Dapsone is better than Prednisone because?

Today I got a fax from our paed.

It was a plan, some pathology results and a script.

That’s right, my friends, you can doctor a patient via fax now.

Don’t get me started.

Yes, I am disgusted.

Anyhoo, the plan; was to wean Ivy off Prednisone because she is at risk of diabetes and brittle bones and a plethora of other nasties the longer she stays on the pred. Our alternative is a drug called Dapsone.

Never heard of it?

That’s because it is not widely used these days. It is mostly prescribed for Leprosy (We don’t call it that anymore, we call it Hansen’s disease because that just sounds so much better).

Dapsone can also be used for other skin diseases, one of which is pemphigus.

The paed has sent a general information sheet about Dapsone, which tells me very little about what my baby girl is about to ingest. It doesn’t matter though because I have researched it and have all that I need to know that this is one scary drug.

Lets throw around a few terms I have learnt about today, shall we?

Yes, let’s.

Agranulocytosis. This means a deacrease in granulocytes or leucocytes or in layman’s terms, it reduces the number of cells that can fight infection. Great for someone who is immune deficient, wouldn’t you say?

How about, aplastic anaemia, which is the decrease of red and white blood cells in the bone marrow or dyscrasias –  the abnormal mix of blood lymph and bile in the body?

They sound like crackin’ side effects,  don’t you think?

Then there is hemolysis which is the disruption of the red cell membrane, causing release of haemoglobin. This means that the red blood cell essentially explodes and cannot carry iron anymore and it has a great sidekick: methemoglobin, which means the haemoglobin can no longer carry oxygen.

It sounds good.

A real easy sell.

Add to that the risk of liver disorders, nausea, vomiting, abdominal pains, pancreatitis, vertigo, blurred vision, tinnitus, insomnia, fever, headache, psychosis (now that’s an extra special one)  and a whole lot of other exciting things, including carcinoma and I am really starting to see that this is a wonderful medication for Ivy.

Not.

So, what the paed is saying, is that this medication is the better choice over Prednisone and all I am wondering is how he can say that?

Just one last thing, if you are a ‘learning doctor’ out there, or even if you are an ‘already doctor’; If you say you are going to be in contact on a certain day, be in contact.

Don’t send through a fax and think that will be adequate. Because it won’t be. Especially if the patient involved is little and is about to take Dapsone and has any parent worth their salt. It will just make them angry.

Very angry.