Adverse drug reactions are one of the 10 most common causes of death. 30-40 percent of side effects can be avoided – said Dr. Jarosław Woroń from the Jagiellonian University at the conference Dangerous drug interactions in clinical practice.
The conference was held at the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products, as part of the nationwide “Safe Drug” campaign.
“It gets worse and worse,” said Dr. Woroń. – Harmful drug interactions – that is, their interaction with each other – will become a growing problem. If two drugs are taken, the risk of an adverse interaction is 13 percent. With five drugs it is already 58 percent, with seven or more – 82 percent. Medicines are widely available – often without a prescription, their harmful effects are sometimes underestimated, and many patients or even doctors are not aware of the risk. When in Krakow, patients were experimentally given a list of drugs to ask doctors to prescribe a lethal combination, only in one out of 10 doctors refused to write a prescription ».
One of the methods of increasing the safety of pharmacotherapy is combating the phenomenon of self-healing. Meanwhile, manufacturers advertise drugs like washing powder, encouraging people to buy larger, “economical” packaging, which later “would be a pity to throw away”. Patients often use preparations with different trade names, but containing the same, e.g. paracetamol or ibuprofen. Sometimes they don’t tell the doctor what they’re taking.
Too often self-medication is undertaken under the influence of random people. During the mourning that had just ended, a patient was admitted to the hospital, to whom friends advised – to improve her mood – six different benzodiazepines. Her blood pressure dropped dramatically and it was impossible to communicate with her.
The simultaneous use of several non-steroidal anti-inflammatory drugs has very unfavorable consequences. Such drugs – e.g. ibuprofen and naproxen – must not be combined with each other – they are not more effective then, but the risk of damage to the gastrointestinal tract, liver and kidneys increases. Besides aspirin, all NSAIDs can harm the cardiovascular system.
Combining expectorants with antitussive drugs does not make sense – an example of such a combination are “smart” syrups for “every cough”. Secretion-thinning drugs should not be combined with the administration of calcium preparations that thicken the secretion. Pyralgina is an effective pain reliever, but together with co-trimoxazole it can damage the bone marrow. Ginseng or ephedrine reduce the effectiveness of the treatment of hypertension. When taken by many people – even in the form of “nerve” remedies – St. John’s wort can interfere with the action of antidepressants and even contraceptives, which can cause unplanned pregnancy. Seemingly innocent paracetamol in too high a dose can destroy the liver, and in combination with warfarin it increases the risk of bleeding – warned the specialist.
Interactions are a particularly big problem among older adults who are taking many different medications. Each of the many specialists can treat a patient for one of the ailments in accordance with the rules of art – and the overall effect can be deplorable. If someone is taking multiple pain medications, taking one of them off helps more than adding another. Multiplication of drugs is a vicious cycle – a new drug to fight the symptoms of existing drugs causes new symptoms. There are drugs that should never be given to elderly people – for example, barbiturates, pethidine and hyoscine butylbromide (Buscopan).
As Dr. Woroń said, in Poland there is no central, reliable website informing about drug interactions, and the knowledge available on the Internet is not always reliable. In many countries, doctors who work in hospitals and clinics use programs that alert them to combining certain medications. Patients are left with popular medical books, knowledge from the media and small print leaflets (PAP).