Did you know that adverse drug reactions (ADRs) have been estimated to be the 3rd most frequent cause of death in the USA today, outstripped only by heart disease and cancer? And this is not even considering all those who suffer, but don’t die.
What can the average person do? After all, those drug information sheets with their tiny print are pretty intimidating. Practically speaking, those who are not medically qualified are at the mercy of the physician, who depends on the accuracy and completeness of what is published in peer-reviewed articles, the judgment of the FDA, the integrity of the pharmaceutical industry, and whether they have time to review all the information. Does this make anyone else a bit nervous? It should. But there is hope.
Ten Rules
According to Ray Strand, MD, you can, and should, do a lot to protect your health from “a harmful or fatal encounter with a prescription drug.” Many of the principles below come from his book.
Understand that no drug is “safe”–whether herbal, prescription, or over-the-counter. All medications have the potential to cause side effects and adverse drug reactions. Pharmaceutical texts are full of warnings against St John’s Wort. So, when you are considering taking a drug or supplement, balance the risks with the benefits. Remember Fen-Phen; would the victims really have been willing to risk permanent heart valve abnormalities, pulmonary hypertension, and death to lose a few pounds? The sad thing is that this drug combination is still available–and not to be recommended.
If you can avoid taking an over-the-counter drug or supplement, do. These theoretically innocuous medicines cause many hospitalizations and even deaths! Tylenol and the treatments that contain it (Nyquil, Theraflu, Midol) can cause liver failure. Colds aren’t fun, but overdosing or combining these remedies with other medications can be far worse.
Healthy Lifestyles Rock
If it is possible to treat a condition requiring a prescription with a lifestyle change, opt for the lifestyle change! Hypertension, high cholesterol, and even type 2 diabetes often resolve with a healthy diet and exercise. The medications used to treat these conditions carry numerous side effects and risks. It is better to reserve their use for those whose conditions will not respond to lifestyle changes.
Be extremely cautious about medicating your children. Only 6% of FDA-approved drugs have ever been tested in the pediatric population. The FDA approved Zantac for children over one month old, but has now recalled it because it contains a cancer-causing agent. And drug interactions, such as between acetaminophen and erythromycin (antibiotic) or cold medicine, can be fatal, especially in children.
New Drugs Aren’t Best
Never take a prescription medication currently being advertised on TV or given to you as a sample. Unless, of course, you like being a guinea pig. The FDA has recently approved these drugs, and as such, their safety and efficacy have been tested in people who are either healthy or only require one medication. They have never been tested in people with complicated medical histories. They have also not been tested in large populations. However, the drugs are being heavily marketed to recoup the pharmaceutical company’s investments made in their development. As the general population uses them, it is hoped that no devastating side effects will emerge. If they do, it will take years for the drug to be recalled, so either way, the company wins — and you may lose. So, ask for a medical equivalent to a recently released drug, preferably one that has been on the market for over five years.
Keep Everyone Informed
Make sure that your primary care physician has a current list of all your prescription medications, all over-the-counter drugs, herbal medications, and supplements that you use (with doses).In these days of many medical specialists, it is also a good idea to have such a list with you at all times. Not only that, but also have a list of your current medications on your fridge, so that emergency personnel can easily access the information. Make sure that your primary care physician is willing to discuss how to reduce the number of drugs you take, whether by lifestyle changes or by elimination of unnecessary scripts–if they do not want to involve you in your medical care, change doctors.
Use just one pharmacy so that the pharmacist also knows everything you take. This is an essential backup in preventing drug interaction problems. Pharmacies catch about 25% of drug errors. Better, but obviously not good enough.
Check and Check Again
Take responsibility for double-checking that you receive the right medicines. Ask your physician to print the name of the drug (so it is legible), make sure the name of the drug on the prescription label matches what the physician prescribed, check that the pill “looks” like it should (product insert), and read about what conditions the medication treats. It has been known that patients are given Xanax (tranquilizer) instead of Zantac (antacid) or Prilosec (another antacid) instead of Prozac (antidepressant). If in doubt, ask.
When a new medication is added to your or a loved one’s existing regimen, run an interaction check yourself. Don’t forget also to run any over-the-counter drugs you may take–they also interact. This tool has saved more than one life and, hopefully, will save many more.
Be Aware
Trust your body. If you feel unwell, do not dismiss the symptoms. Suspect the drugs you are taking and alert your physician immediately.If they dismiss your concerns, persist until you are heard. Nausea, vomiting, and lethargy should never be dismissed as unimportant since they are signs of liver problems and can signal potentially fatal ADRs. Muscle aches, especially in those taking cholesterol-reducing agents, can precede devastating reactions. Even a persistent cough can signal an ADR. It is always a good idea to be familiar with the potential side effects of your medications (by reading the product insert), but remember: these lists are not exhaustive. New side effects are only added to the list as they are reported, and fewer than 5% are reported. The newer the drug, the less likely that your side effect will appear.
I recommend Dr. Strand’s book to my readership. But, since many will not have the time to read the book for themselves, do those you love a favor. Email this article to everyone, post a link on Facebook, get the word out!
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