating, the works.
  • 27 year old girl has chronic shoulder problems, with possibly some inflammation around the joint.

So, what do you think is the wonder medication prescribed to these 4 people, by (incidentally) the exact same GP? Now, I’m not saying the good doctor is wrong, please be aware that I have no medical training and am not able enough to make such judgments, I’m just saying I find this interesting…

It’s Prednisolone, or better known as steroids.

But you might have guessed that… because it’s a very common reaction of GP’s to whip out the old steroids, be it corticosteroid cream for ANY skin condition (and I mean ANY, with capitals, yes), and now apparently Prednisolone for any… eh… other condition. In every one of these cases (and I’m not saying there was never a need of steroids, mind) the GP in question had a look at the person for 5 seconds, a look at the chart for 30, and a look at the medicine cabinet and then the bill for about 360 seconds.

Also, and this is VERY important as we’re not just giving out sugar pills here, at no time was there an explanation on how the drug works, what side effects it will probably have, which side effects it might have that need medical attendance, or what counter effects it will have on other medication. Now that is just sloppy and lazy. I think… personally…

But let’s start with what prednisolone does. It reduces inflammation. My simple understanding of the things is that it mimics a hormone that you would make in the adrenal gland (corticosteroid) to reduce swelling and inflammation. This is incredibly useful when you’ve got a big allergic reaction. You can for example take antihistamines, followed by prednisolone to take down the symptoms that occurred. Awesome. People with chronic severe allergies can live a more pleasant life with steroids, as they are not constantly under attack by their symptoms. Also with people that suffer from chronic inflammation like rheumatic arthritis, asthma and Crohns disease, this drug is literally  a life saver sometimes. There is a big list of conditions that steroids can be used for:

http://www.rxlist.com/prednisolone-drug/indications-dosage.htm

Awesome again. Is it then really such a wonder drug

Hm… maybe, maybe not. I had a good look at this website and realised that  most of it really should be directly communicated and at the very least put on paper for the patient upon distribution. This webpage describes a (very long) list of side effect and precautions:

http://www.rxlist.com/prednisolone-drug/consumer-side-effects-precautions.htm

a few that jump out at me are:

Side effects:
Nausea, heartburn, headache, dizziness, menstrual period changes, trouble sleeping, increased sweating, or acne may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

‘side effects’ means undesirable symptoms caused by this medication. It’s stuff that will possibly occur because it is known that it can have this effect on your body. It is actually quite difficult sometimes to be able to notice the difference between side-effect and persisting or worsening side effect though.

The side effects are followed by:

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

That kind of implies that I’ve been evaluated by my GP, but what to do when you haven’t really, and what if you, when you think of it, don’t think the benefit is greater than the risk? The word `risk` also implies that you’ve put yourself in a dangerous position. I reckon most people that started on these meds hadn’t really thought of it like that. Not at any point in all 4 cases have the patients been told that this medication puts them at risk.

Also I found this list of side effects and interactions:

http://www.rxlist.com/prednisolone-drug/side-effects-interactions.htm

it’s a big list, and I don’t expect you to read it all, but maybe just get the impression of the extent of it.

That’s a lot, and a lot to look out for, yet we didn’t get this on a sheet of paper when we left the hospital, nor were we told to look it up on the interwebs.

Precautions now, as these are very important as well:

Before using this medication, tell your doctor or pharmacist your medical history, especially of: eye disease (such as cataracts, glaucoma), heart problems (such as heart failure, recent heart attack), high blood pressure, liver disease, kidney disease, thyroid problems, diabetes, stomach/intestinal problems (such as diverticulitis, ulcer), brittle bones (osteoporosis), current/past infections (such as tuberculosis, positive tuberculosis test, herpes, fungal), bleeding problems, blood clots, mental/mood conditions (such as psychosis, anxiety, depression), low salts in the blood (such as low potassium or calcium), seizures.

Wow… is there really a doctor out there that would take the time to ask about these things? We don’t know that he or she needs to know these things before we take this medication. When we don’t know that these precautions exist, we might very well choose to not bother them with the fact that we have a wee lurking herpes infection or have low potassium, or we might simply forget to mention it.  I can imagine… It’s such a flash visit, you’ve got like 10 seconds to give your medical history until they lose interest and start working on notes/prescriptions/bills.

This drug may make you dizzy. Do not drive, use machinery, or do any activity that requires alertness until you are sure you can perform such activities safely
No one told us that… and that’s important.

This medication may mask signs of infection. It can make you more likely to get infections or may worsen any current infections.

The annoying thing is that it seems this medication is sometimes given for an infection (with the chronic bronchitis for example). Doc should know this right? Right? I’m not sure if I’m right here, but it seems strange. 25-year old chimney smoker was on the steroids for about 2 weeks and hardly felt better, apart from breathing slightly easier. She was still coughing ugly things up. That to me sounds like she’s got an infection that’s not going away.

I think that is about all I can put into an already massive post. I think I’d like people to be aware of the risks that come with taking ANY kind of medication, and especially when taking it while not generally well. Side effects might very well occur, but when you have the slightest feeling they aren’t right, let someone know. When you feel dizzy on blood pressure medication, you’d rather have a doctor tell you (after examination!!!) that you are fine, than end up with kidney failure (true story). We’ve only got the one body, it’s an incredibly finetuned little machine that runs on thousands of types of fuel. To just put in another type of fuel might mean things will go wacky, so just be aware.

Also your doctor might know best, if he or she knew everything about you, but sometimes, be it because you have a new GP, or an old one that doesn’t necessarily remember you all that well,  they will only know a tiny little detail about your life and health. Often there just isn’t enough time. Not enough time for you to explain yourself to them, and not enough time for them to explain themselves to you.  The only thing you can do personally is squeeze in as many questions  and history as you can and do your research. Even when that annoys them, you should. It’s your body, it’s their 10 minutes of work, who wins when it comes to being most important?

Again, I also want to mention that Prednisolone is a very useful medication, but it’s also a very serious drug. My rant was triggered by the careless distribution of one GP, and does not mean all GP’s that give patients steroids are therefore bad, bad people. I think we need to know that medication is useful and dangerous. Both of those. Also, information is power, easily obtained power. The internet is your oyster…

Jude

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1 Comment

  1. You could certainly see your expertise in the work you write. The arena hopes for even more passionate writers like you who aren’t afraid to mention how they believe. All the time follow your heart.

    Reply

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