Question

A cousin of yours is seen in the outpatient clinic where you work. She has a fever and general malaise. Your cousin is about 5 feet tall and weighs about 100 pounds. The doctor suspects that the low grade fever and nonspecific symptoms may be due to a virus. The doctor directs your cousin to take aspirin to control the fever. The doctor recommends that she take three tablets of regular strength aspirin every three to four hours, up to six times per day. The doctor states that the fever should subside and the symptoms should disappear within a few days. You have not heard from your cousin for two weeks. All of a sudden she shows up at the clinic again. She is hyperactive and somewhat confused. She has a temperature of 102o F. She is hyperventilating and has a blood pressure of 160/100. Within minutes, her breathing tapers off to about 10 respirations per minute and her blood pressure plummets to 90/40. A code is called when she goes into respiratory arrest. She could not be revived.

1. What virus could cause these signs and symptoms?

2. What is “regular strength” aspirin? What are the other strength aspirins and what are they used for? What is the regular dose recommended for an adult?

3. What are the recommendations for low grade fevers and nonspecific mild symptoms when it comes to aspirin? (Hint: Do NOT research this question using the web sites for the manufacturers of aspirin, acetaminophen or ibuprofen.)

4. Under what conditions should a patient NOT take aspirin?

5. The doctor could have directed the patient to take acetaminophen or ibuprofen instead of the aspirin. Is acetaminophen or ibuprofen a suitable substitute for aspirin in all cases? Why or why not? Would your cousin have died had the doctor recommended similar doses of acetaminophen or ibuprofen?

6. What happened to your cousin? Speculate on the cause of her demise.

7. If you observed a doctor making what you think is a mistake, what would you do?

Answer 1

1). The influenza virus that leads to pneumonia or in maybe the COVID-19 or coronavirus can lead to the sign and symptoms as given in the case.

Symptoms of pneumonia (influenza virus): Pain in the chest, low-grade fever in the beginning and high fever in the latter stage of infection, fast and shallow breathing, fast heart rate (high blood pressure), shortness of breathing.

Symptoms of coronavirus: fever, difficulty in breathing in severe case, cough, respiratory arrest (severe case), high blood pressure.

2). 325-milligram dose is the regular strength aspirin. The low dose strength aspirin is less than 100 milligrams, which is taken by the patients daily for the reduction of the risk of stroke and heart attacks. The regular strength aspirin is used for fever and pain relief.

For adults suffering from fever or pain, 300 to 650 milligrams of aspirin dose is recommended orally every 5 to 6 hours as recommended by a doctor.

3). For low-grade fever and non-specific mild symptoms, 300 to a 650-milligram dose   of aspirin can be taken orally every 5 to 6 hours as needed
The maximum dose should not be taken more than 4 grams in 24 hours.

4). Children under the age of 16 and people who have never suffered any stroke and heart attacks should not take aspirin therapy as it comes with many side effects such as stomach bleeding due to ulcers, heartburn, indigestion, and many more symptoms.

5). Acetaminophen or ibuprofen a suitable substitute for aspirin but not for all cases. Aspirin, acetaminophen, and ibuprofen all of these can be used as a pain relief tablets and fever. If the pain is due to the inflammation then acetaminophen is not effective as aspirin. This because acetaminophen and ibuprofen are not anti-inflammatory drugs.

Cousin maybe died with similar doses of acetaminophen and ibuprofen as they are not much effective as aspirin. Also, aspirin is much safer than acetaminophen and ibuprofen drugs.