Every person encounters drugs in his life. Sooner or later, you still have to take pills, syrups, give injections, etc. We are not always attentive and often do not read the annotations on how to properly take this or that remedy. We rely on our own knowledge, the experience of the older generation, acquaintances, friends, etc. However, not always, we do everything right and in some cases we can harm ourselves and our children. Let's look at the safety precautions for taking medications so that treatment is only in our favor.

Can multiple drugs be taken together?

As a rule, drugs should be taken separately from each other. When prescribing a drug, a specialist indicates what and when our body needs. No need to think that taking "harmless" vitamins with the main drug will not affect the process in any way .. Therefore, if you are observed by several specialists at once, let them know about each other's appointments.

However, there are cases when the action of one drug enhances the work of another. Your doctor can also tell you about this. And read the annotation, perhaps it also indicates which group of drugs can be combined and which cannot.

How and what to take pills?

Most often, when taking medications, we do not think about what we drink them with. All liquids that fall under the arm are used. However, there is a strict rule that all medicines for oral administration drink only clean water. Not mineral ( mineral water react with drugs, they contain many trace elements), not carbonated, not juice, not coffee or tea, but plain water. Alcoholic drinks and beer are also strictly prohibited.

However, there are some medicines that are taken with milk or other drinks. This is an extremely rare occurrence and must be specified by the doctor or recommended in the package leaflet.

Correct form of medication

The annotation always indicates how to properly take a particular drug. If the tablet is coated, then you do not need to crack it, this is done so that it dissolves in the desired section of the gastrointestinal tract. If it is a capsule, then its gelatinous coating dissolves exactly where it is better absorbed and its action becomes more effective.

Chewable tablets or sucking plates should not be swallowed whole, but should be allowed to dissolve in oral cavity, especially if these are topical preparations. Inside the body, they will not bring you any benefit.

Despite these rules, the exceptions are the use of drugs by children, since there are no small dosages and the drug must be divided into doses. But, even this requirement must be spelled out in the instructions.

Respect the exact time of taking medications

The recommendations usually indicate when to take the drug - before meals, after or during. However, it should be clarified, because the concepts before meals and on an empty stomach are completely different things. If this rule is neglected, the medicine will be destroyed by gastric juices that accompany the digestion of food and will not bring the desired effect.

If it is indicated that you must eat before taking the remedy, also follow this instruction. Because side effects Some drugs can adversely affect the gastrointestinal tract as a whole if taken on an empty stomach.

What form of medicine is most effective?

If you take medicines in the form of tablets and capsules, then sooner or later, anyway, our gastrointestinal tract will declare discomfort. Since they, getting into the stomach, remain in one place and accumulate, which can lead to damage to the mucosa. Syrups or other liquid forms are much safer for oral consumption. They are absorbed faster and are more often recommended for children.

Other forms of drug administration (rectal, injection, intravenous) pass by the gastrointestinal tract and are immediately absorbed into the blood, which accelerates the action of drugs at times. However, if the drug caused an allergic reaction, its effect will be more difficult to neutralize than if it were taken orally.

One of the most modern forms is transdermal patches and active ingredient systems. In this case, the drug is absorbed locally through the skin. If necessary, its action can be reduced to a minimum.

Be sure to follow the safety regulations for storing medicines. This is especially true when it comes to contact with children. After all, if a child overdoses the medicine, it can lead to lethal outcome.

Also store them at the temperature indicated in the instructions, otherwise they lose their properties, and in the worst cases become toxic. And, of course, do not use drugs after the expiration date.

