Hand over the damn Rx pad.

So yesterday I blogged about a patient taking 24 drugs. I'm going to post a brief list of those drugs just to show how retarded this MD is. BTW HIPAA-nazis -- this is completely fine as long as I detach all patient identifiers, so calm yourselves. Here is the list as best as I can remember with the indication attached, and a dose or two if it was especially obscene:

KCl -- Hypokalemia
Spectracef -- indication unknown
Metolazone -- HTN, Edema
Furosemide -- Edema (80 mg BID)
Lanoxin -- Arrhythmia
Carvedilol -- HTN Arrhythmia
Lisinopril -- HTN
Amitryptyline -- Insomnia
Vytorin -- Hypercholesterolemia
Levemir -- NIDDM (75 U BID)
Acarbose -- NIDDM
Januvia -- NIDDM
Clonazepan -- Anxiety
Niaspan -- Hypertriglyceridemia/Hypercholesterolemia
Accolate -- Asthma
Singulair -- Asthma
Combivent -- Asthma
Albuterol -- Asthma
Zyflo -- Asthma
Aspirin -- Anticoagulant
Plavix -- Anticoagulant
Synthroid -- Hypothyroidism
Citalopram -- Depression
Nexium -- GERD/Pyrosis

See it yet? I'll wait. Yeah there's an interaction between Nexium and Plavix, sure. The real golden nugget is the Niaspan. High doses of Niaspan or patients who cannot handle normal doses of Niaspan are subject to...edema (thus the metazolone and high dose furosemide(thus the KCl)), impaired Glucose Tolerance/increased fasting glucose (Levemir, acarbose, Januvia), arrhythmias (lanoxin, carvedilol), insomnia (amitryptyline), dyspepsia (Nexium), and dyspnea (Accolate, Singulair, Zyflo, albuterol, Combivent). Tally them shits up folks, one could make an argument that Niaspan created a need for 15 other drugs if this patient is in fact on too high a dose or Niaspan-hypersensitive. Do I think that Niaspan actually gave her a bajillion different symptoms? Certainly not. This does however make it blatantly clear that not only is this MD a shithead, but some pharmacist probably should have caught this some time ago. There's no real reason to not take her off the Niaspan (especially given that it increases PTT and the patient also takes two blood thinners, and causes myopathies and the patient takes vytorin which has two drugs that also cause myopathies), but she stayed on it for around 4 years while her med list grew and grew. You're basically weighing the likelihood of a patient having around 7 disease states that all started at the same time, or this patient just shouldn't take this one drug. BTW, this is something that a dispensing machine likely won't have the cogs to figure out and shithead MDs certainly won't -- thus the need for pharmtards was created. On to current events:

If you haven't watched Glenn Beck recently, you definitely lost the opportunity to burn out the reasoning centers of your brain. He asked the question “How can carbon dioxide be poison when it is naturally occurring and trees need it to grow?”. Here's a list of other things that are naturally occurring: snake venom, cool looking mushrooms, and monkshood -- care to try to sustain yourself on any of those? Also, no one with half a brain even argues that carbon dioxide is "poisonous" as much as it is "biologically useless" to humans. On his TV show later, Beck went on to show what carbon dioxide is by exhaling and then exclaiming "Look how much I just polluted!" Way to miss the whole point on global warming, guy.

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Its called "Have a coke and STFU"