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Ibuprofen non selectively inhibits two enzymes called COX1 and COX2. These enzymes convert arachidonic acid to prostaglandin H2, precursors to other inflammatory lipids like prostaglandins, which explains its pain-relieving effect. However, prostaglandin H2 can also be converted to a lipid called thromboxane A2, which is involved in blood clotting. Therefore, Ibuprofen and other non-steroid anti-inflamatory drugs that increase your chance of excessive bleeding are contraindicated prior to a surgical procedure.

However, Paracetamol/Acetaminophen/Tylenol has high affinity for COX-2 only. This means you get the anti-inflammatory effects without interfering with blood clotting, and is considered safe to use prior to a surgical procedure.

The more you know! (ノ◕ヮ◕)ノ*:・゚✧
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Karaii November 18th, 2015, 12:37 am

So, I often make fun of my sister because she has a doctorate of philosophy (in philosophy). I tell her jokingly “you’re not a real doctor! ;D”, and she replies with “well, neither are you :T”, and that promptly shuts me up. Haha! Siblings are great.

Anyway, Ezra is vERY unwisely antagonizing Doctor Voltaire here, who has a PhD in Clinical Psychology. He’s also the son of the Director? of the hospital?? they work in???

Ezra, you are a dumbass.

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Advertisement November 24th, 2017, 8:40 am


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Toli B November 18th, 2015, 5:03 am

3-5 odds they're gonna make out.
2-7 odds they'll be in a state of undress

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lazy-lil-king November 18th, 2015, 9:22 am

I wonder what he did his thesis on.

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Blackchick November 18th, 2015, 9:55 am

Ezra clearly likes playing with fire I see! I like their tense dialogue! ^_^

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redleaveshavefallen November 18th, 2015, 4:54 pm

In my experience, psychologists are unable to prescribe medications, and that must be done by psychiatrists. I might be wrong, and if so I apologize for being nitpicky, but it has made me confused while reading.

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Karaii November 18th, 2015, 7:38 pm

@redleaveshavefallen: Oh, you are most definitely right!! Only psychiatrists (who are actual medical doctors) are allowed to prescribe medication! But ibuprofen is an over-the-counter medication, and easily recommended for headaches and stuff. A real medical doctor would know not to give a patient who is about to get surgery any kind of NSAID, but Lakrios isn't a real doc XD

Doctor Voltaire here also cheats, because his brother is the local pharmacist (that's Andrew from a few pages back) and he can get Andrew to dispense prescription medicine if he really needs it. Doctor Voltaire should /really/ not do that, but, well, he does when he feels like he knows enough.

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Karaii November 18th, 2015, 7:42 pm

@redleaveshavefallen: I should mention I'm basing medicine and psychology as it's done in Mexico. I'm sure that a psychologist without a med degree "prescribing" medicine would be more than frowned upon (possibly even incarcerated?) in the US, but that's not the case here XD Lots of medicine gets prescribed by psychologists "under the water" for patients with ADHD and bipolar disorder and the like by having psychiatrist colleagues write up the prescriptions or being on a good basis with a local regular doctor.

That is not to say this is a proper practice! At all! O-O But it's fairly common where I live, so it didn't feel out of place.

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rattleandhum November 18th, 2015, 9:39 pm

Can I just say, POC representation in this comic is on point.

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redleaveshavefallen November 24th, 2015, 10:44 pm

@Karaii: Okay, that makes sense! Thank you!

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SOABS January 2nd, 2016, 12:24 pm

question, what is the markings on Doctor Voltaire's face? (I wish I could remember the word for it)

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Karaii January 7th, 2016, 11:21 am

@SOABS: Vitiligo, my friend! It's an auto-immune disease that causes loss of pigment in the skin.