Tablets should not be chewed, tablets and capsules should not be crushed, crushed and dissolved in water, unless otherwise indicated. It is preferable to buy medicines in the dosage prescribed by the doctor, and not to divide the tablet with a higher dose into several doses or take several tablets of a lower dose at the same time. If not special instructions, all drugs are recommended to be taken 40-60 minutes after a meal. It is best to drink medicines with ordinary boiled water at room temperature. If the tablet or capsule is difficult to swallow, you can slowly drink a few sips of water before taking the tablet and drink plenty of liquid. If this does not help, ask your doctor to change the dosage form or drug. The tablet should not get stuck in the throat, as the medicines are designed for the acidity and conditions of the stomach and duodenum, not the esophagus (there may be problems with the esophagus and reduce the effect of the medicine). When prescribing medications, be sure to check with your doctor about the doses, frequency of administration, dependence on food intake, withdrawal conditions (is it possible to immediately stop taking or should the dose be gradually reduced), possible side effects drugs. If you need to take several medications at the same time, make a list of appointments by the hour to avoid confusion. Discuss in advance with your doctor what to do if you forget to take your medicine on time. Do not take a forgotten dose as an addition to the next one, this can lead to overdose and serious complications. If you take medications (such as vitamins) on your own initiative or nutritional supplements please notify your doctor about this. When buying medicines, make sure the packaging is intact, check the expiration date and dosage. Buy medicines from trusted pharmacies, not by hand or from stalls. Be wary of medicines given to you by others who no longer need them or who do not fit them: even if the medicine has not yet expired, there is a danger that the storage conditions have not been met. Do not store medicines for future use: the treatment regimen may change. Store medicines in a dry, dark place without temperature fluctuations and sunlight. The bathroom or kitchen is not the right place to store medicines. Only those medicines for which these conditions are indicated by the manufacturer are stored in the refrigerator. Keep medicines out of the reach of children: most of the drugs used in cardiology are deadly to the child's body, even in minimal doses. When choosing medications and their dosage must take into account the age of the patient. In elderly patients and old age there are features of the pharmacodynamics of most medicines associated with age-related changes in the functions of the liver and kidneys and causing a more frequent development of side effects, the effect of cumulation and increased toxic effects. Features of the treatment of elderly patients: start treatment with small doses (usually half the recommended dose); slow increase in doses; careful monitoring of the occurrence of side effects of drugs.

Eye drops

Wash your hands, tilt your head back, pull back your lower eyelid and look up. Drip eye drops into the pocket located between the lower eyelid and the eye. Do not apply eye drops directly to the cornea or touch the surface of the eye with the dropper. This can infect the remaining drops. Close your eye and gently remove excess with a cloth. eye drops from eyelashes or eyelids.

Drops in the ear

Tilt your head back so that the affected ear is on top. Straighten your ear canal by pulling your earlobe down and back. Then drip the required number of drops into the ear. Try not to touch the walls of the auditory canal with a pipette to avoid infection. Keep your head tilted back for a few minutes so that the medicinal substance flows deep into the ear.

Rectal suppositories

Wear rubber gloves before inserting the rectal suppository. For easier insertion, treat the anus with a lubricant such as petroleum jelly.

Lie on your side and enter rectal suppository with the pointed end as deep as possible into the rectum. Move the base of the rectal suppository to the side to make sure it is in contact with the intestinal wall. If you are unable to insert the rectal suppository, you may not insert it as deeply. It is desirable to move the buttocks together for a short time after the insertion of the rectal suppository.

Vaginal preparations

Most vaginal medications, such as those used to treat a yeast infection, come in the form of creams, gels, foams, and suppositories. Wash your hands before and after using the vaginal preparation. Part the labia and inject the drug as directed, usually a few centimeters into the vagina. After that, do not insert a swab, as it absorbs some of the medicine. Use a pad to help protect your clothing from escaping medication.

Local preparations

Creams, gels, ointments, and sprays that you apply directly to your skin can deliver medicine directly to the right place. Wash your hands before and after using the drug. For creams, gels and ointments, apply appropriate amount to the center of the affected area and rub into a thin layer. When using the spray, shake the can and spray from a distance of at least 10 centimeters from the skin, unless otherwise directed.

