Thanks to Lilac Master @ Medical Observation for sharing
One patient, who had been treated with oral calcium atorvastatin for 10 years, developed liver failure 3 days after developing pneumonia.
The patient is only 45 years old, but oral calcium atorvastatin has been 10 years old.
Patient: Male, 45 years
Brief medical history: The patient suddenly lost vision in one eye 10 years ago, and the local hospital diagnosed "1. Cerebral infarction 2. Hyperlipidemia", given routine symptomatic treatment for 2 weeks, control is acceptable, during which no underlying diseases such as hypertension and diabetes were found.
Instructions: Quit smoking and alcohol, regular oral atorvastatin calcium tablets, enteric-coated aspirin. Regularly review blood routines, liver and kidney function, etc.
Insist on re-examination, but sudden liver failure?
10 years ago, atorvastatin calcium tablets were the best hypolipidemic drugs, while stabilizing arterial plaque and having a good effect on preventing blood clots.
Atorvastatin calcium is mainly metabolized in the liver, and although lipid-lowering is good, it may cause severe liver damage and rhabdomyolysis. This has a lot to do with personal physique, the chance of appearing is not large, but the consequences are more serious.
The patient was instructed to perform after discharge, and a review of liver function six months before the onset of the disease also showed normal. The patient has been abstinent from alcohol for 10 years and has no history of hepatitis, so how can he suddenly have liver failure?
I took azithromycin on my own and almost died
Three days ago, the patient visited our hospital with fever and cough, and after chest x-ray and blood routine tests, he considered "pneumonia". The doctor recommended hospitalization, which the patient refused.
After returning home, the patient took azithromycin tablets on his own, two tablets orally on the first day and one tablet daily thereafter.
On the third day after taking the drug, the patient suddenly appeared nausea, vomiting, right upper quadrant pain, yellowing of the skin and mucous membranes all over the body, and strong brown urine. So he went to the hospital for treatment, and the examination found that the transaminases and bilirubin were seriously elevated, and the urea nitrogen, creatinine, and blood ammonia were all elevated.
Despite aggressive treatment, indicators are gradually increasing, and "progressive hepatic necrosis" is considered.
On the third day of admission, the patient developed psychiatric symptoms, which manifested as panic and confusion.
He was immediately treated with artificial liver support, removed harmful substances from the blood, and finally saved the patient from the death line.
Commonly used drugs are misunderstood
Statin lipid-lowering drugs are mainly metabolized by the liver, which requires an enzyme called CYP3A4 to accelerate metabolism. It can be metabolized without this enzyme, but it can speed up the metabolic process by a thousand times. Azithromycin, on the other hand, inhibits this enzyme, which can cause statin metabolism to slow down thousands of times in the body, resulting in drug accumulation. The side effects of statins have a lot to do with their concentration in the body, which is why there are such serious consequences.
There are 7 commonly used statins, divided into three generations. Antibiotics are also divided into many kinds, when he encounters other commonly used drugs, do you know the contraindications to medication? Even fruits can affect metabolism!