When Dolly Sen entered the emergency room of a reputed hospital a few months ago, she was expecting relief from the dizziness caused by her soaring blood pressure
Case (20 Marks)
When Dolly Sen entered the emergency room of a reputed hospital a few months ago, she was expecting relief from the dizziness caused by her soaring blood pressure. The doctors there administered an ‘emergency’ drug that reduced her blood pressure so precipitously that she suffered a blackout. When she was discharged two days later, doctors told her that she was lucky to have survived at all. Others however may not be so lucky. The drug, a short acting calcium channel blocker used commonly in emergency control of high blood pressure in India, can actually precipitate such a rapid fall in BP that the body’s normal functioning could spin out of control and lead to death. Capsules of the drug are available under brand names such as Calcigard, Cardules, Depicor and Depin. Although the ‘sustained release’ variety of these same drugs are safe, the ‘immediate-release’ versions can be dangerous. For this reason, textbooks that the medical fraternity would sweat by, such as Goodman and Gilman’s Pharmacological Book and Braun- Wald’s Cardiovascular Therapeutics, advise against the use of the fast-relief drug. The British Medical Journal says that the drug may actually increase mortality. The USFDA, too, warns against its hazards. The medical textbooks go on to caution that the high blood pressure should not be brought down so rapidly. It could trigger reaction symptoms and result in electrical disturbances of the heart, paralytic attack and even death. However, only the better-equipped health centers have started using safe options. In most other hospitals and dispensaries, the drug is in common usage. Senior officials in the Union health ministry say, tongue firmly in cheek that the drug is most suitable for “bringing down blood pressure in VVIP patients.” Top cardiologists, of course, have almost dumped it. Senior cardiologists at Escorts hospital, Ravi Kasliwal says, “it’s use is now greatly restricted. But some doctors might prescribe it if BP is very high. Now, there are safer options available.” Another senior cardiologist at the All India Institute of Medical Science, K. K. Talwar, who uses “better drugs”, says that they try to avoid using these formulations considering the risks involved.
Answer the following question.
Q1. W.r.t the above facts, explain the various issues relating to public safety.
Q2. What remedial measures do you suggest to prevent the misuse of the BP drug?
When Dolly Sen entered the emergency
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