As with other forms of medicine, follow the principle - "more is not better." In fact, an overdose of some topical drugs, such as glucocorticoid cream, can general action on your body and lead to the development of severe side effects.

Skin patches

One of the newer methods of drug delivery is patches attached to the skin. Skin patches can contain substances ranging from fentanyl, which helps relieve severe pain, to estrogen, which helps hide menopausal symptoms. The skin patch creates a constant "stream" of the drug until it runs out.

Your doctor will tell you where to attach the skin patch and when to change it. You can also read this information on the instructions that come with the medicine. To avoid skin irritation, change the place of application of the skin patch. If you still experience irritation, tell your doctor. Do not remove the patch until your doctor tells you to do so. Also, follow your doctor's advice on how to throw away the skin patch. It's usually best to fold it in half right side up.

Ileostomy and drug treatment

People with an ileostomy always have the same worrying question: "What drugs can and cannot be taken?" With an ileostomy, the length of the gastrointestinal tract is shorter than in a healthy person. This affects the time it takes drugs to pass through the digestive tract. For the same reason, not all medicines have time to dissolve and be absorbed into the blood before emptying the intestines at the usual dosage or dosage form. It follows that not all drugs are indicated for use by people with an ileostomy. The loss of the large intestine (colon) means a high degree of predisposition to dehydration, since it is this organ in our body that plays an important role in absorbing water from incoming food. Patients with an ileostomy need to be extremely careful when choosing medications that can cause them to become dehydrated.

Do not stop your medicine prematurely. Antibiotics are a classic example of this rule: they quickly deplete pathogens so that the patient usually feels better soon. But there are still germs in the body that will destroy the immune system only in the next therapist. This only works if the immune system and the antibiotic can work together long enough. If you drop your antibiotic early, the infection will ignite again. You may also take other medicines only after consulting your doctor.

Even in people with a healthy gastrointestinal tract, the pattern of absorption and dissolution of drugs is different. Therefore, it is not surprising that such a difference is also observed in patients with ileostomy, despite the shorter length of the alimentary canal and the time it takes drugs to pass through it.

Oral drugs first dissolve and then enter the blood through the intestinal mucosa. The stomach absorbs drugs to a lesser extent. The inner surface of the intestine, especially the small intestine, has a large area and is well supplied with blood, so it is in it that the main absorption of drugs occurs. Most drugs are absorbed by the jejunum, located in the upper part small intestine, so they do not reach the ileostomy. Only a few types of drugs are not absorbed in this segment of the human intestine. In the large intestine, medicinal substances are absorbed not so actively.

If you reset the beta-blocker blood pressure knob from today to tomorrow, your blood pressure will suddenly rise sharply or heart rhythm disturbances will occur. Each patient receives an average of 15 drugs per year from his doctor, and he buys another seven packs on his own responsibility. But are we taking drugs the right way? Do not take this medicine with any of the following: if you miss a dose, take it as soon as you can.

Pharmacists estimate that 40% of patients take prescribed drugs incorrectly. However, an incorrect dose involves two dangers for the unwary patient: the drug may lose its effectiveness, or it may increase the risk of producing or even dangerous unwanted side effects.

Dosage forms and pharmacokinetics

The main factor affecting the rate and location of drug absorption by the gastrointestinal tract is the ability of a particular type of drug to dissolve in the stomach and intestines. Recommended dosage forms and dosages for ileostomy are presented in Table 2. The greatest preference is given to drugs that are already dissolved in the liquid or are rapidly dissolving. For example, various kinds of liquid solutions (potions, oral drops, syrups) no longer need to be dissolved. Some types of tablets are designed to dissolve in the mouth or under the tongue. Medicines in the form of suspensions are as well absorbed as solutions (however, there are a number of suspensions of modified absorption, they may not have time to be absorbed by the body before they are eliminated from intestinal tract). Chewable tablets, uncoated tablets, drugs in a gelatin capsule - all this is an alternative solution to solutions or oromucosal tablets. Film-coated tablets and dragees take longer to dissolve but are acceptable for people with an ileostomy. Patients should avoid modified release preparations (see Table 3), as they will not have time to be absorbed when passing through the digestive tract. Among them, tablets of controlled and gradual release are distinguished.

