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Chapter 37 — 6
PROPHYLACTIC
(PREVENTION) DRUGS
Statins
These are frequently used to reduce the harmful effects of cholesterol, but may have other
beneficial effects. Patients who need these drugs are likely to have an increased risk of cardiac
disease, and so should be assessed more completely by their diving physician.
Some recipients will respond to statins with serious muscular and other disorders and so diving
should be delayed for some weeks or months to ensure these problems are not experienced.
Oral Contraceptives — the "Pill"
These preparations can have serious side effects, even without the complication of diving. In
older high dosage drugs, excessive blood clotting resulted in occasional deaths from pulmonary
embolus or strokes.
Occasionally the pill produces serious psychological sequelae, migraine, nausea and vomiting,
which may make diving more hazardous.
The newer low dose oral contraceptives have a lower incidence of these disorders. The concern
with diving is the possibility of more congealable blood interacting with gas bubbles during
decompression. There is no overwhelming evidence to either confirm or refute this theoretical
risk, despite a number of surveys on female divers.
Anti-Sea Sickness Drugs
See Chapter 32.
Antimalarial Drugs
Tropical countries offer some spectacular diving locations but also frequently have endemic
diseases, including malaria.
The chances of contracting this potentially lethal disease are reduced by the use of anti-malarial
drugs such as chloroquine and pyrimethamine ("Maloprim"). Unfortunately many countries
now have strains of malaria which are resistant to conventional anti-malarial drugs, making
their use as a preventative measure not fully reliable. As well as being fallible, these drugs can
have serious side effects including suppression of white blood cell production, anaemia, and eye
damage.
One of the anti-malarials, mefloquine ("Lariam"), can cause coordination disturbances and
vertigo which may have alarming implications and cause diagnostic problems for divers.