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Viveka
refutation bias


Registered: 10/21/02
Posts: 4,061
Last seen: 7 years, 4 months
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Notice how doctors and anyone practicing medicine... 3
#19233218 - 12/05/13 06:34 PM (10 years, 2 months ago) |
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...seem to act as if they have a pretty shit capacity for attention to detail?
Was in the ER today and was prescribed 800mg Ibuprofen(daily dose instructions are 6x the max dose listed on a bottle of store bought, lol), 5/500 Vicodin and Ciprofloxacin. I get home, reading about Cipro, and I see that, "Coadministration of ciprofloxacin with other drugs primarily metabolized by CYP1A2 results in increased plasma concentrations of these drugs". In fact it's a strong inhibitor of CYP1A2. CYP1A2 breaks down Acetaminophen.....so why the hell didn't he prescribe a lower APAP Vicodin? Didn't the FDA just make a big turnaround on the overly-gratuitous APAP content in hydrocodone pills? Fuck sakes. It's probably not worth doing a CWE for a couple pills at a time, I'd lose too much hydro. So I guess I'll just pummel my liver with it, hell, it's the American way.
Also, over the past four days as I've been taking store-bought ibuprofen at home, I've developed sores on my cheeks gums and lips. It makes it hurt like hell to eat anything. I'm reading online this is a common problem with ibuprofen. When the doctor took a look at it(as he was swiping a big wooden tongue depressor all around my lips, ouch motherfucker!) he says it looks like a virus. Oh, ok then. Can't argue with that kind of empirical evidence. Surely there's no chance it could be reaction to Ibuprofen, which he has now prescribed me 600% per day of the max over the counter daily dosage.
I swear man, it's like once they get busy in practice all the meticulous detail of med school goes out the door.
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k00laid
NEMO


Registered: 05/03/10
Posts: 19,636
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Re: Notice how doctors and anyone practicing medicine... [Re: Viveka] 1
#19233229 - 12/05/13 06:35 PM (10 years, 2 months ago) |
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"looks like a virus"
funniest thing i've heard all day.
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Mush4Brains
LOOL HACKED!!!

Registered: 07/31/13
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Re: Notice how doctors and anyone practicing medicine... [Re: Viveka]
#19233231 - 12/05/13 06:36 PM (10 years, 2 months ago) |
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Quote:
I'm reading online this is a common problem with ibuprofen.
I've never heard of such a thing with ibuprofen.
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unknown1123
Experimental

Registered: 05/15/08
Posts: 5,813
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Re: Notice how doctors and anyone practicing medicine... [Re: Viveka]
#19233979 - 12/05/13 09:13 PM (10 years, 2 months ago) |
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Sounds like you don't have good insurance
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koods
Ribbit



Registered: 05/26/11
Posts: 106,395
Loc: Maryland/DC Burbs
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Re: Notice how doctors and anyone practicing medicine... [Re: unknown1123] 3
#19234000 - 12/05/13 09:16 PM (10 years, 2 months ago) |
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Sounds like someone didn't get the drugs they were seeking.
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NotSheekle said “if I believed she was 16 I would become unattracted to her”
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Joban

Registered: 06/09/13
Posts: 145
Last seen: 10 months, 17 days
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Re: Notice how doctors and anyone practicing medicine... [Re: koods]
#19234033 - 12/05/13 09:24 PM (10 years, 2 months ago) |
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I worked in a pharmacy for years. The carelessness of some doctors blows my mind.
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akira_akuma
Φύσις κρύπτεσθαι ὕψιστος φιλεῖ


Registered: 08/28/09
Posts: 82,455
Loc: Onypeirophóros
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Re: Notice how doctors and anyone practicing medicine... [Re: koods]
#19234035 - 12/05/13 09:25 PM (10 years, 2 months ago) |
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well, shouldn't he be prescribed something that works?
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unknown1123
Experimental

