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Limiting Your Risks

January 08, 2001

People who take a number of medications has an increased risk of adverse drug interactions or complications. Included are those with chronic illnesses and the elderly, especially those with memory lapses, who may be too confused to use drugs correctly.

Preventing Complications

All drugs can cause complications. Even aspirin can irritate the stomach lining and trigger bleeding in the gastrointestinal tract. To lessen the likelihood of such problems, patients can follow these steps:

When your doctor prescribes a new medication, make sure you know the name of the drug, what it does, the correct spelling of the drug and any side effects.

Also, be sure to ask your doctor or pharmacist how often to take the medication, whether you should take it with food or water, and whether you should avoid alcohol.

Tell your doctor about other medications you're taking, including over-the-counter drugs and dietary supplements, such as vitamins or herbal products, to avoid drug interactions.

Ask for the package insert that comes with every drug, and take the time to read it carefully, especially the warnings about possible side effects.

Don't skip or double up on doses. Follow your doctor's directions explicitly.

Be wary of drugs that have been on the market for less than a year. If your doctor prescribes a new medication to treat an ongoing condition, ask the reason for the change.

For more information, including the latest drug warning statements, check out the FDA's consumer drug site. The latest medical product safety information can be found on the MedWatch Web site at

Or contact an FDA information specialist: (888) INFO-FDA ([888] 463-6332).

Signs of an Adverse Drug Reaction

About 75% to 80% of adverse drug reactions are dose-related. Either the patient is getting too high a dose, which could cause a toxic reaction, or too little, rendering it ineffective. Premarketing tests of drugs mostly use healthy, young male volunteers to establish dosages. These standard doses, however, may be too much for women, children or the elderly.

Another common side effect of drugs is liver toxicity. The liver is the organ that metabolizes medications. It can be damaged by too much medication; or, if someone has a genetic predisposition, liver enzymes can transform the drug into a poisonous compound that destroys the organ.

Some other common symptoms of drug complications:

* Skin rash or hives.

* Bruising easily or bleeding.

* Severe nausea or vomiting.

* Diarrhea or constipation.

* Confusion, headaches, dizziness, lightheadedness.

* Breathing difficulties.

* Insomnia, tremors or anxiety.

* Listlessness or even depression.

* Heart racing or pounding.

If you experience any of these symptoms, call your doctor immediately.

Drugs That Cause the Most Complications

* Antibiotics can cause nausea, diarrhea and rashes. In extreme cases, people can experience a severe allergic reaction, anaphylactic shock, which can be fatal if not treated immediately.

* Heart medications, such as Lanoxin, which is used to treat congestive heart failure, can cause irregular or erratic heartbeats, or even relax the heart muscle so much that it causes cardiac arrest.

* Blood thinners, such as Coumadin, are designed to prevent blood clots. But they can thin the blood so much that they trigger intracranial bleeding or strokes.

* NSAIDs, or nonsteroidal anti-inflammatory drugs, such as Advil or Motrin, are designed to reduce swelling and pain. But they can also cause gastric hemorrhages.

* Chemotherapies can cause hair loss and nausea, suppress the immune system, and do irreversible damage to the heart.

* Beta blockers, which lower blood pressure, can exacerbate asthmatic conditions.

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