Not Heart Failure
I wasn’t giving in to the patient who wanted a prescription for Levaquin after the standard ZeePack didn’t cure his cough. He had a normal chest x-ray and labs the day before but was convinced that he had pneumonia. I tried explaining the difference between bacteria and viruses. I used the “RAID doesn’t work on dandelions” routine. He wasn’t convinced.
“I NEED a stronger antibiotic to break this up. Levaquin has worked in the past.”
“You know, I think I’m going to start you on some heart medications, instead. Some nitroglycerin and some Lasix for your heart failure.”
“Whaaat? I don’t have heart problems. I had a normal stress test a few months ago. Why would you want to start me on heart medications?”
“You have risk factors for heart problems and coughing is a sign of heart failure. I should probably start you on Digoxin, too. Ehhh … maybe not. That’s kind of strong medicine to start out with.”
“This is ridiculous. My chest x-ray and blood tests were normal yesterday. I don’t have heart failure. I’m calling my doctor and I’m not taking any of those medications.”
“Your chest x-ray was normal. That means you don’t have pneumonia, either. And bronchitis is a viral infection. Levaquin isn’t going to help your symptoms any more than the heart medications would. Do you see my point, now?”
[long pause]
“I’ll just call my doctor.”
I can only imagine what conversation sounded like.
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This and al...
Source: WhiteCoat's Call Room - Category: Emergency Medicine Doctors Authors: WhiteCoat Tags: Patient Encounters Source Type: blogs
More News: Bronchitis | Cardiology | Cough | Emergency Medicine Doctors | Heart | Heart Failure | Levaquin | Nitroglycerin | Pneumonia