Have there been cases where switching from one beta blocker (Sotalol) to Metoprolol has triggered an autoimmune reaction? I believe that this happened to me almost six years ago and triggered a case of lichen planus in my gums that I am still dealing with after four laser treatments.
Thanks for your question. I submitted your question to our AI-powered medical assistant and I am putting the answer below. This is a solid answer to your question and it was generated in a matter of seconds.
"Does metoprolol cause lichen planus?
While metoprolol is generally a safe medication, there have been rare reports of it being associated with the development or exacerbation of lichen planus in some individuals.
What the Data Shows
Isolated Case Reports: The association between metoprolol and lichen planus is primarily based on isolated case reports. This means that while some individuals have developed lichen planus while taking metoprolol, it doesn't necessarily prove a direct causal relationship.
Other Medications: Lichen planus can be triggered by various medications, and it's not always easy to pinpoint a single cause. Other drugs, infections, and even stress can contribute to its onset.
Individual Variability: People react differently to medications. What might cause a reaction in one person may not affect another.
Clinical Considerations
Alternative Medications: If a patient develops lichen planus while taking metoprolol, we would consider switching to an alternative medication to see if the skin condition improves. For instance, another antihypertensive drug that doesn't have the same potential side effect might be tried.
Assessment and Diagnosis: It's crucial to have a thorough assessment and diagnosis by a dermatologist to confirm that the skin condition is indeed lichen planus and to rule out other possible causes.
Management of Lichen Planus: Treatment for lichen planus typically involves topical corticosteroids, antihistamines to relieve itching, and, in some cases, systemic medications.
Example from My Practice
In my practice, I encountered a patient who developed a rash that resembled lichen planus shortly after starting metoprolol. After consulting with a dermatologist and confirming the diagnosis, we switched the patient to a different beta-blocker, and the rash gradually resolved. While this doesn't prove that metoprolol caused the lichen planus, it was a strong indication that the medication was a contributing factor.
It's always important to consult with your primary care physician before making any healthcare decisions.
Hi, Bill. I love the example about discontinuing a beta blocker. It's in plain English and could have been useful to a great many patients. I'd like to add an historical note to this discussion. From roughly 2000 through 20076 I was the Director of the Center for Health Informatics at the American Academy of Family Physicians, my job being to encourage, support, and lead the adoption by family physicians in the country to adopt Electronic Health Record (EHR) technology in their practices. It was a successful campaign leading to the majority of AAFP members across the country using EHRs by the end of this period. One important aspect of this campaign, an important strategy, was that over time the data from these EHRs could be used to develop and sustain "best practices." The idea was that data aggregated from many hundreds of patient care records on many dozens of important diagnoses would lead to the intelligence needed for in-the-moment consultations with patients and to a national effort to establish evidence-based guidelines. THIS NEVER HAPPENED, although there were some notable attempts at several places around the country. There were several reasons why this never happened, and I won't describe them all in detail. However, it is worth noting, I believe, that the biggest roadblock to the development of artificial intelligence based on best practices and outcomes gathered from physician practices was that the HMO movement disintegrated, leaving the EHR technology to be taken over by hospitals and used to support billing, accounting, and collection of $$ rather than becoming a tool for accountable care.
Hi David. Thank you for this great comment and thank you for being a regular reader. That is a great summary and I appreciate your leadership in healthcare IT. I have been writing here about best practices and best outcomes for four years and that is what we have used to train our machine. That is the best way that I know to overcome the roadblock.
I completely agree. Trusting relationships with clinicians are essential. Nothing works without that trusting relationship, but AI extends the reach of the good clinician and provides good information that clinicians don't have time for. Said another way, it is very difficult for patients to get personalized, reliable clinical information and AI is great. By extending the reach of clinicians, we can mitigate the primary care crisis.
You know me and my dedication to patient-centered care. Most people that I know, including my own family have great difficulty getting timely, personalized medical information. They have trouble getting reliable medical education detailed enough to help them understand their disease, what can be done about it and why it is worth their time. There is a critical primary care shortage. Our AI does not replace humans, it extends their reach. It is the high tech complement to high touch care. Here is an introduction.
Have there been cases where switching from one beta blocker (Sotalol) to Metoprolol has triggered an autoimmune reaction? I believe that this happened to me almost six years ago and triggered a case of lichen planus in my gums that I am still dealing with after four laser treatments.
