Agraphia Medical Tragicomedy


Where’d you learn that, Cheech? Drug School?

Pharmacology scares me. Not because it's a lot of information (which it is), because each class of drugs contain countless specific variations (which they do), or because our notes are crappy (which they are).

No, pharm scares me because what we have learned is that drugs are metabolized differently from person to person. More fat and the THC from marijuana sticks around longer (good luck with the drug test, porky!). Less liver and drugs build up in your system. There are even people who get no pain relief from codeine because they simply lack the enzyme needed to make it work.

My point is that right now I'm reading about digoxin. Digoxin (affectionately referred to as "dij" by clinicians) is used to treat heart failure, but has a very small therapeutic window. What this means is that it is very, very easy to overdose - unlike, say, on Tylenol, from which thousands of angsty teenagers have failed to die over the years. What scared me was a throwaway sentence in our notes "in women, digoxin therapy for heart failure is associated with increased risk of death from any cause". I've added the italics for emphasis.

This makes me think that prescribing drugs will do more harm than good. Maybe I'll go be an alternative doc and prescribe acupuncture for everything.

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  1. zac, i am actually studying some meds myself. “dig” being one of them! while you are prescribing them, i’ll be looking for those wonderful reactions. so when you open your alternative practice- im with you! anyway good luck studying! hope everything else is going well! :-)

  2. Yeah my school doesn’t really go into pharm that well so i basically have to teach it to myself if i want to pass the USMLE. Plus everything goes by different names here. They don’t have tylenol–even the OTC stuff is different. Ugh. On the upside, you can get codeine OTC here. hm…. maybe for the flight home?

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