Registered: 05/15/08
Posts: 5,813
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Re: Notice how doctors and anyone practicing medicine... [Re: akira_akuma]
#19234078 - 12/05/13 09:35 PM (10 years, 2 months ago) |
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Quote:
akira_akuma said: well, shouldn't he be prescribed something that works?
5mg of hydrocodone will suppress the pain of most injuries and/or pain troubles that you happen to fall into, with almost every person. Of course not if you have a fucked up injury or fell off of a building...
Not saying OP is looking for opiates but I hate the junkies that get prescribed what the normal drug is for that injury/surgery/whathaveyou and complain the doctor doesn't know his shit. News flash, he/she does, you're just a junkie.
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akira_akuma
Φύσις κρύπτεσθαι ὕψιστος φιλεῖ


Registered: 08/28/09
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Re: Notice how doctors and anyone practicing medicine... [Re: unknown1123] 1
#19234082 - 12/05/13 09:35 PM (10 years, 2 months ago) |
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or maybe he has a different pain threshold then you or i, or the other guy?
who's to say, other then him?
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unknown1123
Experimental

Registered: 05/15/08
Posts: 5,813
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Re: Notice how doctors and anyone practicing medicine... [Re: akira_akuma]
#19234108 - 12/05/13 09:42 PM (10 years, 2 months ago) |
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Quote:
akira_akuma said: or maybe he has a different pain threshold then you or i, or the other guy?
who's to say, other then him?
like I said, wasn't really talking about the OP
I don't even think the OP complains about the narco's, just APAP and the other 2 things
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hidenseek1
Its got all the dinks.
Registered: 12/22/12
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Re: Notice how doctors and anyone practicing medicine... [Re: akira_akuma]
#19234118 - 12/05/13 09:44 PM (10 years, 2 months ago) |
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the virus has probably lowered his pain threshold
-------------------- You can drink at 7 A.M., because the Beastie Boys fought for that right -------------------------------------------------------------------------- pons asinorum -------------------------------------------------------------------------- lsd and the vietnam war changed music forever
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akira_akuma
Φύσις κρύπτεσθαι ὕψιστος φιλεῖ


Registered: 08/28/09
Posts: 82,455
Loc: Onypeirophóros
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Re: Notice how doctors and anyone practicing medicine... [Re: unknown1123]
#19234133 - 12/05/13 09:47 PM (10 years, 2 months ago) |
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Quote:
unknown1123 said:
Quote:
akira_akuma said: or maybe he has a different pain threshold then you or i, or the other guy?
who's to say, other then him?
like I said, wasn't really talking about the OP
I don't even think the OP complains about the narco's, just APAP and the other 2 things
well, it was a hypothetical question, with a hypothetical answer.
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pcplease
Salame

Registered: 09/02/11
Posts: 6,089
Last seen: 9 years, 11 months
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Re: Notice how doctors and anyone practicing medicine... [Re: Viveka]
#19234284 - 12/05/13 10:24 PM (10 years, 2 months ago) |
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@OP You got two very common prescriptions, and both are safe (yes, even in those amounts for a short period of time) to take together. If you hadn't got ibuprofen with your hydrocodone/APAP you would have gotten 5-6x the daily dose of naproxen (Brand name Alieve) instead.
Sores are not a common reaction to any NSAID less an allergic reaction, but presumably, judging by the doctor's reaction, your sores looked more like those caused by viruses as opposed to allergens.
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skatealex2
////////////////


Registered: 07/04/08
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Re: Notice how doctors and anyone practicing medicine... *DELETED* [Re: pcplease] 1
#19234337 - 12/05/13 10:38 PM (10 years, 2 months ago) |
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Post deleted by skatealex2Reason for deletion: Ffffff
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koods
Ribbit



Registered: 05/26/11
Posts: 106,395
Loc: Maryland/DC Burbs
Last seen: 7 minutes, 36 seconds
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Re: Notice how doctors and anyone practicing medicine... [Re: skatealex2]
#19235485 - 12/06/13 08:14 AM (10 years, 2 months ago) |
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By the way, OP, the CPY450 route is the secondary pathway that creates toxic metabolites when the normal pathway has been saturated.
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NotSheekle said “if I believed she was 16 I would become unattracted to her”
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lovesexdubstep
buy the ticket, take the ride


