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Safety Concerns of Prescription Drugs

Instructor: Amanda Robb
In this lesson we'll be examining the negative side of prescription drugs. Although most of us are familiar with their benefits in treating disease, these drugs also have negative side effects. In this lesson we'll examine the issues of side effects, non-adherence to medication, and the possibility of addiction.

What Does Prescription Drug Usage Look Like?

Nick feels like he has trouble concentrating at work sometimes. He's often distracted by the internet. Nick also has time management problems and is frequently late. He goes to the doctor, who suggests he might have ADD (Attention Deficit Disorder). Nick is prescribed Vyvanse, a strong stimulant that is used to treat ADD, but is also often abused by people wanting to stay awake or concentrate more easily.

Soon Nick finds himself too jittery and feels like his heart is racing. Returning to the doctors, he is prescribed a benzodiazapene, an addictive anti-anxiety medication that helps with sleep. Now, Nick develops other problems; he feels addicted to the pills and is experiencing side effects from both, like high blood pressure from the Vyvanse and confusion and dizziness from the benzodiazapene.

Unfortunately, this scenario is common in the United States. According to the Centers for Disease Control and Prevention (CDC), nearly 50% of Americans used a prescription drug in the last 30 days of 2014, and over 10% were taking five or more between 2009 and 2012. Despite their benefit in treating diseases, prescription drugs are often overused and can cause serious safety concerns.

Side Effects

All prescription drugs come with side effects, or unintended effects that negatively impact a patient's health. We've all seen the commercials for medications, perhaps a prescription antacid for heartburn or a migraine medication. At the end of these commercials is a long list of side effects, many of which can be fatal. However, pharmaceutical companies spend enormous amounts of money on advertising. In 2007, five billions dollars was spent marketing drugs directly to consumers, and even more was spent advertising to physicians according to a study done by the accredited medical journal Pharmacy and Therapeutics. This aggressive marketing can result in over-prescribing by doctors, as well as patients with many prescriptions experiencing side effects, such as Nick with his Vyvanse.

For example, Lisinopril, a medication for high blood pressure, had over 87 million prescriptions in 2011 in the United States. Roughly 30% of the population in the United States takes this drug. This medication can cause severe dizziness, a cough, and headaches. Other rare but serious side effects include fever, high levels of potassium in the blood (which can be fatal for the heart), and low blood pressure.

Lisinopril pills have both benefits and side effects
lisinopril

Non-Adherence to Medication

Other medications are prescribed for acute infections, like a virus or bacteria. When you have a bacterial infection like strep throat, your doctor will prescribe you antibiotics which are used to kill bacteria. Your doctor will prescribe a certain dosage and also set times to take the pills. It's very important that you adhere to this schedule. When you don't take your pills on time, or stop taking them but still have more, it's called non-adherence to medication. This can be dangerous for both yourself and the entire human population. Let's look at why.

When you take antibiotics, you kill off most of the bacteria in an infection. However, there will always be some bacteria that are immune to the antibiotic. We call these bacteria antibiotic resistant. If you take the antibiotic as you're supposed to, you'll kill off everything but these resistant guys. Then your immune system can probably take care of those. But, if you stop halfway through your antibiotics regimen, you still have a pretty big population of bacteria remaining. Some of these will be the resistant bacteria and they'll multiply. Now, you have a big population of antibiotic resistant bacteria and no way to kill them. The next time you go to the doctors, the same antibiotics won't work like they did the first time.

Antibiotic resistance
antibiotic resistance

This is happening more and more frequently with bacterial infections such as methicillin-resistant Staphylococcus aureus (MRSA), which plagues hospitals and is resistant to many antibiotics, not just one.

Other medications, such as the drug Lamictal, can have serious consequences if you stop taking it suddenly. Lamictal is an anti-seizure drug and can also be used as a mood stabilizer. If you stop taking your Lamictal suddenly, the symptoms it manages all come rushing back. Patients are at risk for serious mood swings, which can lead to suicidal thoughts and seizures, even if they did not have them before taking the medication. If you are taking any medications and need to stop, talk to your doctor about slowly tapering off the drug.

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