Tuesday, August 14, 2007

Preventing Adverse Drug Reactions

In part 3 of the Healthy Aging Presentation, we are going to examine the very common but under-reported phenomenon of Adverse Drug Reactions.

In North America:

• There are over 2 million serious adverse drug reactions each year
• Over 100,000 deaths occur yearly due to adverse drug reactions
• According to the Journal of the American Medical association (JAMA); most serious (often fatal) adverse drug events are preventable.

To illustrate the problem of adverse drug reactions, we are going to use a case study of a patient named Jenny.

Jenny’s is a single 48 year old, working mother with 2 teen age boys. Jenny experienced a health crisis from an adverse drug reaction compounded by self medication.

Jenny presented to her physician with the following symptoms:

• Anxiety
• Headaches
• Fatigue
• Low back pain

The medical examination findings revealed:

• Increased Total Cholesterol
• She was 40 pounds overweight
• An increase in blood pressure (measured at 150/100)
• Extreme Tenderness of her low back and neck muscles

Therefore, Jenny was diagnosed with:

• Hypercholesterolemia
• Hypertension
• Tension headaches
• Anxiety

She was prescribed the following medications to treat her symptoms:

• Lipitor (to decrease cholesterol)
• Ativan (to decrease anxiety)
• Naproxen (an anti-inflammatory) to relieve symptoms of her back pain and headaches

Each and every medication has common side effects. The common side effects of Lipitor include:

• 1. Headaches
• 2. Constipation/diarrhea
• 3. Stomach pain
• 4. Muscle and Joint Pain
• 5. Rash
• 6. Muscle weakness and tenderness

After taking the medication exactly as prescribed for 2 weeks, Jenny experienced:

• 1. Increased intensity of headaches
• 2. Increased fatigue which prevented her from performing her regular job duties.
• 3. Severe Abdominal pain
• * These are all signs of an ADVERSE DRUG REACTION

Instead of reporting the symptoms to her doctor, Jenny decided to self medicate by taking Tylenol #3 and Percocet. Both these medications are very potent analgesics. It is no surprise that Jenny ended up in the hospital with a diagnosis of:

• 1. Adverse Drug Reaction
• 2. Adverse Drug Interaction from self medication

After being treated at the hospital, Jenny decided to visit her local chiropractor. She explained her problems to the chiropractor and asked him if there was anything that he could do. After taking a thorough history and performing a comprehensive physical examination, the chiropractor told Jenny that he agreed with the medical diagnosis. Jenny was somewhat perplexed and asked the chiropractor 2 questions:

• 1. Why do I have high cholesterol, high blood pressure, and ache all over?
• 2. Why can’t I lose weight Doc?

The chiropractor said that all her signs and symptoms pointed to one underlying cause. His diagnosis was that she suffered from Couch Potato Syndrome! Her symptoms were mainly due to inactivity and a sedentary lifestyle. She was looking for a quick fix with pills and potions.

After several minutes of a heated discussion, the chiropractor proposed the following treatment program.

• 1. Walk 30 minutes daily with Nordic walking poles
• 2. Yoga classes
• 3. Regular Chiropractic care
• 4. Take all old medications to her local pharmacy in a brown bag for proper disposal.
• 5. In future, report all side effects of medication to the physician.

Jenny agreed that the treatment plan made sense, but quickly retorted that she didn’t have time to exercise. The doctor replied, “What fits your busy schedule better? Exercising 1 hour a day or being dead 24 hours a day?”

Jenny finally agreed to the treatment program and has never looked back since.

After 2 months of following her treatment plan Jenny has:

• 1. Lost 15 pounds
• 2. Takes only 1 medication
• 3. Reduced frequency and intensity of her headaches
• 4. Has signed up for her first ever 5 kilometer fun run!

Remember the facts:

• In North America there are over 2 million serious adverse drug reactions each year from prescriptions taken as prescribed
• Over 100,000 deaths occur yearly due to adverse drug reactions
• Adverse drug reactions are the 4th leading cause of death ahead of AIDS, pneumonia, accidents and automobile deaths

Medications are necessary, may be life saving and may improve the quality of your life, but why not try safer conservative measures first?

When was the last time your doctor wrote you a prescription for exercise?

Today’s action steps are:

• 1. Put all old prescriptions in a brown paper bag and bring to your local pharmacy for proper disposal.
• 2. Make an Appointment for a Chiropractic Check up today.
• 3. Take a walk around the block with your family and friends. Instead of playing cards or drinking coffee, meet at the park every week to exercise!