Saturday, July 13, 2013


   In medicine we often use drugs and get 'used ' to it so much , that we don't even think twice about writing a script any time .But then comes a patient or we learn about an incidence that make us think twice. The story that I am going to tell today is one such .
    The Aspirin has been in the use for many years . It was invented in 1897. Felix Hoffman of the Bayer company , was credited for the invention . But then there was another chemist , who was Jewish , who claimed to be the one whose work was purged by Nazi, as he was a Jew . In any case it was marked for aches and pain and the fever . It was widely used in the flu epidemic and was thought to have helped . Though some believe that children died because of the use of aspirin . We use it today everyday . In fact it is used for heart attack and there are studies that show that it prevents colon cancer too . Since it is 'over the counter '  drug , we use it without any thought for the safety . If it was prescription drug , then we would have been seeing many TV ads on how it caused deaths or problem and 'how you may be entitle for the compensation'. So this is one such story .
    I was called  to see this patient , who was being admitted to ICU with respiratory failure . I spoke to the ER  doctor . Patient came to ER in respiratory distress , and they could not even intubate the patient . The ER doctor had to do emergency tracheostomy .I went to see the patient . He was a patient with a history of asthma . He had a cold and saw the primary care physician . He was given the prescription for an antibiotic . Patient went home and had not yet filled the prescription for the antibiotic . He felt like he had flue and so took the aspirin . Within very short time he started feeling like he could not breath . The wife called 911 . The paramedics came in less than 5 minutes . They put him on oxygen , gave him some shot and moved him to ER . HE continued to get worse and they could not put a tube down the throat in to main wind pipe ,to help him breath . When he was brought to ER , the ER doctor could not intubate him either ,as his throat was closing . So then he did tracheostomy .
    I examined him and the treated for asthma , though interestingly the asthma was not a problem at all .He really did not sound that bad . We weaned him off the respirator . We had consulted an ENT to fix his tracheostomy , as the one that he had done was done as an emergency procedure . He was off the respirator and the we had ENT do the repair of the tracheostomy . It took about 6 months to get it out . I still see him and his asthma is fairly stable .
    This was a typical case of severe allergy to aspirin . I am not sure if he had taken the aspirin before , but this time it almost killed him . He had a major reaction to  aspirin and he had swelling of his throat to such extent that if it was not for the ER physician or he was not brought to ER soon enough , then he would died
   I saw a case of acetaminophen killing a patient , recently , and I will talk about it next time ..

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