I can see health

Chapter 84 Licorice Tablets

Lu Chen was very happy and successfully gained a little gratitude.

After the old woman ate the snacks, her symptoms of hypoglycemia, such as palpitations and cold sweats, were much better.

Back in the duty room, Lu Chen couldn't sleep anymore.

He was woken up halfway, which made him sleepless.

He simply put on his white coat and came to the office.

The office was empty, and Teacher Min Ling should have gone to rest too.

Lu Chen sat in front of the computer and clicked on the testing system.

The little girl with hypokalemia who was admitted to the hospital in the middle of the night had blood potassium levels that had risen to 2.8mmol/L.

According to the doctor's order, Dr. Min Ling prescribed a few more potassium tubes, and the blood potassium will be checked again at [-] o'clock in the morning.

Taking advantage of his energy, Lu Chen focused his attention on the cause of "hypokalemia".

Take out a blank piece of A4 paper.

Lu Chen wrote all the common causes of hypokalemia on paper.

First, the intake of potassium is insufficient.Including fasting or anorexia, which had previously been ruled out.

Second, potassium excretion increases.

Loss of digestive juices, including diarrhea, severe prolonged vomiting and long-term gastrointestinal drainage, in addition to potassium loss of the skin.

These are also ruled out.

In addition, there is renal potassium loss.

Including the use of diuretics, hydrochlorothiazide, furosemide, etc., as well as renal disease, Cushing's syndrome, renal artery stenosis, reninoma, pheochromocytoma, and Liddle's syndrome.

Through the relevant examinations of the patients in the county hospital, they were all excluded one by one.

Finally, it is the abnormal distribution of potassium in the body, including heart failure, renal edema, excessive infusion, and insulin action.

These don't seem to match.

Lu Chen fell into deep thought again.

He kept flipping through the patient's medical records, and at the same time used his mobile phone to check related papers in the literature library, trying to find clues.

……

Time passed slowly.

Four in the morning.

Even relying on the super comprehension ability of the "literature reading" skill book, he still failed to find the reason for the girl's low potassium.

Is it really necessary to attribute her hypokalemia to "idiopathic hypokalemia" for which no cause can be found?
But if it is not a last resort, try to find out the cause of low potassium.

After all, this is just a teenage girl!

……

Five in the morning.

Lu Chen still hasn't found the cause of the hypokalemia.

He went back to the duty room, ready to squat for a while.

Because I have to get up again at six o'clock to test my blood sugar.

……

six in the morning.

Lu Chen opened his eyes, wearing a white coat, holding a blood glucose meter, and began to measure blood sugar from ward to ward.

At this time, most patients are awake.

Lu Chen has a lot of blood sugar to measure.

The journey of "jaking poking" has begun again.

"Auntie, the blood sugar is 6.2mmol/L, which is well controlled."

"Mother-in-law, your blood sugar is too high, it's 16.9mmol/L, did you eat something last night? Hey... don't eat at night, you see that your fasting blood sugar is high during the day!"

"Uncle, your blood sugar is 7.3mmol/L. Didn't take any medicine or insulin? If you continue to control your diet and exercise more, you may not need to take medicine to lower your blood sugar in the future."

.......
Go to the ward where the 12th bed is located.

After Lu Chen finished measuring the blood sugar of other beds, he came to the bed of the 12-bed girl.

The girl was lying on the bed, curled up in the corner of the bed, and was fast asleep.

"Is she better?" Lu Chen looked at the middle-aged woman beside him and asked softly.

"It's better, thank you doctor."

The middle-aged woman nodded, and then helped the girl tuck up the quilt.

"Ah That's good."

Lu Chen was about to leave when he was suddenly stopped by a middle-aged woman.

"Doctor, do you have licorice tablets in your hospital?"

"Licorice tablets?" Lu Chen stopped in his tracks, "What's wrong? She's coughing?"

"Hey, she has poor physical fitness since she was a child, and she is prone to colds and coughs."

The middle-aged woman sighed.

"Take cough medicine when you cough?" Lu Chen frowned.

