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【drug-news】新研究显示常用药和oTC药可对某些病
Drug Dangers
A new study identifies common prescription and over-the-counter drugs that produced serious adverse effects in some patients. The list may surprise you.
By Jennifer Barrett
Newsweek
Updated: 5:50 p.m. ET Oct. 17, 2006
Oct. 17, 2006 - Every medication has risks as well as benefits. But a new study finds a handful of drugs appear to produce a disproportionate amount of adverse effects that require emergency room visits and, sometimes, hospitalization. The study, published Tuesday in the Journal of the American Medical Association, tracked adverse effects—from allergic or other reactions to accidental overdoses—in patients who visited 63 hospitals in 2004 and 2005. Based on the sample data, researchers estimate that at least 700,000 (and probably more) Americans suffered unintended health problems related to the over-the-counter or prescription drugs they were taking during that time period, and one in seven of them were sick enough to require hospitalization.
The problems most often occurred in patients 65 or older, who suffered adverse effects twice as often as those under 65 and were nearly seven times as likely to need hospitalization. Though many of the common conditions reported weren’t life-threatening (like rashes or stomach aches), all were serious enough to require a hospital visit. The most common culprits included insulin, blood thinners and antibiotics; but some of the most popular over-the-counter pain medications were also on the list. Are patients misreading labels or are doctors prescribing inappropriate doses or drugs? NEWSWEEK’s Jennifer Barrett spoke with the study’s lead author Dr. Daniel Budnitz, a medical epidemiologist at the Centers for Disease Control and Prevention’s National Center for Infectious Diseases, about the results. Excerpts:
NEWSWEEK: You estimate that at least 700,000 Americans suffered adverse drug effects in 2004 and 2005 that were bad enough to require a hospital visit. Were you surprised by the number?
Dr. Daniel Budnitz: Actually, it is most likely an underestimate. It might just pick up a third of the emergency visits—the number could be much higher. We don’t know how much. But we are confident that there were at least 700,000 emergency department visits. Another point to remember is that these are medications that we’re giving to patients to help them, and they are experiencing some degree of harm. So some might argue that even one of these events is bad. All drugs have benefits and risks, so it’s probably unfair to say that every ER visit is unavoidable. But many of these events—especially the most severe—are due to this handful of drugs that we already knew we need to closely monitor.
Which drugs produced the most adverse effects in patients?
Insulin, warfarin [a blood thinner], and amoxicillin [an antibiotic commonly used to treat infections] were the most common. And we knew that this could be a problem with them.
Why? Are people misreading the label or are doctors not being clear about the instructions on how to take it?
In the case of insulin, we found cases where patients would take insulin but then forget to eat their meals, or they might be confused about the proper dose. Insulin is a more severe case. Diabetics can get hypoglycemic and have complications like passing out if they don’t eat.
What about warfarin?
The key point for that drug is to ensure patient education about the proper dose. Also, it commonly reacts with other drugs and even foods. So patients need to inform their doctor if they are taking other drugs, other antibiotics, and even if they change their diet. Certain foods like some green leafy vegetables and grapefruit juice are known to change anticoagulation [the blood’s ability to clot]. So if a patient suddenly starts or stops drinking grapefruit juice every morning, he should tell his doctor. It’s also important to keep up with lab monitoring to check their level of coagulation [the drug is intended to decrease the blood’s tendency to clot but not to prevent clotting altogether, so dosing is often adjusted based on blood tests].
What problems were associated with amoxicillin?
The most common adverse effect is a rash but patients can have more serious allergic reactions [such as] anaphylaxis [a potentially life-threatening reaction]. With this one, it’s not so much a dosing issue. But it’s important to assure its appropriate use to prevent complications.
Adverse effects were also reported in several patients who took common over-the-counter drugs like aspirin and ibuprofen. Were you surprised?
Whether or not a drug makes it onto this list is a function of how commonly the adverse effects occur and how many people take the drug. So, you have to remember that many millions of people take aspirin and ibuprofen [but adverse effects only occurred in a small proportion of users].
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作者:admin@医学,生命科学 2011-07-10 17:28
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