Skin reaction can be lethal

Q. Doctors sometimes ignore dangerous drug reactions. I recently ended up in the hospital after taking terbinafine pills. Three doctors called my reaction a rash, but it wasn’t. It was actually Stevens-Johnson syndrome. Too many doctors don’t know about Stevens-Johnson syndrome. This drug reaction can kill you. It’s been more than a month, and it looks like it will take months more before I am fully recovered. Only one doctor out of the four identified the problem so it could be treated.

A. Stevens-Johnson syndrome (SJS) can be lethal. It is far more serious than a simple drug rash. Medications that can trigger SJS include anticonvulsants, antifungal medications such as terbinafine and itraconazole, some antibiotics and even certain pain relievers. Patients must be warned about symptoms of potentially life-threatening reactions. We provide a list of the common errors doctors may make when prescribing and critical questions patients should ask to avoid becoming statistics. These can be found in our new book, “Top Screwups Doctors Make and How to Avoid Them,” available in libraries, bookstores and online at www.peoples- pharmacy.com.

Q. My son battled warts for years. They were on the bottoms of his feet, under his thumbnail and on his knee. We used many over-the-counter products and even had the one on his knee burned off twice. A student at my school told me that his doctor recommended Tagamet. Taking two pills a day got rid of the warts within a month. We tried this. It took about a month, but all my son’s warts shrank away and never came back. This was more than a year ago, and to this day my son is still wart-free.

A. Dermatologists disagree about the value of this treatment. Some prescribe it and some deride it. A review of the literature found no conclusive evidence one way or the other (Journal of Dermatological Treatment online, Nov. 6, 2010). Despite this, many readers report success treating warts with cimetidine (Tagamet).

Q. I have irritation in my digestive tract, with possible bleeding in the small intestine. Which is better for me to take, baby aspirin or enteric-coated 81 mg aspirin? I have taken a baby aspirin since the early ’80s. At some point I switched to enteric-coated aspirin. When I started Niaspan more than a year ago, I increased it to three per day.

A. Doctors have recommended enteric-coated aspirin to protect the stomach from irritation that could lead to ulcers. The special coating on these pills keeps the ingredients from being released in the stomach. Instead, they are dispersed in the small intestine. New technology has allowed physicians to view the small intestine and discover that it also is quite susceptible to damage from aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) (Clinical Gastroenterology and Hepatology, January 2005). Aspirin may be too risky for you. Talk to your doctor.

2011 King Features Syndicate, Inc.