Doctors, What's The Rarest Condition You've Seen?

nurses doctors of reddit what's the rarest least common medication you've ever had to administer and why respiratory therapist i gave nebulized morphine to a sweet old lady who was dying very painfully in front of her family there were about 12 of us in the room including me the pa fought a pulmonary group that was covering the iq for the weekend that ordered it and her family 12 of us in a tiny room i didn't think about it at the time because i was very concerned about it being out of my scope of practice and because it was the weekend i didn't have a chain of command to really ask but you know nebulizing an opiate in a tiny room with a lot of people when the pa and i came out after four minutes in the treatment was finished i said i felt kind of funny and the pa laughed kind of weakly then sat down my pupils were pinpoint we also used to nebulize vodka for pulmonary edema although i've never done it so can't vouch for it a poop fecal transplantation at my first internship during nursing school there was a patient with a bowel infection caused by clostridium difficile a few months before he got treated with broad spectrum antibiotics for a pneumonia which caused the infection they tried other treatments to cure the infection but nothing worked eventually the patient got accepted in a clinic trial for a feckle transplant one of his kids was the poop donor after the transplantation the infection actually cleared up i love when fecal transplant stories pop up i had a doctor friend of a friend who wouldn't believe me a few years ago that feckle transplants were not only a real thing but also a valid treatment for c diff i am truly going to gloat silently about this for the rest of my life hahaha methylene blue i gave it to a girl who tried overdosing on aura gel the active ingredient is benzocaine which caused her to develop a methemoglobinemia treated with the blue drug it truly is an artificial looking bright blue and i gave it to her in her iv pharmacist here that showed up a few times as a drug which always made me chuckle because for so long in my head it was just something used to stain bacteria now i use it to stabilize technetium 99 meters examitazine methylene blue really has run a wide gamut as far as spheres in which its found use sodium thiopental truth serum in residency someone had a conversion disorder in a movie theater i know way back when it was a normal thing to do the entire place cleared out after the movie his buddies are talking and realize he's not getting up he finally tells them he is paralyzed and can't move medics brought him in he's laying in the gurney in the sitting position like he's an astronaut i walk in the room and think to myself why the foo work i go ahead and take his history go back and present him to my attending attending asks me what i want to do i'm at a serious loss here i have no freaking clue other than wait him out nobody's core is that strong he says we should give him fire pencil of course i say let's do it we go in with justice and a nurse he turns the lights off the nurse pushes the meds in my attending proceeds to walk this guy down with confidence and empathy like he's walking him through the worst lsd trip ever sure enough my attending asks him to realize that his arm is attached to his chest which is attached to his back which connects to his neck which connects to his brain he tells the guy now is the time to move your arm the kid moves his freaking arm amazing after a bit longer the kid is lying flat soon enough he's upper moving craziest crap i saw that year emergency medicine still not dull 10 years later maggots we had a drug addict come in who had let an infection go so long in his arm from repeated needle usage that all our attempts to clean it failed we ended up using maggots to eat away the dead tissue while leaving the healthy tissue intact dude just had an open wound full of maggots loosely covered in some gauze for like several days the worst part is always having to collect them afterward the medication most people are shocked by a c hydrochloride yep see it's a good vassa constriction agent and topical anaesthetic it was many years ago and i was working with end-stage cancer patients this one woman who began her treatment outside of the united states was given a mixture of c h alcohol morphine phenothiazine and some other anti-metics it was specially made into a liquid and imported from somewhere in europe i remember this made so vividly because it's not every day you give someone h i think it was called something like brompton cocktail and the lengths that were gaunted to check out and administer a dose of that stuff we're talking who's got the nuclear codes type of system i have to admit though it worked like magic yep brompton cocktail developed in the royal brompton hospital in london it can also contain chloroform water and thorazine and some formulations specified gin as the preferred alcohol apparently a gave an old manner m m one time when he was demanding a sleeping pill blood pressure was too low so doctor wouldn't order a real one worked great anyone saying that this is unethical please realize that this was done with the patient's safety in mind in a real world hospital safety is always the first priority things aren't always as clean neat perfect and morally sound as they are on grey's anatomy also i've done this maybe twice in 11 years this isn't common practice and it has happened in very very special circumstances when the family has been aware and agree encourage it i don't just go around lying to patients and giving candy instead of medicine on a daily basis my co-worker had to use something called hyuleronidase recently it's given sub when vancomycin infiltrates in a knife meaning that it gets out of the vein and starts pooling in the local tissue vanco is toxic at high levels and it kills the tissue so when this happens you have to give multiple small doses of