Patients Must Monitor Prescriptions

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Keep Better Track of Your Prescriptions

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Medical doctors practice evidence-based medicine. Years of study and continuing education shape the view of patient treat­ments. Nearly every prescrip­tion has potential side effects. Yet, they are approved by government agencies like the US Food and Drug Administration (FDA) because the risks are slight or outweigh the benefits. Over 20,000 prescription drug products are approved by FDA for marketing.

In today’s healthcare system within the United States and elsewhere, physicians rarely monitor individual reaction to prescrip­tions. Patients receive lengthy pages to read. The responsibility for evaluating drug response effec­tively transfers to patients. Not reading or under­stand­ing the litera­ture can lead to puzzling adverse events.

Serious OTC Drug Reactions

Taken up to 4 weeks, a prescription for Omeprazole (a proton pump inhibitor) can cause a type of kidney problem (acute interstitial nephritis), diarrhea, bone fractures, or certain types of lupus erythe­mato­sus. That is a pretty diverse range for a drug sold over the counter (OTC) as Prilosec®.

Currently, the FDA does not list lupus erythema­tosus as a possible reaction, though it is widely reported in litera­ture. Many people believe lupus to be an acquired auto­immune disorder linked to environ­mental, genetic, and hormonal factors. It can attack major organs, including the skin. Who would imagine it is caused by an OTC remedy for stomach discomfort? Fortunately, the subacute condition may resolve upon discon­tinuance of the medica­tion. In the interim, patients unaware of the source may try many remedies.

Reporting reactions unsupported by photo­graphic or some other verifiable evidence might lead some physicians to doubt such side effects. So sending an email to your doctor saying, ‘I developed lupus after taking the prescrip­tion so it was discontinued,’ may cause some skepticism. Your anecdotal report might not be sufficient convincing evidence.

⚠️ People who use proton pump inhibitors (PPIs) may be more likely to get COVID-19. This finding was reported in a study by Brennan Spiegel, MD, MSHS, et al. published online on July 7, 2020 in The American Journal of Gastroenterology. —Medscape

Another OTC medication has life-threatening conse­quences. Meclizine (Antivert®) is an anti­histamine that is used to prevent and treat nausea, vomiting, and dizziness caused by motion sickness. It may also be prescribed during otolaryngology visits to reduce dizzi­ness and loss of balance (vertigo) caused by inner ear problems.

Notify your doctor immediately if you notice any serious side effects, including: mental/mood changes (such as restlessness, confusion), fast/irregular heartbeat (tachy­cardia), shaking (tremors), difficulty urinating, or seizures. What may be picked up at your local drug store, administered on a cruise ship, or given to sea sick people on a small boat or yacht might cause a serious cardiology problem.

Resources For Information

Doctors and patients used to commonly purchase the Physician’s Desk Reference (PDR), which is still available. It shows pictures of drugs, describes how they are to be used, lists side effects and contra­indica­tions. Much of this information is now available on Drugs.com or the Epocrates® app. However, any pharmacy prescription includes a patient handout detailing much of the same information available from these sources. OTC medications likewise include a leaflet, albeit with tiny text, that warns patients of potential reactions.

In light of the above examples, it is imperative that patients educate themselves about potential drug risks. Do not take drugs prescribed to another person. To remain A Bit More Healthy, be alert and report unusual reactions to your doctor.

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Kevin Williams is a health advocate and writer of hundreds of articles for multiple web­sites, including: A Bit More Healthy, KevinMD (WebMD), and Sue’s Nutrition Buzz. He is a prior 15-year con­sul­tant for Neutrogena Research and Scientific Affairs.

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