"I can't help it, she keeps coughing, and we feel uncomfortable hearing her coughing." The middle-aged woman looked helpless and distressed.

"Didn't you check why?"

"I checked it. I went to all major hospitals in Jinghua to check it, but I didn't find out the reason."

"Auntie, but eating licorice tablets like this is not an option." Lu Chen frowned, "There is a substance in licorice tablets that can make people addicted."

Compound licorice tablets mainly contain licorice liquid extract powder, opium powder, camphor, star anise oil, sodium benzoate, etc.

Among them, opium powder has analgesic, sedative, and antitussive effects, and is a drug that easily causes human dependence.

Even at low levels, it can become addictive if taken over a long period of time or in high doses.

Therefore, taking compound licorice tablets for a long time may become addictive, and patients may experience pleasure and gradually develop desire and dependence on it.

"Addicted?" The middle-aged woman was stunned. "Doctor, then give us another cough medicine."

"Yeah." Lu Chen nodded, "However, maybe she doesn't have a bad cough, but she just wants to eat licorice tablets."

"I really didn't pay attention to this." The middle-aged woman said in a deep voice, "When I saw the doctor for the first time, he asked me to eat licorice tablets, but I have been taking them intermittently since then."

"How long has she been eating?"

"It's been half a year."

Lu Chen frowned.

Half a year?
This seems to be about the same time as her dizziness and limb weakness symptoms appeared!

Lu Chen held back the doubts in his heart.

He was going to check all the blood sugar, and then read the instructions of the licorice tablets to see if it caused hypokalemia.

Just like that, Lu Chen poked his finger faster.

Hit the nail on the head!

……

After measuring blood sugar, return to the doctor's office.

Lu Chen opened the doctor's order system, entered licorice tablets, and immediately popped up information about the medicine, including the adverse reactions of the medicine.

Adverse reactions of licorice tablets: slight nausea and vomiting reactions...

He did not see a description of low potassium.

"Isn't it because of the licorice tablets?"

Lu Chen frowned, and the thoughts he had just now were interrupted again.

"Xiao Lu, did you get up so early to check your blood sugar?"

At this time, Min Ling walked into the office.

She stretched and sat beside Lu Chen.

"I can't sleep, so I tested my blood sugar in advance." Lu Chen smiled.

"Yeah." Min Ling nodded slightly, glanced at Lu Chen's computer screen, "What are you looking for? Licorice tablets?"

"Yeah." Lu Chen nodded, "I just found out when I tested my blood sugar that the girl with hypokalemia last night had actually been eating licorice tablets, so I wanted to find out if the low potassium was related to this. It was not found."

When Min Ling heard this, she was startled.

"She's been taking licorice tablets?"

"Well, yes." Lu Chen looked at Min Ling suspiciously, not knowing why she reacted so strongly.

"There's no need to investigate, licorice tablets can cause hypokalemia!" Min Ling said in a deep voice.

"Huh?" Lu Chen was stunned.

Min Ling explained: "There are glycyrrhizic acid and glycyrrhetinic acid in licorice tablets. The chemical structure of these two substances is similar to that of corticosteroids, and they can directly act on mineralocorticoid receptors to play a role in maintaining sodium and excreting potassium, resulting in hypokalemia. .”

"Additionally, glycyrrhizic acid can enhance the physiological effects of other glucocorticoids, resulting in intracellular potassium shifts, leading to hypokalemia."

Lu Chen rubbed the back of his head, "But I didn't find this adverse reaction in the drug instructions."

"Drug instructions are updated only after a long time, and the information lags behind." Min Ling smiled, "Actually, your time in the clinic is too short. As long as you stay longer, you will understand this knowledge."

Lu Chen also only practiced clinically for a year, and he was exposed to more textbook knowledge.

Medicine is an empirical science.

In addition to textbook knowledge, practical experience is equally important!
"In other words, the cause of her hypokalemia is long-term oral administration of licorice tablets?"

"Probably yes." Min Ling nodded and looked at Lu Chen with a smile.

　Thank you Pepsi Colaway for your reward.

　　
　
(End of this chapter)