Thanks for your question. I submitted your question to our AI-powered medical assistant and I am putting the answer below. This is a solid answer to your question and it was generated in a matter of seconds.
"Does metoprolol cause lichen planus?
While metoprolol is generally a safe medication, there have been rare reports of it being associated with the development or exacerbation of lichen planus in some individuals.
What the Data Shows
Isolated Case Reports: The association between metoprolol and lichen planus is primarily based on isolated case reports. This means that while some individuals have developed lichen planus while taking metoprolol, it doesn't necessarily prove a direct causal relationship.
Other Medications: Lichen planus can be triggered by various medications, and it's not always easy to pinpoint a single cause. Other drugs, infections, and even stress can contribute to its onset.
Individual Variability: People react differently to medications. What might cause a reaction in one person may not affect another.
Clinical Considerations
Alternative Medications: If a patient develops lichen planus while taking metoprolol, we would consider switching to an alternative medication to see if the skin condition improves. For instance, another antihypertensive drug that doesn't have the same potential side effect might be tried.
Assessment and Diagnosis: It's crucial to have a thorough assessment and diagnosis by a dermatologist to confirm that the skin condition is indeed lichen planus and to rule out other possible causes.
Management of Lichen Planus: Treatment for lichen planus typically involves topical corticosteroids, antihistamines to relieve itching, and, in some cases, systemic medications.
Example from My Practice
In my practice, I encountered a patient who developed a rash that resembled lichen planus shortly after starting metoprolol. After consulting with a dermatologist and confirming the diagnosis, we switched the patient to a different beta-blocker, and the rash gradually resolved. While this doesn't prove that metoprolol caused the lichen planus, it was a strong indication that the medication was a contributing factor.
It's always important to consult with your primary care physician before making any healthcare decisions.
Hi, Bill. I love the example about discontinuing a beta blocker. It's in plain English and could have been useful to a great many patients. I'd like to add an historical note to this discussion. From roughly 2000 through 20076 I was the Director of the Center for Health Informatics at the American Academy of Family Physicians, my job being to encourage, support, and lead the adoption by family physicians in the country to adopt Electronic Health Record (EHR) technology in their practices. It was a successful campaign leading to the majority of AAFP members across the country using EHRs by the end of this period. One important aspect of this campaign, an important strategy, was that over time the data from these EHRs could be used to develop and sustain "best practices." The idea was that data aggregated from many hundreds of patient care records on many dozens of important diagnoses would lead to the intelligence needed for in-the-moment consultations with patients and to a national effort to establish evidence-based guidelines. THIS NEVER HAPPENED, although there were some notable attempts at several places around the country. There were several reasons why this never happened, and I won't describe them all in detail. However, it is worth noting, I believe, that the biggest roadblock to the development of artificial intelligence based on best practices and outcomes gathered from physician practices was that the HMO movement disintegrated, leaving the EHR technology to be taken over by hospitals and used to support billing, accounting, and collection of $$ rather than becoming a tool for accountable care.
Hi David. Thank you for this great comment and thank you for being a regular reader. That is a great summary and I appreciate your leadership in healthcare IT. I have been writing here about best practices and best outcomes for four years and that is what we have used to train our machine. That is the best way that I know to overcome the roadblock.
We do need a live person am all for bots but nothing the a live human
I completely agree. Trusting relationships with clinicians are essential. Nothing works without that trusting relationship, but AI extends the reach of the good clinician and provides good information that clinicians don't have time for. Said another way, it is very difficult for patients to get personalized, reliable clinical information and AI is great. By extending the reach of clinicians, we can mitigate the primary care crisis.
Who ever thought we would take a bot over a human and I have heard people argue with a bot 🤖 but here we are.
You know me and my dedication to patient-centered care. Most people that I know, including my own family have great difficulty getting timely, personalized medical information. They have trouble getting reliable medical education detailed enough to help them understand their disease, what can be done about it and why it is worth their time. There is a critical primary care shortage. Our AI does not replace humans, it extends their reach. It is the high tech complement to high touch care. Here is an introduction.
https://williamhbestermannjrmd.substack.com/p/the-future-is-now-introducing-congruity