Possible mistakes already begin with the choice of liquid with which the tablets fall: many medicines cannot be taken with fruit juices. For example, antibiotics can lose their resistance through fruit acid and are then no longer absorbed by the body in sufficient amounts.

Also, milk is wrong: there are drugs that form calcium from complexes or salts insoluble in milk. This is especially true for tetracycline preparations. However, this antibiotic also forms insoluble complexes with iron preparations or iron-containing tonics and with gastric agents containing aluminum or magnesium salts.

Controlled release tablets are created using a special technology. They are gradually absorbed over several hours, passing through the human gastrointestinal tract. The effect is achieved by gradual melting of the tablet and the release of the next dose of the drug at regular intervals. Such tablets do not have to be taken 3-4 times a day, 1-2 doses are enough. It is very relevant and convenient for forgetful people who often forget about the time of admission. The likelihood of missing the required dose of the drug is reduced. However, despite the valuable advantage of this type of tablet, there may simply not be enough time for complete absorption of the drug after reaching the ileostomy.

Basic forms of drugs

The psyche can also affect the absorption of drugs: thus, anxiety delays gastric emptying. And even the position of the body plays a role: emptying is slower if on the left side. When lying on the right side, the contents of the stomach reach the intestines faster.

Medicines that require slow absorption into the body should be taken with or after meals. These include drugs to treat blood flow, many drugs, blood pressure, antibiotics, and psychopharmaceuticals. In addition, rheumatids, which can have an aggressive effect on the gastric mucosa, are best taken with food.

Timed release tablets have a coating that is resistant to gastric acids. However, they dissolve only upon reaching certain segments of the human digestive tract or after a certain period of time. This includes enteric tablets. Usually they have a special stable coating that dissolves only when they reach the intestines. In an ileostomy, however, the coating may not have time to dissolve to allow the drug to be properly absorbed by the intestine before emptying.

Little is known about the fact that smoking can also greatly affect the intake of certain drugs in the body. Cigarette smoke contains specific substances that can also affect the body's enzymes. Last but not least, regular alcohol consumption can affect drug use: liver enzyme activity is accelerated by alcohol, some painkillers, sleeping pills and psychopharmaceuticals are therefore eliminated more quickly and do not work as prescribed by a doctor.

How to find the right dose? "What is poison and what is not poison?" Probably the most famous German physician of the Middle Ages, Paracelsus, asked, and found the answer to this day: "Everything is poison, and nothing is poison, but the dose makes this thing a poison or not." The correct dosage of the drug requires a lot of knowledge from the doctor. In the case of many medicines, it should go to the lowest, already enough effective dose from below. He must take into account the gender, age and physical characteristics of his patient.

Medications that can cause dehydration

The main function of the colon is the absorption of water and electrolytes from food (sodium and potassium). In patients with an ileostomy, the small intestine takes over some of the absorptive functions of the large intestine. However, ileostomy stools are loose and almost permanent, so the body constantly loses a lot of water and electrolytes. People with a normally functioning ileostomy always have mild dehydration, which can lead to dehydration very quickly, especially with a number of factors.

He must know the rate of absorption and release of the drug. Important: the idea of ​​"double doubling" can be a dangerous mistake for drugs. Always follow the dosage instructions and take the medicine only in the prescribed amounts. It is important that children do no harm so that they can get better. It is also often not recommended to return to medications immediately, for example, to treat a fever in the same fever.

Some complaints can often be overcome with special attention and simple home remedies such as warmth, herbal teas, massage, and the like. This, of course, does not mean that you should minimize it if your child has pain. And in no way does this mean delaying any necessary medical or medical treatment.

