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Monday, January 23rd 2006

I'm Afraid

Don’t ask me for figures but plenty of medical students become little miniature “hypochondriacs;” especially in the early years. Actually, hypochondria is a serious condition that I shouldn’t make light of.

But really there are a lot of frightening things, not just diseases, mixed amongst the pages of our biochem and microbiology books.

Take what I’m looking at in biochemistry right now. I recently had a lecture on prostaglandins and thromboxanes.

That’s not important in and of itself. The important thing is that cyclooxygenase is an enzyme used in the production of these molecules. Efforts to inhibit a form of cyclooxygenase, COX-2, has led to Merck opening up its wallet.

These COX-2 inhibitors, such as Vioxx, were suppose to be the safer anti-inflammatory painkillers, developed to target COX-2, and spare another enzyme COX-1. They were to be our bodies’ friends, if you will, even going to far as inhibiting the development of some cancers.

Back to the story at hand. A few of your typical medicine cabinet painkillers (aspirin and ibuprofen) inhibit COX-2 and the inflammation it causes (good for reliving pain) but also its brother enzyme COX-1, which has to do with blood coagulation and gastric acid secretion.

Being the rational future physician I am I was sitting in class wondering if the next time I got a headache and then cut myself with a cheese grater (it could happen) if I was going to bleed out. And this is while I develop an ulcer from the increased acid secretion.

It turns out Tylenol (acetaminophen) is preferential for another form of cyclooxygenase, COX-3, which has nothing to do with bleeding or inflammation. Great news. No risk.

I went and bought some the next day.

Literally, twenty pages further in my biochemistry book (and several days later) I learn that this stuff is worse. Our bodies are so smart acetaminophen is metabolized, especially in the presence of alcohol, into something pretty nasty for our liver. More people make calls to poison centers involving acetaminophen than any other substance.

I think I’ll try incense from now on to help relieve minor aches and pains. I don’t know what I’m going to do however when we get to bacteriology later in the year in microbiology. All I have to say is that if Adriana Lima wants to make out with me, she better let me know before I learn what’s in her mouth.


I better go lay down…I think I feel a touch of a Hantavirus (studied last Thursday) coming on.