Despite the fact that one must hold the pharmaceutical industry directly responsible for most of the side effects (and deaths) caused by drugs there is no doubt that the number of problems could be reduced if patients were more aware of how best to protect themselves from side effects.
It is a sad but true fact that of all the drugs prescribed only a relatively small number are taken in the way that the prescriber originally intended them to be taken. Drugs arc taken at the wrong time, they are taken too frequently and they are sometimes never taken out of the bottle at all.
It is important to remember that modern prescribed drugs are not only potentially effective but also powerful and potentially dangerous.
There are several questions which should be answered before a patient starts taking a drug – for example, how long the drug should be taken for, whether it should be taken before, during or after meals and whether it can cause drowsiness. Usually the answers to these questions will appear on the label of the bottle containing the drugs. If the answers do not appear there then the fault may lie with the doctor who wrote the prescription or the pharmacist who dispensed it.
Here are some things to watch out for:
- Some drugs can be stopped when symptoms cease. Others need to be taken as a complete course. A small number of drugs need to be taken continuously and a second prescription will have to be obtained before the first supply has run out. The patient who knows what his drug is for, why he is taking it and what the effect should be, will be more likely to know when a drug is to be stopped.
- If a drug has to be taken once a day, it is usually important that it is taken at the same time each day. If a drug has to be taken twice a day it should be taken at intervals of 12 hours. A drug that needs to be taken three times a day should be taken at eight-hourly intervals and a drug that needs taking four times a day should be taken at six-hourly intervals. The day should be divided into suitable segments.
- Some drugs which may cause stomach problems are safer when taken with meals. Other drugs may not be absorbed properly if taken with food.
- A number of patients (particularly the elderly) are expected to remember to take dozens of pills a day. When a day’s medication includes tablets to be taken twice daily, three times daily, mornings only and every four hours, mistakes are inevitable. If a patient needs to take a number of drugs a day mistakes can be minimised by preparing a daily chart on which the names and dines of different drugs are marked. Such a chart will reduce the risk of a patient taking one dose twice or struggling to remember whether a particular pill has been taken yet. To avoid the risk of overdosage, sleeping tablets should not be kept by the bedside. It is too easy for a half-asleep patient to mistakenly take extra tablets. In the case of a suspected overdose medical attention must be sought.
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Here is a list of some possible, common side effects:
- Drowsiness is a common problem with all drugs which have an effect on the central nervous system – these include sedatives, tranquillisers, sleeping pills, most drugs used in the treatment of anxiety and depression and drugs used in the treatment of epilepsy. Drowsiness is also common with antihistamines (these are commonly used for allergies and so patients suffering from hayfever, for example, should be aware that their medication may make them feel sleepy).
- Nausea and vomiting may be caused by many different drugs including pain relievers, drugs used to treat infections, hormones and drugs prescribed for heart conditions.
- Dizziness is commonly caused by aspirin but drugs used to treat high blood pressure, nerve disorders such as anxiety and depression and infections can also cause this side effect.
- Drugs such as penicillin which are used to treat infections often cause diarrhoea – as do some drugs prescribed for intestinal disorders such as indigestion, gastritis and constipation.
- Headache is a symptom that is associated with an enormous range of drugs.
- Drugs used in the treatment of high blood pressure and in the treatment of nerve problems seem particularly likely to produce a dry mouth.
- Pain relievers, drugs used to treat infections and steroid drugs are the prescription products which seem most likely to cause indigestion or wind.
- Skin rashes are extremely common among patients taking drugs. Drugs used to treat infections – such as penicillin and sulphonamide – are commonly associated with this problem. A skin rash may suggest an allergy to a drug.
- Itching associated with a skin rash means that an allergy reaction is almost certain.
- Constipation is a common side effect with pain relievers, antacids, cough medicines and (naturally enough) drugs used in the treatment of diarrhoea.
- Other side effects which are commonly noticed by patients taking prescription drugs include: confusion, hallucinations, tremors, fainting, wheezing, palpitations, blurred vision, depression, sweating, ringing in the ears and sexual problems such as frigidity and impotence.
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Here are some tips to help you minimise your risk of developing a side effect if you have to take a prescription drug.
- Always follow any specific instructions that you have been given by your doctor. Read the label on your bottle of pills and take notice of what it says.
- When you’re not using them drugs should be stored in a locked cupboard out of reach of children, in a room where the temperature will be fairly stable. The bathroom is probably the worst room in the house for storing medicines. Your bedroom -which probably has a more stable temperature – is much better.
- Never take drugs which were prescribed for someone else. Return all unused supplies of drugs to your pharmacist.
- It is wise to assume that all prescribed drugs can cause drowsiness. You shouldn’t drive or operate machinery after taking a drug until you are sure that you are safe.
- Drugs do not mix well with alcohol. If you want to drink while taking drugs ask your doctor whether or not it will be safe.
- Do not take non-prescribed medicines while taking prescribed drugs unless your doctor has told you that you can.
- Do not stop taking drugs suddenly if you have been advised to take a full course. Ring your doctor for advice if you need to stop for any reason. Some drugs have to be stopped gradually rather than abruptly.
- Be on the look out for side effects and remember that if you seem to develop new symptoms while taking a prescription drug then the chances are high that the new symptoms were caused by the treatment you are taking for your original symptoms.
- Report any side effects to your doctor – and ask him if he’s going to report the side effects lo the authorities. The vast majority of doctors never bother to report side effects – with the result that potentially hazardous drugs remain on the market for far longer than they should.
- If you need to see a doctor, while taking a drug make sure he knows what you are taking – particularly if he intends to prescribe new treatment for you. Many drugs do not mix well together and may, indeed, react together in a dangerous way.
- Do not assume that a doctor you have seen in the past will remember what he prescribed for you on a previous occasion.
- Learn the names and purposes of the drugs you take. If you are not sure when to take the drugs that you have been given ask your doctor or the pharmacist. If you think you will forget the instructions you are given ask for them to be written down. The name of the drug should always appear on the container.
- Do not remove drugs from their proper containers except when you need them or if you are transferring them to a device intended to improve compliance.
- Try to see the same doctor as often as possible. If several doctors are prescribing for you there may be an increased risk of an interaction between drugs which do not mix well.
- Use drugs with care and caution, but do use them When they are required. Doctors sometimes divide patients into two main groups: those who are willing to take drugs for any little symptom and who feel deprived if not offered a pharmacological solution to every ailment, and those who are unwilling to take drugs under any circumstances. Try not to fall into either of these extreme groups.