this drug with a tiny needle into the surrounding tissue to break down the vanco and save the tissue hyaluronidase is also used to dissolve bad face fears lip filler and stuff if they turn out wonky or more serious if they are injected into a blood vessel which can cause necrosis not a doctor or nurse rather the patient i have a super rare liver disease called wilson's disease there are trace amounts of copper in everything that we consume for most people it's bound to your urine and excreted the normal way it was a mystery illness causing all the weird symptoms twice on the tv show house literally every single doctor i've come into contact with except for my liver consultant has remarked that they've never met a patient with wilson's disease and that it is one of the diseases that they learn about in medical school because of the weird ways it can manifest not only that but there are two different chelators drugs that help to bind copper which are used to treat patients with wilson's disease the more common of these two penicillin caused me to become immunosuppressed my immune system basically shut down and i had to go into isolation so not only do i have a ridiculously rare liver condition but i also get prescribed the less common drug that is used to treat it it's called trentine and i have long lost count of the amount of times i have been asked how to spell it some people have stars in their eyes but you've got rings by far not a doctor but a relative of mine had a lot of problem with allergic reactions especially on the skin where weird-looking welts would form after about a year of trying out treatments they eventually used a medication of which the basic component or ovaries of a hamster they had to repeat giving him those syringes a few times but then it was successfully treated sounds like urticaria hives which is an allergic type reaction omelet zuma is a drug that can be used to treat it and is produced in bioreactors from chinese hamster ovary tissue like a lot of of other similar drugs are it works by blocking id receptors therefore reducing histamine so is an indirect antihistamine when i was a travel nurse the nurse next door to me had a patient who was bitten by a rattlesnake was in pretty bad shape by the time they made it to the aiku because they were hiking in desert rural nowhere when it happened the two pharmacists which is already unusual brought the antivenom down to the unit like they were holding the keys to the ark of the covenant but seriously they were walking slowly and one of them was holding it and the other was holding their hands underneath it turns out the cost was something like forty thousand dollars a vial and the patient needed three total i didn't give the medication but it was one of the most interesting nights i've ever worked in the aiku and that's saying something i've gotten to give rattlesnake and to venom three times basically my former hospital would stabilize the betty by giving the initial doses of anti-venom in the ed then send them to my unit then i will base the decision for additional doses on my assessment of any symptoms and a call to poison control and written protocol it was interesting scary because after the protocol was initiated it was up to my nursing judgment whether to give more anti-venom or not which it how any protocol works but it was just weird following one with such an uncommon expensive three dollars k plus med demerol used to be a fairly common pain med but is rarely used for that anymore i used it once in the ed for this weird intractable tremoring that was thought to be a side effect of an experimental cancer treatment only used it because the oncologist asked that was kind of interesting pharmacy called me and thought i had lost my mind until i explained also got to give dantraline for post anesthesia malignant hyperthermia it's on all the tests but outside of maybe anethesia you don't see it so that was cool for me as well i literally used this last week to treat post anesthesia tremors it's the only reason we stock it in our pacu tuberculosis to treat bladder cancer not in healthcare but my grandfather has bladder cancer and one of the recent treatments was injections of tb i have no idea why i just know it didn't work i worked with a guy who had this done it was administered via the urine catheter not iv so apparently it causes the bladder cancer to be surrounded by fibrous scar tissue and slowly destroyed as the tb has difficulty leaving the bladder it just attacks the cancer and dies out after obligatory not a doctor but i realized recently i was laboring under the delusion that fentanyl was 100 illegal when i was given some in the aiku lem tell you that gave me pause in the middle of a high fever when i was getting a colonoscopy i remember the drugs they gave me said fentanyl or had fentanyl in the name of the vial as they were administering it to me i was like how that's interesting and then five seconds later completely freaked out of my mind lol it was a while ago that when i was a physician in the military i prescribed dabzone among a couple other unusual medications for a case of hansen's disease aka leprosy that a marine contracted in the middle east i was on the medical team caring for the patient but i remember orthopedics being heavily involved because somehow the disease was in the bone for those wondering in the west while leprosy is a disease people hear about because it's mentioned often in history it's something you learn about once in medical school and almost never see in civilian practice i'd also add i was not the person who made the diagnosis i just did what i was told by my attending i was an intern my friend was a pharmacist sometimes she had to fill prescriptions for c c hydrochloride i think the label read she said it was used in eye operations she had an empty bottle at home to show four kicks it had a skull and crossbones on the front this was in the early 80s i was told it didn't give the