This is a pretty nerdy story here, so unless you have some kind of bizarre interest in medicine and/or pharmacology, don't bother - just go to bed and see if I post something tomorrow.
So I was talking to a patient recently and going through her medications. She mentioned she was taking Endone, which is an opioid analgesic. I asked why and she said it was for her chronic back pain and it was helping a bit. But the real benefit was that since she started taking it, she only had to get out of bed once each night to go to the toilet.
This really confused me. I sat there for the rest of the consult feeling baffled as to why an opioid might stop you urinating. Perhaps she really meant that she was constipated? Perhaps it's something to do with anxiety from the pain causing her blood pressure to rise and hence her glomerular filtration rate goes up? Perhaps I actually have no idea at all about the effects of opioids?
Afterwards I started looking through her file and yes, sure enough, she's on Endep. Wait - Endep? Not Endone? Argh, she definitely said Endep and that's what I wrote down and that's what is in the notes, even though for some reason I was thinking of Endone.
What's Endep again? It's a tricyclic antidepressant that is useful for treating chronic neurogenic pain. It also has anticholinergic effects that can cause urinary retention and reduce urge incontinence. Boy, what a crazy mix-up!
Great story huh?
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