Recognizing Drug Side Effects
- By: Sheryl L. Szeinbach Ph.D
No doubt, medications have improved our quality of life and longevity. For many individuals, improvements in health are so remarkable that any mention of the word “side effect” or “drug interaction” evokes an immediate response of denial. What side effects? After taking a medication for so long, these headaches can’t be from the medication. Or, this strange feeling has never happened before, not sure about the cause; if it goes away – everything is cool.
While those little episodes (e.g., headaches, unusual sensations, feelings of pressure, rash, dryness, subtle changes in behavior, etc) may be explained away by family and friends as harmless, to truly “know thyself” also means to focus internally and understand how each of us reacts to medications.
Expectations also play a role in how we “expect” a medication to work. Commercials for medications relate to us what our symptoms are and how to fix them. Everyone is telling us this medication will work and everyone in the world knows this medication will work. Friends continue to support us and take note of positive changes in appearance or mood. Just when everything appears to be working and expectations are high, that’s when side effects may be easier to ignore or tolerate.
As we confront the aging process, medications that were once tolerated may become our worst enemies. Our bodies sometimes respond differently to prescribed medications when they are combined with over-the-counter medications, nutritional supplements, or with other medications. Side effects may appear within days, a couple of weeks, or months after starting a new medication.
Chances are there is nothing to worry about unless the episodes or experiences get worse. However, like most folks, we need assurance that these events are not serious. Considering how much time we devote to medication use, an application or simple program is needed to let us know if we should be concerned about possible side effects from medication. As the risk for side effects and drug interactions is compounded when prescribed medications are added, knowing which medication is causing the problem would also be helpful.
One such tool in development is the Pharmaceutical Therapy Related Quality of Life (PTRQoL) “side effect” evaluation system, which is designed to easily, rapidly, and efficiently screen patients who are receiving prescription drug therapy for the presence of acute or on-going side effects. 1 Within minutes, patients can respond to a 5-question checklist that will identify about 60% of known side effects likely to occur across drugs in similar therapeutic areas.
Drugs included in the checklist can be pre-selected by pharmacists according to medication profiles and discussions with patients. From the printouts, pharmacists can determine the severity of a side effect, how frequently it occurs, and how bothersome the side effect may be to patients.
At this time, the PTRQoL application maintains a complete database of the interaction, but does not retain participant specific data. However, once fully developed, the system will provide information that is suitable for use in reimbursement billing, documentation of quality assurance, and a comparative analysis of drugs used to treat specific conditions.
Currently, the system lacks the ability to adjust for different physical characteristics and genetics. Other hurdles include incorporating laboratory results, medical records from hospitalization, and routinely prescribed medications obtained from pharmacies outside the pharmacy network or competing pharmacies. But these are just technical issues, and opportunities to consolidate this information await further development of the idea- but for now the development of a basic tool to assess side effects is a starting point.
In summary, while allergic reactions require immediate medical attention, subtle symptoms that occur more than twice after taking a medication or do not go away after a day should be evaluated by a pharmacist, nurse, or prescriber. In some cases, patterns may be present but difficult to detect unless a record is kept. When keeping a record, the type of episode, time of episode, type of food consumed, and other symptoms should be noted when taking new medications, changing medications, and adding prescribed or over-the-counter medications to the regimen.
Reporting this information to health care professionals can help them track drug side effects after a drug is marketed. In addition, health professionals have access to timely information such as drug recalls, changes in dosing, and additional warnings that may be added to medication labels and patient information sheets. This information would also be used to update the checklist for the PTRQoL “side effect” evaluation system.
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Sheryl L. Szeinbach, PhD, MS, BSPharm is professor at Ohio State University. Her PhD is from Purdue University, MS from the University of Kentucky, and BSPharm from the University of Texas, Austin. Website: www.zbachhsc.com(http://www.zbachhsc.com).
Mathew M. Murawski: http://www.japha.org/data/Journals/JAPhA/926466/JAPhA_53_1_61.pdf