same recreational higher street coke because it was so pure i may or may not have experienced diverted chcl and hypothetically can confirm it is much different way more relaxing than no snow hypothetically of course car t cells engineered t cells from a patient that are modified in a manufacturing center after being removed from the patient then reinfused the products on the market x axicapta gene sodalusor goes for nearly five hundred thousand dollars in the us despite all the federal funding that went into its development the approved products are approved for pediatric or a type of leukemia and adult dlbcl a type of lymphoma always interesting to click on the show charge button when i verify these i don't remember the name of it it's been almost 10 years a hemophiliac suffered a traumatic amputation we had constant blood transfusing no massive hemorrhage but he was steadily leaking we gave him some sort of clotting factor replacement an iv dose three or four times a day pharmacy hand delivered each dose they ran about five thousand five hundred dollars each i think right now i'm giving a lot of remedies of it that'll be a cool story one day had a hospice patient who was getting a continuous infusion through an iv for uncontrolled pain from their terminal illness she was getting 30 milligrams of dilaudid an hour for those who don't know a typical dose is like 0.5 milligrams the pharmacist called me to clarify and i even had three other nurses verify and sign off on it with me and we had to outsource for the medication bc this one patient was basically taking up the entire hospital's store of it 30 milligrams would probably take out an elephant easily and she was just sitting up in bed talking i think someone told me later that she had some metabolic disorder also that wouldn't let her metabolize pain medicine like normal people do there used to be a psychiatrist in my area that would prescribe insane amounts of opioids to patients claiming that they had that metabolic disorder the most egregious script i ever saw was oxycodone 30 milligrams five tabs six times per day 900 pills per month maybe not quite as bad as that hydromorphodose but pretty ridiculous nonetheless the doctor lost his license by the way i worked on a gi unit as a new nurse and our last resort for really constipated people was a milk and molasses cinema i can't stand the smell of molasses now the milk draws water into the bowel and the molasses acts as a lubricant if i recall correctly you have to heat up the milk to mix in the molasses and then let the mixture cool otherwise you school the inside of someone's rectum when you administer one of these suckers you do it in the bathroom next to the toilet or with a bedpan or bedside commode really close by because they are quick and effective more often than not you end up with a major code brown afterwards i respect you i was a hospital pharmacy intern and i dispensed allendronic acid it's quite pricey for treating osteoporosis and it's a really weird drug to administer it has to be taken in the morning only on an empty stomach you have to remain standing for 30 minutes after taking it it must be taken with pure water and no other beverage as a nurse i'd say working with mill renowned a continuous iv med to treat heart failure it's a last ditch effort they have to wear a pump constantly and if it stops infusing you have just a few minutes to get it going again otherwise their chf symptoms hit suddenly and you better be on the phone to 9-1-1 did not enjoy as a vet assistant wasn't an actual registered tech vodka iv for a cat that drank antifreeze just straight vodka in a licensed vet tech we keep high and vodka in our omnisol for this reason only ever seen it used once though whiskey i had a patient with dementia who used to drink one glass of whiskey every night before bed for the last 40 plus years she wouldn't settle at all without it and became a huge falls risk as she broke her hip a few weeks earlier and was struggling with her mobility we had a doctor prescribed 25 mls of whiskey once per day and had a bottle brought to the ward for her it was funny signing it off on her meds chart every night we had a patient an 82 year old guy whose only medication was a glass of wine in the evening his doctor wrote an order for him to have it while he was in the hospital if it ain't broke don't fix it medical maggots i'm a trauma nurse had a guy with a severely necrotic foot covered in ulcers once maggots eat away the dead flesh around the wound i've used a leech on a night trauma someone had to stay in the room with the patient while the leech was applied to ensure it didn't fall into the nasal passage or mouth pharmacist here medical grade c to compound ci drops there were two other people watching my every move i did feel like scarface a little bit picking up a one-stroke two-pound bag of pure sea powder leukemia patient here cml to be more specific i was on gleevec and now on sprissel every time i go to a new urgent cur my cml makes me prone to infections somewhere or someone new is working at my regular doctor's office they always look at me very confused when i tell them the meds i am on are these meds not very common they are stupid expensive as well oncology pharmacist here the most common meds for cml but otherwise very rare i hope your da sat in a b is treating you well hospital pharmacist here had a baby with congenital hyperinsulinism pretty much a neonate who biogenetic defect just provides more insulin than they should resulting in low blood sugars and all the bad side effects involved with that we use disoxide to treat him which messes with the atp channels on your pancreatic cells and inhibits the release of insulin he ended having to go home on it long term and boluses of dextrose as needed medical student on a pediatrics rotation and i didn't administer the drug myself for obvious reasons patient was diagnosed with spinal muscular atrophy certain forms of the disease