Sleepless Doctor

When Yuan Xiaoli heard about mitochondrial diseases, he was more inclined to what Academician Lin said.

But when he heard the whisper of the apprentice brought by Academician Lin, his brows wrinkled involuntarily.

Every ward round must be recorded. Surgery may not be good at this point, but the internist does it very well. Muscle memory has almost been formed.

Without even thinking about it, this missing piece of past history must have been added to the hospital after I slept last night.

Is it athlete's foot? What's so interesting, Yuan Xiaoli thought.

Internal medicine records everything that can be recorded in every detail, and they have their own opinions on this. Yuan Xiaoli stared at Academician Lin closely, observing his expression.

Academician Lin frowned first, then moved his eyes to the screen, as if looking carefully at the medical record, and as if there was something new.

His eyes were shining brightly, wondering if it was reflecting the light and shadow of the screen.

Is it athlete's foot? No, how can athlete's foot be related to the quadriceps. Yuan Xiaoli looked at Academician Lin in a daze, observing suspiciously.

After 32", Academician Lin stretched out his right hand and patted Academician Guo's arm.

"Old Guo, come and see."

"I've seen the first journey." Academician Guo stopped to speak.

"Not the first trip, but the ward round last night."

Academician Guo was taken aback, what's so interesting about the rounds at night? He just skipped that paragraph and didn't read it.

The hospital has a three-level ward round system. At night, it is the records left by the doctor on duty or the general inpatient treatment of patients.

For the two academicians, there is no need to look at everything in every detail, especially the content of the ward rounds, if the irrigation is serious, just jump and watch.

Academician Guo stood up, walked behind Academician Lin, and squinted at the computer screen.

"here."

Academician Lin stretched out his hand and pointed to a line on the computer screen and said.

Others are also curious. Except Yuan Xiaoli, no one knows what happened last night. I wanted to go over to see what happened, but I was afraid of squeezing into Academician Guo.

The old man was in his seventies. He looked tough and energetic, but he accidentally bumped him. What should I do in case of a fracture?

And there is no respect for the elderly.

Someone has sat down quickly, turned on the doctor's workstation, and started looking for the ward round record last night.

Anyway, there are not many records of the course of the disease. Although I don't know what academician Lin said, I just read it all over.

"Is itraconazole used? It turned out to be so." Academician Guo said, "It's no wonder that there will be quadriceps pain."

"Did itraconazole increase the concentration of simvastatin?"

"should be."

The voice of the two elderly people communicating with each other was very small, and Yuan Xiaoli barely heard it with his ears erected. He felt nervous. Is there a drug reaction to itraconazole and simvastatin?

No, it's not stated in the instructions, where is the drug reaction!

At this time, other people also saw the record of the illness that was recorded in the hospital last night, and knew that Academician Che had athlete's foot, and he was treated with itraconazole.

One month ago, less than a week after that, there was pain in the quadriceps.

Not many people knew about the drug reaction of simvastatin. Everyone was whispering. After more than ten minutes, Academician Lin and Academician Guo looked at each other. Finally, Academician Guo returned to his seat and coughed slightly.

"Let me just say a few words." Academician Guo said, "Now that the situation is obvious, it is Academician Che who took itraconazole orally for the treatment of athlete's foot a month ago. This drug changes the concentration of simvastatin in the body. There was quadriceps pain and decreased muscle tone."

"Does Academician Che still take simvastatin by mouth now?"

"Yes, I'm still taking it orally." said the director of the Department of Neurology of the Imperial City People's Hospital.

"If you stop simvastatin, your quadriceps pain will get better after a week." Academician Guo said.

"Old Guo, is itraconazole and simvastatin related?" the director asked in confusion.

"Statins are widely used clinically, but some patients may have adverse reactions. Muscle pain and weakness is one of the most serious side effects." Guo Lao said, "But it is very rare in clinical practice. I have only seen two of them so far. Cases of similar patients."

Everyone was solemn and listened to Academician Guo's words.

"In fact, it is not so rare that statins cause muscle pain and weakness, at least not as rare as we have seen.

Generally speaking, the doctor will tell when prescribing the medicine, and the patient himself will also pay attention to it, and stop the medicine once it feels uncomfortable. "

Everyone nodded. Normally, if they had time, they would say something to the patient. But the specific details depend on the situation at the time.

"The most dangerous point is that the interaction between statins and other drugs increases the blood concentration of statins." Academician Guo said seriously, "This point must be paid close attention to clinically."

"There are few relevant studies now, and you don't know it is normal." Academician Guo, seeing the director of the Department of Neurology lower his head, comforted him, "In recent years, there have been research papers on the interaction between statins and other drugs. The effect between simvastatin and itraconazole ~www.wuxiaspot.com~ increases the plasma concentration of simvastatin by 10-20 times."

"Moreover, the time to increase the concentration will not be rapidly decayed by stopping oral itraconazole."

"If you must take itraconazole, you can suspend simvastatin; or switch to statins that are not affected by cytochrome cyp3a4 inhibitors, such as fluvastatin."

"If simvastatin must be used, antifungal drugs should be used with cyp3a4 non-inhibitory antibacterial drugs, such as fluconazole."

"Academician Che's situation is clearer. Do you have any different opinions?" Academician Guo asked.

Yuan Xiaoli was a little confused. His eyes were full of khaki colors. As for the sunglasses and lambskin gloves... he couldn't see it at all. He felt like he was lying in front of Wu Mian, and he could only see the windbreaker as far as he could.

Looking back on what happened last night, Yuan Xiaoli was a little horrified.

He glanced at the medical records and took photos and sent them. Wu Mian took a few minutes. What did he ask afterwards? Is there any athlete's foot in the car?

Why do you ask? Obviously he has already judged that Che Lao has taken itraconazole by mouth!

In other words, Wu Mian immediately determined that the quadriceps pain and weakness were due to the drug reaction of simvastatin.

During the whole process, Wu Mian derived it backwards!

He saw the essence of the problem at a glance, and then looked for clues from the beginning.

It may not be athlete's foot, but other drugs that require oral itraconazole. It's just that athlete's foot is more likely and more common.

Unknowingly, Yuan Xiaoli had replaced the concept of athlete's foot with athlete's foot, and unknowingly, he was as "soiled" as Wu Mian.

This kid is really awesome! Yuan Xiaoli had to admit this.