Polite Dissent

Superman #675 “Camelot Falls”
Kurt Busiek, writer
Carlos Pacheco, penciler

It’s the future in the DC universe. Not far in the future: just seven years, but sometime in these seven years a massive disaster has occurred. Tidal waves, volcanoes, floods, and resulting “nuclear winter” have killed millions if not billions.
Among the survivors are a band of resistance fighters that includes Lois Lane, Jimmy Olsen, and Lex Luthor. As the book begins, Jimmy is returning from a foray into what’s left of Metropolis.

Let’s take a minute to look at the medications Jimmy collected, and how useful they may or may not be in a post-apocalyptic world:

Amoxicillin — A broad spectrum antibiotic. This definitely would be useful. With fewer people around and fewer doctors over-prescribing medications, bacterial drug resistance should wane over the years and Amoxicillin would probably be more useful in this future world than it is now. (Background reading: MedlinePlus information on amoxicillin)

Prednisone – A corticosteroid. Used most commonly in the treatment of inflammatory disorders (asthma, certain types of arthritis, lupus, etc.). Also used for immune suppression, both long term (transplants) and short term (poison ivy dermatitis). I can see how this would be useful to have on hand. (Background reading: MedlinePlus information on prednisone)

Macrodantin (generic name: Nitrofurantoin) — Another antibiotic. This one is more specific than Amoxicillin and is used almost exclusively for the treatment of urinary tract infections. Another useful medication. (Background reading: MedlinePlus information on nitrofurantoin)

Dilantin (generic name: Phenytoin) – Used to prevent seizures. Like many of the older seizure medications, Dilantin has a specific blood concentration where it is most effective and requires fairly regular monitoring of these levels. In an ordinary post-apocalyptic scenario (if there is such a thing), you would think that blood levels would be impossible to monitor, but with Lex Luthor involved here, he’s probably worked something out. This would be a useful drug to have on hand if there are patients with a seizure disorder; a way to check blood levels would be nice. (Background reading: MedlinePlus information on phenytoin)

Coumadin (generic name: Coumadin) – A blood thinner. Used in patients where blood clots are present or may develop. Like Dilantin, Coumadin needs regular blood tests. It requires testing more regularly than Dilantin because too many things can affect the level of blood thinner including other medication and diet (and a regular diet is probably pretty rare in a post-apocalyptic situation). Levels of Coumadin that are too high greatly increase the risk of bleeding from regular activities such as brushing the teeth or going to the bathroom.
Even at correct levels, Coumadin is not always a safe drug and the risk of serious bleeding is always present. There is a definite risk/benefit ratio we watch closely when prescribing Coumadin and I suspect that in a post-apocalyptic world this would be skewed far to the risk side, particularly if there is no way of checking the level of blood thinning. (Background reading: MedlinePlus information on warfarin)