There was a "thunderclap" in the corridor of the hospital. It turned out that Director Li of the Department of Cardiology was doing ward rounds, clutching a prescription tightly in his hand, and his face was pale.
- "Who wrote this?" Director Li's voice echoed throughout the ward, causing the little nurses to bow their heads in fright.
- On the prescription, a 32-year-old lactating female patient was diagnosed with hyperlipidemia, hypertension and gout. The drugs are atorvastatin calcium tablets and hydrochlorothiazide tablets. This is simply a combination of "stepping on thunder"!
- Director Li first scolded: "Atorvastatin calcium tablets are forbidden to be used in lactating women! Who taught you to prescribe medicine like this?" The audience was silent, and the doctors looked at each other and thought: "This is miserable, the director is really angry."
- However, Director Li's "anger" has not been extinguished. He continued to widen his eyes, pointed to the hydrochlorothiazide tablets on the prescription and said, "High blood pressure combined with gout, you still dare to use thiazides? This will aggravate the patient's uric acid problem! What do you think?"
- At this time, the atmosphere in the entire ward had dropped to freezing. The doctors thought to themselves that this time they really stabbed the hornet's nest.
- Finally, Director Li took a deep breath and said earnestly: "Prescribing medicine is not child's play, and every decision may be related to the patient's life. Everyone should always be vigilant and not make such low-level mistakes!"
Atorvastatin with hydrochlorothiazide
In the above scenario, we saw that Director X of the Department of Cardiology was furious because of an improper prescription, and the two drugs involved in this prescription - atorvastatin calcium tablets and hydrochlorothiazide tablets, today, we will comprehensively popularize the two drugs of atorvastatin and hydrochlorothiazide, as well as their precautions in clinical use.
1. Atorvastatin calcium tablets: lipid-lowering drugs should also be used with caution
Atorvastatin calcium tablets, as a representative of statins, are widely used in the treatment of hyperlipidemia and the prevention of cardiovascular diseases. It mainly lowers cholesterol levels in the blood by inhibiting cholesterol synthase, thereby reducing the risk of atherosclerosis and coronary heart disease. However, as Dr. Li emphasized, atorvastatin is not suitable for all populations.
Atorvastatin is a definite contraindication especially for lactating women. The ingredients of the drug may be passed on to the baby through breast milk, posing an unknown risk to them. It should also be avoided in pregnant women, patients with active liver disease or abnormally elevated liver enzymes, and people with allergies to statins. Even in the general population, long-term use of atorvastatin may cause side effects such as abnormal liver function and muscle pain, so regular monitoring is required.
2. Hydrochlorothiazide tablets: the choice for blood pressure lowering, but not all-round
Hydrochlorothiazide tablets are a commonly used thiazide diuretic that lowers blood pressure by increasing renal excretion of sodium and water, and is an effective treatment for many people with high blood pressure. However, it is not suitable for all people with high blood pressure.
In the scenario mentioned by Director Li, the patient also had gout, which is a special factor to consider when using hydrochlorothiazide. Because hydrochlorothiazide interferes with uric acid excretion, it may cause an increase in blood uric acid levels, which can worsen gout symptoms or trigger gout attacks. For this reason, doctors often avoid thiazides when prescribing antihypertensive drugs for people with a history of hyperuricemia or gout.
In addition to patients with gout, hydrochlorothiazide should be used with caution in patients with renal insufficiency, electrolyte abnormalities (e.g., hypokalaemia), and allergies to sulfonamides. In addition, long-term use of hydrochlorothiazide may also cause abnormalities in blood lipid and blood glucose metabolism, as well as increase the risk of osteoporosis.
3. The way of medication: individualization, prudence and monitoring
From the contraindications and precautions for the use of the above two drugs, it is not difficult to see that drug treatment is not simply "prescribed for the right medicine", but needs to comprehensively consider many factors such as individual differences of patients, concomitant diseases, and potential drug interactions.
- Individualized care: Each patient's physiological status, genetic background, lifestyle, and comorbidities are unique, so treatment should be tailored to the patient's specific situation.
- Use with caution: Doctors must carefully assess the efficacy and risks of medications when prescribing, especially when using medications with potential side effects or contraindications.
- Regular monitoring: Medication is often a long-term process, and regular monitoring can help not only assess efficacy, but also identify and manage potential side effects or complications in a timely manner.
Returning to the story itself, although Director Li's anger frightened the medical staff present, behind his anger was a deep concern for patient safety and a lofty sense of responsibility for the medical profession.
Atorvastatin and hydrochlorothiazide play an important role in lowering blood lipids and blood pressure as commonly used therapeutic drugs. However, as the saying goes, any drug needs to be used with caution. Through an in-depth understanding of the indications, contraindications and potential side effects of drugs, we can use drugs more scientifically and rationally, so that drugs can truly become a powerful tool to protect our health.