are extremely detrimental and result in early death unless you give xolgensmer it's gene therapy and can give kids an honest shot at life price dollar sign 2.1 million albuterol tablets patience was on some clinical trial for an illness i no longer recall albuterol is a branch odylator used in an inhaler formulation don't know of an indication for the tablets but this fellow was taking several a day his illness was not respiratory arsenic yup straight up poison i've actually administered it a few times over the years but it definitely isn't common it's used to treat apml an uncommon subtype of acute leukemia i'm an oncology nurse so i deal with a lot of uncommon medications at least as far as the rest of the world of medicine is concerned 20 years ago a patient actually had a doctor's order allowing him to smoke in his room recovering from vascular surgery different patient about five years later was having a beer it came with his meal and was ordered by the physician i was curious and checked the pharmacy formulary and sure enough miller light hacker shaw and stolly vodka were available in the pharmacy ex-theater nurse here there's a rare condition called malignant hypothermia which is essentially a severe and life-threatening reaction to anaesthetic drugs the antidote is dantrolene which is bright orange expensive af and kept on site at all times i'm pretty sure there's a relatively small amount distributed across my state however since this condition is so rare it often just expires gave anakinra a very strong medication to short-circuit the immune system that same patient got methotrexate which is actually common but in this case i had to do a lumbar puncture and get into the patient's spinal fluid and give the methotrexate in the spinal fluid just ask my eso doctor he said when working in palliative care he has prescribed the odd wine gin if the person wants it but has no family to give it to them nurses etc are busy but if you prescribe it they have to administer it a normal saline bolus for placebo effect it works in many of occasions where patient complains a lot but actually does not have any symptoms so giving them this for placebo effect actually soothes their mind and helps them calm down and to toxin for botulism had to go to the airport to receive it from the cdc and rush back to administer it closest i've come to a tv medical drama i was asked to repeat the story for months after hydrochloric acid drip in the miku during residency i honestly don't recall the exact clinical circumstances that led to this dude getting so alkalemmic but i do remember him getting uptunded out of nowhere only to find an arterial ph close to seven point seven required direct call between our badass conservative attending and pharmacy before it was approved i was asked to prescribe the nitrophenol it's basically a poison but the most potent fat burner there is it's used by the bodybuilding community for fat loss it's not currently legal even for doctors to prescribe so i had to decline i have prescribed hcg human chorionic gonadotropin for weight loss it's a hormone secreted by women when they're pregnant but also a good appetite suppressant ethanol to an infant as a central line lock i took care of a baby born with gastroschisis which resulted in short gut syndrome and malabsorption the child received tpn via a central line 12 hours a night at home he had so many central line infections from his parents inability to properly care for the central line that's now his access sites were very limited when he was down to the last site i was sent into the home twice a day to teach the parents and manage the line make sure the dressing remained occlusive and start and stop the tpn which included instilling a small amount of ethanol into his broviac when not in use to prevent infection vodka gave one time because patient was withdrawing and wanted to prevent seizures and his heart rate was insanely high watching someone go through alcohol withdrawal is pretty harsh i had a patient once who had dressing changes with the dressings soaked in this weird bright purple solution that stained anything it touched permanently she had necrotizing flesh eating disease that was complicated by a reduced immune system response due to chemotherapy she was getting for cancer i don't remember the name of the purple stuff i only saw it used that one time in 17 years of nursing we spilled a little bit on the floor and the doctor said that the floor would always be purple in that spot antibiotics enema root the entire unit including me thought it was a mistake so we called the hospitalist there was no mistake the patient was bowel incontinent it went as you would expect not really a rare medicine but a rare occurrence i worked in the emergency room and had to deliver abs treatment twice in one day for two separate unrelated wild animal bite incidents not a nurse but the patient in 2018 13 years old i had a case of severe pancreatitis the worst pain i've ever felt i remember rolling around on the floor of the sick bay i could barely breathe it felt like i was getting kicked in the stomach they ended up giving me a large dose of ketamine i felt dizzy and sleepy according to my mum who is an ex-registered nurse they don't give ketamine to patients that often anymore nvm i realized katamine is actually pretty common not a doctor but don't we use maggots still in some surgeries to remove dead tissue might not be the most unusual but it certainly is pretty dang weird not during surgery as part of general wound care they eat the dead tissue without harming living tissue if you are new to the channel you can subscribe i publish new videos every day until then check another video [Music] bye for now

Channel: Updoot Everything

Views: 45,588

Rating: 4.8702703 out of 5

Keywords: doctors, nurses, medical, emergency, hardest medication, hard medical case, medication

Id: ZFaNi_3DRFI

Length: 25min 22sec (1522 seconds)

Published: Sun Aug 30 2020