Another episode, another article in our House, M.D. Project. This time it’s episode 3 of season 1, called Occam’s Razor. Occam’s Razor, by the way, is the name of a principle that says that the simplest explanation tends to be the best one. This is one of the rules in medicine, similar to “What’s common is common” or “When you hear hoofbeats, think horses, not zebras”.
In any case, on this episode a nineteen year old guy named Brandon collapses during sex. He also has cough, fever, abdominal pain, low blood pressure, a rash, kidney failure and later low white blood cell count, neuropathy (painful tingling in the fingers and toes) and then hair loss.
Not too many diseases can do all of these things together. Indeed, this guy didn’t have a disease per se, but an overdose of a drug called colchicine. Instead of giving him an anti cough medicine, the pharmacist gave him a drug that looks similar (but doesn’t have any letters on, as the genuine cough medicine would).
Dr. House and Dr. Wilson at the pharmacy in the Occam’s Razor episode. Photo by Fox Broadcasting Company. Credit: Mitch Haaseth/FOX..
What is colchicine?
Colchicine is a drug used to treat gout. Gout is an inflammation of joints caused by high levels of uric acid in the blood. We already discussed it here in the past.
Colchicine. Read on about the possible side effects and you might understand the skull drawing on the bottle.
What can it do?
According to web site Epocrates Online, these are the things colchicine can do to you. We explain each medical word in simple terms. Please note: As with each drug, a list of side effects doesn’t mean you will definitely get them all, or even one of them. In the House episode many of them appeared both because the guy had an overdose, and because, well, it’s TV.
Serious reactions:
1. Myelosuppression – This means suppression of your bone marrow, where your blood cells are created. When our bone marrow is suppressed, we can have anemia, be more prone to infections, and we may bleed more easily.
2. Leukopenia (lack of white blood cells – responsible for fighting infections), thrombocytopenia (lack of platelets – responsible for stopping bleeding), granulocytopenia (lack of a type of white blood cells also responsible for fighting infections), pancytopenia (this means lack of all types of blood cells altogether) – All of these can happen when your bone marrow is suppressed.
3. Diarrhea, severe – Well, this doesn’t require any explanation, does it?
4. Myopathy – This means an inflammation in your muscles, causing them to be weak, among other things.
5. Rhabdomyolysis – This means breakdown of muscles.
6. Neuropathy – This is something the guy in the show had at the end, and it means an inflammation of nerves. It can cause tingling, pain or a lack of sensation in our fingers.
7. Hepatotoxicity – This means a toxic effect on our liver.
8. Nephrotoxicity – This means a toxic effect on our kidneys.
9. Multiple organ failure, including fatal – This means that instead of just one organ in our body having problems (like the liver or kidney above), many organs stop working properly altogether.
10. DIC – This means “disseminated intravascular coagulation”. It’s a condition in which blood clots form inside blood vessels throughout the body while at the same time bleeding can happen.
11. Hypersensitivity reaction – This means an allergic reaction to a drug. It can be anything from a rash or fever (seen on the show) to a potentially fatal condition called anaphylaxis. The latter one can show up as a low blood pressure (like the guy on the show had).
12. Azoospermia – This is a condition in which a person doesn’t have enough sperm in the semen.
Common reactions:
1. Diarrhea, nausea/vomiting, cramping, abdominal pain
2. Fatigue
3. Headache
4. Pharyngolaryngeal pain – This means pain in the throat and mouth.
Words marked in orange are symptoms the guy on the show had.
Summary
There you have it. A simple change of a pill, plus overdosing on the new one can certainly kill you. Don’t try this at home kids…
What next?
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