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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Did antibiotic cause lethal aortic rupture?

Q. Four years ago, my 93-year-old father fell, and his neighbor took him to the emergency room. When the hospital called, I said I would come right away. I warned them NOT to give him any quinolone antibiotics because I’d had a bad experience with such drugs myself. I also reminded the hospital that he had an aortic aneurysm and shouldn’t be given warfarin (Coumadin).

By the time I arrived, Dad had no idea who I was. Before the fall he was sharp as a tack.

I was told they presumed he had pneumonia (although he did not) and gave him Levaquin. It caused him to hallucinate for the next six weeks, until his aneurysm ruptured and he died.

I just read that quinolones can trigger aortic aneurysms, and I am sure that the Levaquin contributed to my father’s death.

A. An article in JAMA Internal Medicine (online, Oct. 5, 2015) reveals that quinolone-type antibiotics are associated with a greater risk of aortic aneurysm.

In this condition, the main artery leaving the heart develops a weak spot in its wall and balloons out. Sometimes it tears or ruptures. This complication is rare, but it happens twice as often in people taking a quinolone antibiotic like levofloxacin (Levaquin). As far as we can tell, the Food and Drug Administration has not yet required warnings for this potentially fatal reaction.

Quinolone antibiotics such as ciprofloxacin (Cipro), levofloxacin and moxifloxacin (Avelox) can cause hallucinations, and other readers have written about their own frightening experiences with such antibiotics.

Q. I found decolorized iodine works remarkably well for toenail fungus. Applied to the top of the nail and around the cuticle, it dries quickly and does not stain stockings or bedding. Cost: about $2.50.

I used it five times a week starting out. After the nail was once again normal, I started using it about once a week for maintenance and prevention. I don’t want ugly toenails ever again.

A. Iodine has broad-spectrum antibacterial activity that has been recognized since the early 19th century. It also is active against yeast, mold, viruses and fungi.

Readers have reported that iodine is effective against warts and nail fungus. Tincture of iodine stains the skin and nails brown, which is why people prefer decolorized iodine.

We discuss this and many other remedies for nail fungus in our Guide to Hair and Nail Care. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (70 cents), self-addressed envelope to: Graedons’ People’s Pharmacy, No. H-31, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.

Q. I have been taking cetirizine (Zyrtec) for years to treat my allergies. Within days of being off the drug, I itch all over my body.

I have an allergy test next week, and I was supposed to be free of any antihistamines for one solid week. I couldn’t do it. The itching was too intense. Has anyone else experienced this weird withdrawal?

A. You are not alone. Many people have used our website to report this problem of itching upon cetirizine withdrawal.

Cetirizine is an over-the-counter drug, and its packaging offers relatively little side-effect information. The medical literature notes that cetirizine is used to relieve itching but not that itching may occur upon stopping. Patients need to inform each other, as you have done.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of this newspaper or email them via their Web site: www.PeoplesPharmacy.com. Their newest book is “Top Screwups Doctors Make and How to Avoid Them.”