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Chapter 38: Coping
with Side-Effects |
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Doctors
are men who prescribe medicines, of which they know
little, to cure diseases, of which they know less,
in human beings, of whom they know nothing.
- Voltaire
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Medicines have certain desirable effects (which
is why the doctor prescribes them in the first place!)
and these effects of a drug are known as the drug's
effects or therapeutic effects. Drugs, however,
have undesirable effects as well, and these are
broadly called side-effects or adverse reactions.
Some side-effects are expected and unavoidable,
but others may surprise the doctor as well as the
patient, and some of these unexpected reactions
may be due to an individual's specific response
to the drug.
Side-effects generally fall into one of two major groups - those that are obvious and those that cannot be detected without laboratory testing. A discussion between you and your doctor about your medicines should not be restricted to the most easily recognized side-effects because other, less obvious, side-effects may also prove harmful. Some side-effects may signal a serious, perhaps dangerous, problem, and if such side-effects appear, you should consult your doctor immediately.
If you know that a particular drug produces a particular
side-effect, you can afford to relax a little. Most
expected side-effects are temporary and need not
cause alarm. You'll merely experience discomfort
or inconvenience for a short time. For example,
you may become drowsy after taking an antihistamine
or develop a stuffy nose after taking certain drugs
for treating high blood pressure. Of course, if
you find certain minor side-effects especially bothersome,
you should discuss them with your doctor, who may
be able to prescribe another drug or at least assure
you that the benefits of the drug (you are currently
taking) far outweigh its somewhat irksome side-effects.
Sometimes, side-effects can be minimized or eliminated
by changing your dosage schedule or taking the drug
with meals, but you need to check this aspect with
your doctor!
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Even if you experience minor side-effects, it is very important that you take your medicine exactly as it has been prescribed. Don't stop taking a medicine just because you think that it does not 'suit' you ! You should take the full dose at the specified times for the length of time prescribed by your doctor. Taking a lesser amount of medicine to avoid side-effects or because your condition appears to be improving is NOT advisable. A smaller dose may not provide any benefit whatsoever; that is, half the dose may not provide half the therapeutic effects !
Some obvious side-effects of commonly used drugs include blurred vision, a dry mouth, heartburn, nausea, vomiting, diarrhoea, constipation, loss of appetite, drowsiness, dizziness, stuffy nose, skin rash, swelling, itching and sweating. Remember that these side-effects do not mean that you are 'allergic' to the drug, it may simply be one of the reactions of your body to the drug.
Other side-effects may be subtle and more difficult to detect. You may not notice any symptoms at all, or you may notice only slight indications. Therefore, your doctor may advice you to go in for periodic blood tests or eye examinations to ensure that no subtle damage is occurring while you are on certain medicines. Such damage could affect your heart, kidney or liver; or cause anaemia or loss of hearing.
USE OF DRUGS DURING PREGNANCY
AND BREAST-FEEDING
Before taking ANY medicine, it is very important
to tell your doctor if you are pregnant (or planning
to become pregnant) or are breast-feeding your baby.
For most drugs, at present, complete information
on safety during pregnancy and while breast-feeding
is woefully lacking. This shortcoming cannot be
attributed to negligence or lack of concern on the
part of regulatory agencies, but to the fact that
it would be unethical to conduct drug experiments
on pregnant and nursing women. Keeping this aspect
in mind, you should discuss in an unambiguous manner
with your doctor the risks versus the benefits of
taking any medicines during pregnancy or while nursing
an infant.
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MANAGEMENT
OF SIDE-EFFECTS
First of all, check your drug information leaflet or consult your doctor to determine whether, the side-effects you are experiencing are minor (relatively common and usually not serious) or major (symptoms that you should consult your doctor about). If your side-effects are minor, you may be able to compensate for them (see the following table for suggestions). However, consult your doctor if you find minor side-effects persistent or particularly bothersome.
Common Minor Side-Effects
Side-effect and its Management
Constipation: Increase the amount of fibre in your diet; drink plenty of fluids; exercise regularly
Diarrhoea: Drink lots of water to replace lost fluids; if symptoms last for longer than three days, consult your doctor
Dizziness: Avoid operating machinery or driving a car
Drowsiness: Avoid operating machinery or driving a car
Dry mouth: Suck on candy or ice chips
Headache: Remain tranquil; take aspirin or paracetamol
Insomnia: Take the last dose of the drug earlier in the day; drink a glass of warm milk at bedtime; request your doctor to draw up in exercise programme
Itching: Take frequent baths or showers, or use wet soaks; also calamine lotion or antihistamines may help
Nasal congestion: If necessary, use nose drops
Upset stomach: Take the drug with milk or food
On the other hand, if you experience any major side-effects,
contact your doctor immediately. Your dosage may
need adjustment, or you may have developed an allergy
to the drug. Consequently, your doctor may want
you to switch over to a different medicine to treat
your disorder. Never stop taking a prescribed medicine
without first consulting your doctor!
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