Bruce Lee and Drug Allergies

27th November is the birthday for the legendary Bruce Lee. Almost anybody in this world will know that he died prematurely. But what most people do NOT know, is that he died due to a drug allergy.

 

 

According to official sources (Campbell, Sid (2006), The Hindu (India). February 26, 2006), Bruce Lee "died by misadventure", and that misadventure was an allergic reaction to a pain killer/muscle relaxant called Equagesic (See Pic Below).

Equagesic, the pill that allegedly killed Bruce Lee

Equagesic contains the commonly found ingredient Aspirin (325mg), and 200 mg meprobamate, a muscle relaxant. It was given to him for his headache. After taking the tablet, he took a nap, which he never woke up from.

So the topic of the day is -- Drug Allergies.

 

Drug Allergies are more common than you think. Anybody can potentially be allergic to ANY medicine, but the rate of allergies differ for each individual, and each medicine. Allergic symptoms can range from a very small itch to full blown Toxic Epidermal Necrolisis.

Toxic Epidermal Necrolysis

Drug Allergies happen because of an atypical immune reaction to the chemical compound of the medicine. Allergic response occur at different rates, but most of the time, the reaction will occur within the 1st 3 doses of the new medication introduced. The reaction is usually a release of IgE antibodies, which in turn releases histamine, which causes rash and hives. However, there may be other types of antibodies that can be released, and these will cause various other reactions (like the dreaded TEN syndrome above).

 

While all medicines may cause allergies, some have higher probabilities than the others. A few notorious yet commonly used medicines are:

  1. Allopurinol (for gout/uric acid)
  2. Antibiotics (Penicillin, Amoxycillin, Ciprofloxacin, Bactrim etc)
  3. Pain killers (Mefenemic acid, Ibuprofen etc)
  4. Seizure Medication (Phenytoin, Carbamazepin etc)

 

The question I get a lot when customers encounter an allergic episode is:

"Why did the doctor give me this medication when he knows that it can cause allergies?"

A valid question, yet the answer is simple. Would you ban the use of fire since they kill 7 people in the U.S every single day? Certainly not, as the use of fire far outweighs the risk. What we can do, is to stick to a few rules to minimise these risks.

 

Which is exactly what we need to do to minimise the risk of drug allergies. Take down the following pointers to aid in reducing the occurrence and intensity of allergic episodes.

  1. As often as possible, take a new medicine when you are wide awake, and wait at least 2 hours before going to bed. Serious allergies like anaphylaxis typically occur 2 hours after ingestion. Therefore, if in the unfortunate case anaphylaxis does happen, at least you will have noticed the changes in your body earlier than say when you are sleeping soundly, and can act accordingly.
  2. The same goes for little children. I monitor my child for at least 2 hours for airway related allergies in case their tongue or throat swells up, as this can lead to the blockage of our airway. This is even more important for children below the age of 2, as most of them do not know how to express bodily changes like swelling of the tongue etc.
  3. If you have a medicine allergy, always carry an allergy card with you, and show it to healthcare professionals every time you visit them BEFORE THEY START PRESCRIBING MEDICATION. They are doctors and pharmacists...not fortune tellers. A drug allergy bracelet or pendant is also recommended if the nature of the allergy is severe.
  4. If your allergic reaction is just simple rash and itch, try taking a fast acting antihistamine to minimise the reaction, and shorten the allergic duration. Your pharmacist will be able to help out in this aspect.
  5. If you have a history of life-threatening allergies like anaphylaxis, I would recommend the use of a device called the EpiPen, and bring it along with you all the time. This pen contains epinephrine (or adrenaline), and in emergencies, it can at least help keep our airways open.

 

So, If Mr Bruce Lee had just waited a while longer before going to sleep after Equagesic, or had he taken something he was used to, we'll all be much more enlightened by his philosophy, his charisma, his films. 

Another thing that we CAN do, is to actively REPORT these allergic response to our governing body MADRAC. By reporting these occurrences, we can have a better idea on which drugs are more allergenic, and can put warnings on those that are found frequently to cause allergies.

 

Ask your retail pharmacist for this form, and I'm sure they will assist you in filling this and sending it to MADRAC.

Reminder: Nobody can predict whether or not you will be allergic to a certain medicine. Don't blame the fisherman who caught you the fish when you get a fish bone stuck in your throat.