Registered: 12/18/11
Posts: 665
Last seen: 5 years, 4 months
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Re: Notice how doctors and anyone practicing medicine... [Re: koods]
#19235550 - 12/06/13 08:48 AM (10 years, 2 months ago) |
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you could always, you know, not go to the doctor.
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 molly lucy maryjane resident med student, PM science based questions
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badchad
Mad Scientist

Registered: 03/02/05
Posts: 13,373
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Re: Notice how doctors and anyone practicing medicine... [Re: Viveka]
#19235609 - 12/06/13 09:12 AM (10 years, 2 months ago) |
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The difference in the OTC dose vs. the prescription dose of ibuprofen doesn't mean its dangerous. However, when you get into doses that large, a physicians supervision is recommended. This is exactly why it's a prescription only.
CYP interactions don't necessarily increase harm (although they can). Often, it's just an increase in plasma levels (Cmax and AUC).
-------------------- ...the whole experience is (and is as) a profound piece of knowledge. It is an indellible experience; it is forever known. I have known myself in a way I doubt I would have ever occurred except as it did. Smith, P. Bull. Menninger Clinic (1959) 23:20-27; p. 27. ...most subjects find the experience valuable, some find it frightening, and many say that is it uniquely lovely. Osmond, H. Annals, NY Acad Science (1957) 66:418-434; p.436
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koods
Ribbit



Registered: 05/26/11
Posts: 106,395
Loc: Maryland/DC Burbs
Last seen: 7 minutes, 36 seconds
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Re: Notice how doctors and anyone practicing medicine... [Re: badchad]
#19235747 - 12/06/13 10:09 AM (10 years, 2 months ago) |
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Quote:
badchad said: The difference in the OTC dose vs. the prescription dose of ibuprofen doesn't mean its dangerous. However, when you get into doses that large, a physicians supervision is recommended. This is exactly why it's a prescription only.
CYP interactions don't necessarily increase harm (although they can). Often, it's just an increase in plasma levels (Cmax and AUC).
Like I said above, acetaminophen itself is not toxic, it is its metabolites that are toxic.
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NotSheekle said “if I believed she was 16 I would become unattracted to her”
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Viveka
refutation bias


Registered: 10/21/02
Posts: 4,061
Last seen: 7 years, 4 months
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Re: Notice how doctors and anyone practicing medicine... [Re: koods]
#19237286 - 12/06/13 04:21 PM (10 years, 2 months ago) |
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Quote:
koods said: Sounds like someone didn't get the drugs they were seeking.
Quote:
lovesexdubstep ( ) said: you could always, you know, not go to the doctor.
Hah, well I smashed my balls really effectively in a dumb fall and only after two days when my scrotum was the size of a large grapefruit did it seem prudent to go in. And everybody who knew what was going on with my nuts was screaming at me to go in at that point. For days before this I'd been dealing with unusual, intense pain and tension in my SCM in my neck and had excruciating neck and headaches for days in a row. So by this point the combined pain and difficulty in mobility was pretty intense. I'd been using ibuprofen and aspirin to get me through but it was barely cutting it. The vicodin has been a blessing even just the two I had yesterday and one today so far.
Quote:
pcplease said: Sores are not a common reaction to any NSAID less an allergic reaction, but presumably, judging by the doctor's reaction, your sores looked more like those caused by viruses as opposed to allergens.
Can viruses cause ulcers? There are certainly many other things that can cause them. I'm pretty certain what I have are mouth ulcers - they are white or greyish-yellow sores a few millimeters across with a distinct, thin red border. That is the definition of a mouth ulcer from what I've read. I also stopped smoking the day my neck/headaches got really worse so I hadn't smoked for about 4 days when the ulcers kicked in and I've been reading that stopping tobacco can cause ulcers. I only smoke couple smokes a day but it still seems plausible. I also found this thread and lots of mentions elsewhere that ibuprofen cause cause mouth sores. When these things are bad, it's pretty rough, because eating is torture. Take it from this guy:
And to whoever I said I don't have good insurance, how do you figure? Does having "good" insurance somehow magically prevent medical professionals from doing stupid shit? And while I'm sure it's not as good as what Warren Buffet has I do have relatively good insurance so you lose bud.
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