75 y/o M is brought in by EMS after he fell off the light rail and hit his head. In the ED he is A&Ox3, and is asking for a urinal. Two minutes later the tech comes running to show you the following:
What is the cause of this patients Jolly Rancher Green Apple looking urine sample?
Answer:
Pamabrom side effect. Patient admitted to taking an “over the counter diuretic” called Diurex. The generic name is pamabrom. Pamabrom is a xanthine diuretic with only modest diuretic effect. It is marked mostly for weight loss to lose “water weight” and for relief of bloating during menstruation. A common side effect of the pills is a blue, green or golden discoloration of the urine. The capsules do not have the same side effect. The side effect is otherwise harmless and will disappear after stopping the diurex.
