"Prepare a gastric tube. Just a temporary one will do. Bring the clonidine gastric tube to administer the medicine later," Zheng Ren said.
"Oh."
Chief Wang was a little confused but did not ask. Instead, he got busy.
This was the least he could do for Boss Zheng. Moreover, it was not a controversial drug. It was just clonidine. Could 0.2 mg of clonidine be fatal? Definitely not.
It was not accurate to say that. There was a high probability that it would not be a problem. After all, clonidine had certain side effects and was on the verge of being eliminated in clinical practice.
No matter what Boss Zheng was thinking, he had to get the clonidine in first. Chief Wang knew that there was no time to explain during emergency treatment.
Very soon, a circulatory medicine doctor ran over and brought the clonidine over. A gastric tube was inserted and 0.2 mg of clonidine was administered through the gastric tube.
"Let's observe for 20 minutes," Zheng Ren said calmly.
"Boss, clonidine … What does it mean?" Su Yun could not help but ask.
"According to Chief Jiang and Chief Wang's medical history, the patient is suffering from bipolar disorder caused by continuous nightmares." Zheng Ren looked at the color of the patient's System panel. "Nightmares usually occur during REM sleep and can be triggered by a variety of factors, including stress, anxiety, trauma, sleep deprivation, drugs, etc.
"Bupropion is a NE and DA reuptake inhibitor. It can affect sleep structure by increasing REM sleep and density," Zheng Ren continued. Zheng Ren continued, "Studies have shown that prolonged oral administration of bupropion may lead to nightmares."
"Bupropion causes nightmares?" Chief Jiang was stunned. He had been in the psychiatry department for decades. How did he not know about this?
"Prim.
There's a related study in Disord. It's not very common. It's usually seen in patients who take sustained-release bupropion tablets. " Zheng Ren looked at the color of the patient's System panel that had begun to fade and said confidently, "Antidepressants such as bupropion can prolong REM sleep and latency, increase REM activity and density."
"This is the basic principle of drug action," Zheng Ren said. "Clonidine is an adrenergic α2 receptor agonist. It can be used to treat attention deficit hyperactivity disorder and high blood pressure. The mechanism is to reduce sympathetic transmission from the central nervous system."
This was a public lecture without any rehearsal.
There were no lights, no microphone, and no Su Yun's current appearance. There was only Zheng Ren and his calm and confident demeanor.
Zheng Ren stood beside the patient. He did not even look at the people around him. Instead, he stared intently at the patient's System panel and monitors.
The color of the System Panel became lighter and lighter as the drug took effect. Unknowingly, a smile appeared on his face.
"The mechanism of action of clonidine can inhibit or reduce REM sleep, which may counteract the effects of bupropion on REM sleep to a certain extent, thereby improving nightmares."
"…"
Chief Jiang was dumbfounded.
If he had previously misdiagnosed other diseases as mental illnesses, he could still argue that the diagnosis and treatment specialties were different, and it was understandable that he had misdiagnosed it.
But now, he was talking about the diagnosis and treatment of purely mental diseases. Boss Zheng did not use any new drugs that he had never heard of. Instead, he only used an old antihypertensive drug that had already been used in the clinic — clonidine.
Would it really work? Chief Jiang was a little puzzled.
"The drug clonidine itself is dangerous. Patients who engage in dangerous activities such as operating machines or driving should be aware of the possible sedative effects of clonidine. This sedative effect can be enhanced by the concomitant use of alcohol, barbiturates, or other sedative drugs.
"That's why clonidine can't be bought in ordinary pharmacies because of its sedative effect. Professional guidance is needed when stopping the drug."
As the patient's agitation gradually subsided, Zheng Ren smiled and said, "Looks like it's working."
"Boss, why are you researching clonidine?" Su Yun asked doubtfully.
"I've encountered similar patients in Sea City," Zheng Ren said perfunctorily.
Su Yun pursed his lips. His boss was willing to use this excuse. He had gone to the emergency department a few days ago. How could this guy have the nerve to say this every time! His skin was as thick as it could get.
After waiting for another ten minutes, the patient's manic state had completely subsided. He began to fall asleep and snore loudly.
"Do a head CT scan." Zheng Ren smiled and said, "Chief Jiang."
"Yes!" Chief Jiang immediately responded and bowed a little deeper.
"The dosage this time is a little high. In the future, to reduce the recurring nightmares, give the patient 0.1mg of clonidine every night," Zheng Ren said. "The nightmares can be alleviated in about three days. Normally, they will disappear in about ten days. Pay attention to the patient's condition. When the nightmares are completely gone, you can change to oral clonidine every other day and stop taking it after a month. "
"Yes, yes." Chief Jiang nodded hurriedly and tried hard to memorize Chief Zheng's medical advice. Fortunately, the medical advice was not complicated and Chief Jiang was not worried that he would forget it.
"The nightmares may be a side effect of bupropion treatment. Clonidine may help improve the situation. However, if you prescribe clonidine to the patient in the future, pay more attention to the patient's blood pressure, "Zheng Ren reminded." Okay. If there's nothing else, I'll be leaving. "
After that, Zheng Ren looked around and said to Director Wu with a smile, "Director Wu, Chief Wang, I won't be going for dinner. It's still early. I promised my girlfriend that I would go home for dinner."
Director Wu had nothing to say when he mentioned his girlfriend.
Chief Zheng was at the age where he was dating his girlfriend. No wonder he did not usually go out for dinner. He was a romantic.
"Chief Zheng, look at this mess." Chief Wang was still a little embarrassed and kept apologizing, "You came to lecture, but Professor Su and I didn't even get to eat a hot meal. I'm so sorry."
"It's okay. If there's anything in the future, contact me on WeChat." Zheng Ren smiled and strode out of the People's Hospital with Su Yun.
Feng Xuhui had been waiting at the entrance for a long time. Zheng Ren opened the door, turned around and waved before getting in the car.
Chief Wang sighed as he watched the off-road vehicle quickly disappear into the misty night.
Chief Zheng was really impressive, especially when he stood next to the stretcher trolley and explained the diagnosis and treatment of the disease. The patient's agitation was gradually weakening in the background. His words did not sound like much at the time. Now that he thought about it, it was like a thunderclap.
He seemed to be good at general surgery. Chief Wang thought to himself that he must find an opportunity to invite him to perform a few surgeries in the future and observe him live.
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