Hypochondriasis

Also known as Medical Students' Disease. I'm pretty sure I caught it.

It's finally Thanksgiving Break! Unfortunately my sniffing and sneezing is getting in the way of my relaxation. The problem is that I'm terrified to take something that might help me sleep, like NyQuil. NyQuil contains pseudoephedrine that helps to relieve nasal congestion by shrinking swollen nasal mucous membranes. Today we learned that the pseudoephedrine also causes an increase in the secretion of a "natural drug" produced by the body called norepinephrine. Norepinephrine directly increases the heart rate and therefore increases blood pressure.

Flashback 12 hours: Lecture 2, Case 3: 45 year old female with history of depression comes in with a cold and cough. You, the doctor, tell her to go home and take over-the-counter cough medicine. She takes 2 tablespoons of NyQuil. Two hours later she experiences cardiac arrest.

So, the problem was unfortunately the doctor didn't ask about other medications the patient might have been taking. This woman was taking medication for depression (MAO Inhibitors) that prevent the breakdown of norepinephrine. So, one medication (NyQuil) increases the release of norepinephrine that directly increases the heart rate and the other drug (for depression) prevents the break down of this "natural drug," further increasing its effect on the heart. Result: cardiac arrest.

No, I'm not taking anti-depression drugs. But, maybe the Tylenol I took earlier (for which the mechanism of action in the body is still debated) or the Mucinex I just took (that is so potent that it should only be taken every 12 hours) has some component that will interact with a component of NyQuil and stop my heart, or neurons, or liver....

The simultaneously fascinating and extremely scary thing about being a med student is learning about these things you never really considered before. This also includes learning about how cancer develops (which I'm more than terrified about), or how many things have to go right in order to have a healthy, genetically normal and successfully delivered baby (without damage to the very fragile brachial plexus).

I hope this hypochondriasis is only temporary, but I have a feeling it might last for about 3.5 more years.