Monday is the day for administrative rounds, and the dean, vice dean, and head of the medical department must all participate.
This time it was Chen Xia's turn to go to the pediatric department.
Chen Xiadu is already an old acquaintance in the pediatric department. The three little ones in his family have received meticulous care from all the pediatric staff, so he was familiar with the ward rounds this time.
During administrative rounds in other departments, the director is always the first to lead the way, wearing a white coat and followed by a group of younger brothers and sisters. He looks so majestic and cool.
But it was completely different when it was Chen Xia's turn to make rounds. Although he was the vice president, the directors of these departments were all of his father's generation, and were his elders after all. How could he dare to act like the boss?
This is easy to get beaten.
The old director doesn't care whether you are the vice president or a war hero. If you don't do it, he will slap you on the head.
Like now, the director of pediatrics, Liu Shumei, is a veteran in the hospital, and Vice President Chen can only smile and follow her into the ward obediently.
Director Liu's strictness and fierceness are well-known throughout the hospital. The young doctors who followed him dared not even breathe and tried to hide behind others, for fear that they would not be able to answer the director's questions. Then they could only wait for the storm.
Chen Xia was the most relaxed at this time. Anyway, the questions would not be directed to him. No matter how domineering Liu Shumei was, she would not attack a hospital leader.
So he didn't even have the interest to squeeze forward to act as the leader. He just followed behind the team, chatting and laughing with Yao Yinping.
Yao Yinping is also the only girl in the whole hospital who has had an affair with Chen Xia.
But there was really nothing between these two people. Anyway, at that time, Chen Xia was wholeheartedly serving Gu Lin as a servant. The little girl probably had this thought, but so much time had passed that she had long since let it go.
Just as the two were whispering, they suddenly heard crying coming from the ward in front.
This is the voice of a little girl: "I don't want the injection, I don't want the injection, I don't want to get fat, I don't want to get dark, I don't want to become ugly, wuwuwu~~~~"
Will getting an injection make you fat, darker, and uglier? What kind of sorcery is this?
Chen Xia squeezed forward with a head full of questions, and what caught his eye was a little patient about 10 years old sitting on the hospital bed, crying and wiping his tears, crying very sadly.
The key point is that the little girl is indeed chubby, but her skin is relatively dark, and the hair on her face has increased significantly.
"Director Liu, what's wrong with this kid?"
Liu Shumei stroked the little girl's hair and sighed:
"This is a child with childhood asthma. She suffers from recurrent attacks every year. Every time she comes to the hospital, she has to be given dexamethasone injections to relieve her asthma. She used to be very slim and pretty, but now, look at her..."
Dexamethasone injection, which is a long-acting hormone.
The biggest side effect of excessive use in children is that it will inhibit their growth and development. In the long run, it will also cause avascular necrosis of the femoral head, osteoporosis and fractures.
Another side effect is a more serious change in appearance, which is medically called Cushing's syndrome.
It manifests as a moon face, that is, the whole face is fat and swollen, sometimes as if it has been beaten.
There is also central obesity, where the belly is large and fat, but the limbs are very thin and long. The most important thing is that hair grows, just like hirsutism.
If a girl uses it for a long time, her appearance will gradually become more masculine. In a word, she will be further away from beauty and slimness.
If you don’t know, just think about the female singer who sang “That is a magical road to heaven~~~Yeah~~~~” and you will understand.
Whether it is growth inhibition or osteoporosis, these are internal factors. They cannot be seen or touched, so children don’t care.
But her appearance is getting uglier and uglier, and she is getting fatter and fatter, which is a fatal blow to the little girl who loves beauty. This is also the reason why the little patient cried and shouted that he didn't want to have an IV drip today.
Chen Xia glanced at the medication record and saw that this was the dexamethasone injection.
Childhood asthma has been confirmed to be a chronic airway inflammatory disease in later generations, presenting as an allergic state. Therefore, decades later, pediatricians rarely use antibiotics on children, and will not give intravenous hormones at will except for severe asthma.
In more stringent areas, anyone who wants to use hormone injections must obtain approval and signature from a doctor at the rank of associate chief physician or above. Furthermore, the hormones used are short-acting hormones such as methylprednisolone and prednisone.
If any doctor dares to prescribe dexamethasone injections for children, he will be despised by all his medical colleagues. It is said that there is either a problem with his medical skills or a problem with his medical ethics.
The most commonly used method for treating asthma in children is "nebulization inhalation".
Commonly used drugs for nebulization: The first type is glucocorticoids, which is Pulmicort Respules, also known as budesonide suspension, and another commonly used one is beclomethasone dipropionate.
The second category is β2 receptor agonists, also known as bronchodilators. The most commonly used is Bricanyl, which is a nebulized solution of terbutaline sulfate. Another type is Ventolin nebulized solution, a salbutamol sulfate solution.
The third category is anticholinergic drugs, the most commonly used of which is Atropine, which is ipratropium bromide solution.
The advantage of nebulization inhalation is that you don’t need to take medicine. The medicine is directly converted into aerosol through the nebulizer compressor and inhaled into the trachea and lungs through the nose to achieve a targeted drug delivery effect.
It has definite efficacy and few side effects and is one of the mainstream treatments for childhood asthma.
But back in China in 1986, doctors believed that asthma was an inflammation. No matter what kind of patient came, they would prescribe two kinds of medicine: antibiotics and dexamethasone injections.
Is this treatment okay?
Yes, the effect is quite good.
But when it comes to medication for problem children, it’s not just about whether you can do it, but also about whether you have side effects. Both are indispensable.
Just like this little girl, there is no need to use antibiotics during an asthma attack. It makes the same difference whether you use them or not. On the contrary, long-term use may cause bacterial resistance.
Excessive use of dexamethasone can lead to Cushing's syndrome, which is why the little girl cried and said that she became fatter, darker and uglier.
Regarding asthma treatment, Chen Xia had seen too many strange "folk doctors" misusing drugs in his previous life.
There was a doctor who was very famous in the local area. According to folklore, he was very skilled and all the medicines he prepared were prepared by himself, and the effects were very good.
But he was later caught by the Food and Drug Administration. Let’s not talk about his illegal medical practice, but where did his “miracle medicine” come from?
It is a mixture of hormone tablets, ketotifen tablets, and sulfamethoxazole tablets in extremely large doses, 10 times the normal clinical usage range, ground into powder with a juicer, and then infiltrated into the licorice mixture.
Just shake it before drinking. A bottle of this "miracle medicine" costs no more than 3 yuan, but it is sold for 50 yuan. Moreover, one bottle can only be consumed for 2 days. Patients need to prepare multiple bottles every time. It is really a fortune for him.
Another type is the "miracle medicine" purchased online. I won't tell you where it's produced specifically, so as to avoid any readers from making false accusations. To put it bluntly, it's actually a large dose of hormones.
It's simply murder for money.
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