Pharmacist's Antidote | Use the Internet celebrity's "magic medicine" with caution, don't let tragedy happen again

A real case, a heartbreaking story, it all started with a popular "magic medicine"...

A friend of Yan Zhe (pseudonym) bought a pack of "Five Centipede Cough Pills" from a Thai purchasing agency. The pills are known as "cough magic medicine" and are commonly known as "centipede pills". The friend said that these small pills are used to treat coughs, and a few pills in the mouth are particularly effective for sore throats. Yan Zhe looked at the small white medicine bag with English and Thai words on the packaging, and only remembered that these "centipede pills" were used to relieve pain.

One day, Yan Zhe felt a sharp pain in his teeth, so he thought of the "centipede pills". He put a few pills in his mouth. Although they were a bit bitter, the coolness brought by the mint made the painful teeth feel numb, and the pain was slightly relieved. As the medicine in his mouth melted and disappeared, the severe toothache came again, and Yan Zhe took it a second time, and a third time... Over and over again, holding it in his mouth and swallowing it, Yan Zhe finished all 150 "centipede pills" in one day. In the evening, Yan Zhe felt much better, so he went to a friend's party as usual. He drank 7 bottles of beer as he had a good alcohol tolerance. At night, he began to have chills, high fever, severe abdominal pain, nausea, vomiting, his mouth was full of the taste of "centipede pills", and his urine was reddish brown.

After being treated in two local hospitals, Yan Zhe's condition did not improve, but gradually worsened, with symptoms such as loss of consciousness, decreased blood pressure, dilated pupils, clenched jaws, and shortness of breath. Feeling the seriousness of the situation, his family drove nearly 500 kilometers to send Yan Zhe to Beijing Chaoyang Hospital, but it had been five days since Yan Zhe took the "centipede pill". Although the doctor actively treated him, due to the long duration of drug poisoning and multiple emergency rescues, his condition did not improve, and Yan Zhe's life remained forever at the age of 23...

What exactly is “Centipede Pill”?

The founder of "Wu Centipede Biao Cough Pills" was Shen Shuishi, a Chinese who lived in Thailand before World War II. Mr. Shen worked in a pharmacy in Fujian, China before coming to Thailand. He accumulated a lot of knowledge about Chinese medicine and prepared a Chinese herbal medicine preparation for treating cough. After his family and neighbors took it many times, they proved that it really had a unique effect. After World War II, Shen Shuishi opened his own pharmacy in Thailand - Shen Tianhe Pharmacy, and founded his own brand "Wu Centipede Biao", producing cough pills and selling them in Thailand. Soon, the effects of "Wu Centipede Biao Cough Pills" in promoting body fluid, relieving cough and removing phlegm were recognized by the people and became a household cough medicine in Thailand.

The name of "Centipede Pills" comes from the saying that Chinese medicine uses poison to fight poison, so the centipede is used as the brand logo, which means "fighting poison with poison". Although there are 5 centipedes prominently drawn on the package, there are no centipedes in the medicine, but it is composed of 9 kinds of Chinese herbal medicines. Among them, the content of active ingredients in each 4 pills is: 581.2 mg of gallnut, 19.2 mg of bitter almonds, 19.2 mg of polygonatum, 12.8 mg of lotus seeds, 12.8 mg of bone drynaria, 12.8 mg of licorice, 12.8 mg of cinnamon, 12.8 mg of ophiopogon, and 6.4 mg of peppermint oil. The medicine has the effects of promoting fluid and moistening the throat, nourishing yin and moistening the lungs, consolidating the lungs and relieving throat itching. Usage and dosage: 4 times a day, take 2 to 4 pills each time, and hold them in the mouth. Overdose can cause poisoning

In recent years, with the development of tourism, a large number of tourists have traveled to Thailand, and "centipede pills" have become a must-buy item when traveling to Thailand. They are even hailed as "miracle cough medicine" and "Internet celebrity miracle medicine" on the Internet.

However, many people do not know the correct way to take "centipede pills", which has led to frequent incidents of poisoning caused by overdose of "centipede pills". In August 2017, a 3-year-old boy accidentally ingested 175 centipede pills in Quanzhou, Fujian. According to reports, after the child accidentally ingested the drug, he experienced vomiting, impaired consciousness, shortness of breath, and black and blue symptoms all over his body. He was treated in the intensive care unit of Quanzhou Children's Hospital and was rescued within 72 hours. In August 2018, the media reported that a 53-year-old man in Anhai, Jinjiang, Quanzhou, Fujian, consumed 900 centipede pills in one month, and suffered from vomiting, diarrhea, and soy sauce-colored urine. He was successfully treated in the intensive care unit of the Second Affiliated Hospital of Fujian Medical University.

Why does "centipede pill" cause poisoning? Taking "centipede pill" in excess can cause poisoning, so what ingredients in the medicine cause it? In the ingredient list of "centipede pill", there is a Chinese medicine - bitter almond. Bitter almond has the effect of lowering qi, relieving cough and asthma, and moistening the intestines and relieving constipation. "Shennong's Herbal Classic" records that it is slightly toxic. When bitter almonds are used in normal amounts, the amygdalin contained in them is decomposed by amygdalinase to produce a small amount of highly toxic substance hydrocyanic acid, which can inhibit the cough center and have an antitussive and antiasthmatic effect. Excessive hydrocyanic acid first excites and then paralyzes the various life centers in the medulla oblongata, inhibits the activity of enzymes, hinders metabolism, and can cause tissue suffocation and poisoning. Taking 60g of it can be fatal for adults, and the lethal dose of hydrocyanic acid is about 0.05g.

So, why were the two cases of "centipede pill" poisoning in Fujian treated successfully despite the fact that both cases took larger amounts of medicine than Yan Zhe? There are three reasons for this analysis: First, overdose. Yan Zhe took a large amount of medicine in a short period of time and drank 7 bottles of beer at night. The effect of alcohol accelerated blood circulation, allowing more toxins to be quickly distributed to the body's tissues and organs, causing great difficulties for treatment; second, the timing of treatment. The best time for rescue was delayed because of the long journey; third, the source of the medicine. The medicine is a foreign medicine, not an imported medicine approved by my country's drug regulatory authorities. Moreover, there are some illegal merchants on the market who make counterfeit "centipede pills" to make huge profits. Yan Zhe obtained the medicine through online purchasing and could not distinguish the authenticity of the medicine.

Looking back at every detail of Yan Zhe's experience, do some of these scenes often occur in your daily life? For example: recommending drugs to others at will, taking drugs blindly without knowing the indications of the drugs, increasing the dosage of drugs on your own, drinking alcohol after taking drugs... Little do you know how terrible the consequences will be if you inadvertently adopt these bad habits and wrong ideas!

Drug safety is no small matter. If you feel unwell, you must go to a regular hospital for diagnosis, purchase drugs through regular drug purchasing channels, follow the doctor's instructions to choose treatment drugs, choose the correct usage and dosage, the correct course of medication, and use drugs safely under the guidance of doctors and pharmacists. I hope such tragedies will not happen again!