Christine Dacera’s case: A pharmacist’s perspective

As we wait for the completion of the investigation on Christine Dacera’s case, I would like to share at least five recommendations as a pharmacist, hoping these could help investigators.1) It is crucial to look into Dacera’s recent doctor and pharmacy visits (if any), or her belongings, for possible presence of prescription medications, over-the-counter medications, and herbals, especially those acting on the cardiovascular system. Examples are those drugs for allergy, common colds, and flu.

It’s common for these drugs to contain ingredients that may cause sedation that potentiate the effects of alcohol. Some of these drugs also contain vasoconstrictors that narrow blood vessels. Alcohol, on the other hand, does the opposite, relaxing or widening blood vessels. Also, some cough suppressants are linked to extreme sedation and respiratory depression. There are hundreds of prescription and over-the-counter medications and herbals that are not safe to mix with alcohol, and they can interact harmfully even if they are not taken at the same time. In fact, certain medicines contain up to 10-percent alcohol, such as cough syrup and laxatives.

Was there also a possibility that Dacera accidentally took a sleep aid (another CNS, or central nervous system, depressant) since she was a flight attendant and she could be experiencing disturbed sleeping patterns? This is why the toxicology report and confirmatory testings are critical here.

2) Alcohol intoxication (either accidental or intentional) is more likely to happen in females. When a woman drinks, the alcohol in her blood typically reaches a higher level than the male counterpart, even though both may have taken the same amount. The reason is that the female body generally has less water and more fat than the male body. Water helps flush alcohol out of the system while fat retains it, leading to a more concentrated alcohol retention and more dramatic physiological responses. Alcohol intoxication is serious. It affects not only breathing but also body temperature and heart rate. Sometimes, it can lead to coma or death.

3) It was reported that there were soft drinks during the party, aside from alcohol. Soft drinks usually contain caffeine which is a CNS stimulant and can narrow blood vessels. On the other hand, alcohol is a CNS depressant and can relax and widen blood vessels. Energy drinks also contain caffeine. When alcohol is combined with caffeine, the caffeine can mask the depressant effects of alcohol, making drinkers feel more alert than they would otherwise. Consequently, they may consume more alcohol and become more impaired than they realize, elevating the risk of alcohol-related harms.

4) What was their party food? Was it full of cholesterol? Cholesterol is linked to cardiovascular problems. But unknown to many, we are commonly dealing with food and drinks that contain tyramine, which is often found in fermented products like alcoholic beverages, cheese, and cured meats. Excessive tyramine intake may lead to a hypertensive crisis, a severe increase in blood pressure that can damage blood vessels and can lead to a stroke.

5) Did she have an infection? Some infections can cause cardiovascular problems, even aneurysm. Though rare, it’s possible to develop an aortic aneurysm if someone had an untreated infection. Some antibiotics that are used to treat infections can cause cardiovascular problems as well. Moreover, as colleagues have discussed in social media, the wrong application of cardiopulmonary resuscitation (CPR) can cause aortic aneurysm. It was reported that Dacera’s friends tried to resuscitate her through CPR. Doing CPR incorrectly can injure the person.

Amid all these, the country needs better police investigation and forensic investigation systems.

TERESA MAY BANDIOLA
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