One of the tasks of a physician is to manage acute and chronic medical conditions. Often, this involves prescription of medications. Many medical problems are matched with a drug that treats it. Physicians follow guidelines for diabetes, heart failure, osteoporosis, hypertension and other conditions, and are prescriptive in what they suggest to achieve goals of care. Frequently, goals are improving symptoms, reducing hospitalizations and/or avoiding the complications associated with having these illnesses.
Even before physicians are visited by their patients, an array of over-the-counter medications, herbal supplements and vitamins can be purchased to help treat patients’ symptoms and conditions. Yes, we are a species that uses substances to help improve the quality of life. Often, we have evidence to back up the claims and expectations of what these substances are meant to do.
Sometimes, though, people become very concerned about the potential side effects of the medications they take or have been prescribed. The attention on side effects may overshadow the benefits of the medication. One example is the risk of osteonecrosis of the jaw associated with use of bisphosphonates, a class of medications prescribed to help reduce the risk of fracture associated with osteoporosis. Though the risk of this potential side effect was 1 in 10,000, the medication and all of its benefit in patients was abandoned due to fear of this rare side effect. One other medication class that received a lot of attention was statins and their potential risk of cognitive impairment. People stopped taking it for fear of developing “dementia,” and abandoned the benefit in reduction of risk of heart attack in individuals with known history of diabetes or prior coronary artery disease.
One needs only to do an internet search for a drug or listen to a TV commercial to learn about horrible or life-threatening side effects. Medications are merely substances that provide benefit, but are never free of side effects. It should also be mentioned that over-the-counter medications have a side-effect profile that people may not be familiar with. Herbal supplements and many compounded supplements available over the counter without need of a prescription have a myriad of side effects that are not mentioned because the manufacturer is not required to disclose them. Each single component of these multi-substance supplements could be considered a drug in and of itself. A significant concern for these over-the-counter medications is that physicians may not be aware that the patient is taking them, and there may be interactions between these substances and prescribed medications.
To avoid medication-related problems, some simple things can be done:
— Confirm with your doctor all prescribed and over-the-counter medications.
— Make sure all of your medications are prescribed for a specific reason.
— Check to see if medications are prescribed to treat the side effects of other medications (if this is the case, consider stopping the medication causing the side effect).
— Make sure the medications are doing the things they’re supposed to do.
Any concerns about side effects of medications should never be ignored, but before stopping the medication on your own, be sure to review your concerns with your doctor. This way, together you can make sure that the risks that you are concerned about are outweighed by the benefits expected from the medication.
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Medications: Balancing Risks and Benefits originally appeared on usnews.com
