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Friday, October 09, 2009

Lactose Can Kill... and Other Misleading Headlines

A very, very bizarre story caught my eye. The story of the lactose that killed a woman.

Absolutely true, but also absolutely not anything that will affect you. Instead, it's a tragedy that contains a warning to all people who seek to take medications in unapproved, unauthorized, and dangerous variations. And I'm also using it as an object lesson in the way that stories can be slanted to take information and facts totally out of context to produce shocking but misleading headlines.

The best version of the story comes from the site

The story starts with the worldwide fears of a deadly flu outbreak. The H1N1 virus hit earlier this year, a virus that then seemed to be either new or a warped version of a older known killer version of the flu. While most cases were mild, with the most serious effects on those with what the media terms "pre-existing causes," patients were understandably scared and demanded relief, if not cures. With a vaccine not yet available, the only solution was antibiotics, specifically Tamiflu and Relenza.

Relenza, made by industry giant GlaxoSmithKline, is not a pill or a shot. Instead, it is a powder that is inhaled via the mouth through a special device the company calls a Diskhaler.

You would think that the existence of a special device would be enough of a warning sign in and of itself. Who would take the powder and find a totally different and unauthorized way of using it?

Yet such were the fears sent up by the flu outbreak that some people who apparently could not use their inhalers made up their own rules.

Glaxo has heard reports of its powdered form of Relenza being removed from its packaging, dissolving it in water, and converting it into a fine mist, a process called nebulization, officials said. Doctors may be modifying the composition of the drug in order to give it to patients who cannot take oral medications or inhale the drug. However, nebulization is not recommended for administering Relenza Inhalation Powder, the FDA said.

“The safety, effectiveness, and stability of zanamivir (Relenza) use by nebulization have not been established,” the FDA warned.

Relenza Inhalation Powder is a combination of zanamivir and a lactose drug carrier. When subjected to nebulization, lactose sugar in the product can prevent mechanical ventilator equipment from working properly, the FDA cautioned.

A pregnant woman - talk about pre-existing conditions - outside the U.S. used this nebulized powder for three days in a mechanical ventilator. As I've frequently noted, lactose - mostly tasteless and non-reactive - is used as a filler, coater, sweetener, and sealer in hundreds in medications.

Tragically, the lactose, never intended for use in this form or format, blocked the ventilator and the woman died. The FDA is contacting health care professionals to warn them against nebulization of Relenza.

I've also written about misguided parents feeding their infants soy "milk" instead of soy formula, leading to their deaths. That's similar to this case. Neither soy nor lactose is deadly. Totally inappropriate and improper use of them, of almost anything taken into the body, had serious consequences.

A bizarre tragedy. And a lesson.

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1 comment:

Anonymous said...

Tamiflu and Relenza are not antibiotics, but anti virals.