Drugs that can cause dehydration should be taken with caution or avoided altogether. Diuretics (diuretics) should be used with caution, as frequent urination causes too much water and electrolytes to be excreted from the body.

Some antibiotics cause diarrhea, which can also lead to dehydration. If antibiotic use cannot be avoided, it should be investigated whether this drug cause diarrhea and what measures should be taken to avoid dehydration of the body. Drugs such as Regidron help restore salt balance with diarrhea and massive fluid loss. In severe cases, this is used intravenous administration salt solutions.

Enteral administration: advantages and disadvantages

For some diseases, drug treatment has importance. In particular, infections caused by viruses and bacteria - such as urinary tract, middle ear or sinus problems - which are relatively common in a child's age - usually require drug treatment. For some chronic diseases even regular medication is required. . Your pediatrician or your pediatrician will certainly weigh carefully when drug treatment is necessary and appropriate and which drug is best for your child.

Antacids (acidifiers) containing magnesium can also cause diarrhea, so patients with an ileostomy should use them with caution. Before taking a new medicine, study the side effects described in the instructions that may occur, whether there is diarrhea among them. Stomas with an ileostomy are not recommended to take laxatives - dehydration of the body can develop very quickly. (Table 3). In cases where a laxative is usually used, such as before a bowel exam or before surgery, people with an ileostomy should stop eating salty foods and drink more clean water 24 hours before the procedure.

Possible problems in dealing with a doctor

Children are often reluctant to apply for remedies and feel ambiguous about their parents very accurately. Often this combination will result in the remedy not being given with sufficient frequency and duration. If you have any concerns about addiction treatment and take care of it, you should discuss it when you visit your doctor. Let yourself explain how the medicine is, how and for how long they should be taken, what you should look for and what side effects you may experience. If your child is on medication, it is important that you have confidence in yourself. . If your child is already suffering from an illness other than an acute one, you should definitely tell your pediatrician or paediatrician.

Tips for ostomy people when choosing medicines

An important thing that guarantees the correct choice of a drug is consultation with the attending physician or other employee of a specialized medical institution.

Every time you get a prescription, make sure your doctor knows about the ileostomy and about drugs that may not be absorbed when taken by mouth. Double check for modified release tablets on the prescribed list.

For example, some active substances can adversely affect other diseases that already exist. Or there may be interactions with medications that are taken regularly, resulting in increased or decreased absorption active substance. This also applies to prescription and over-the-counter drugs, which should not be underestimated under any circumstances.

Advantages and disadvantages

In addition to the correct dosage, many medicines also have an abundance, time and duration of taking them. These indications are important for the active substance to develop its optimal efficacy, but also to avoid possible side effects or incompatibilities.

If the medicine is taken orally, one of the following dosage forms listed in Table 2 is used, if possible. for example, vaginally or by means of a patch.

If antibiotics are used, they should not be taken with milk, as some antibiotics prevent the active substance from being taken. Some substances can significantly increase the effect of drugs and cause serious side effects. This may play a role when certain side effects are to be avoided, such as gastrointestinal effects, or if absorption of the active ingredient is dependent on digestive processes. For some drugs, the body must first be carefully accustomed to the active ingredient to ensure better tolerance. In this case, start with a low dose, which is gradually increased according to a specific schedule. Likewise, these drugs are not usually stopped abruptly, but the dosage is gradually reduced.

• In general, all medicines should be taken with plenty of water.
• No medication should be taken with grapefruit juice.
• Sometimes the question arises whether the medicine should be taken before, after or after a meal.

You should not change your dosage schedule or dosage.

Pre-crushing the tablets or pouring the contents of the capsules into food or drinks aids dissolution and absorption, but should not be done without the approval of a physician or specialist. This may not be safe. Modified release tablets should not be crushed or crushed, and most capsules should not be opened as too much medication can enter your bloodstream at one time and cause serious side effects. The medicine can cause both indigestion and irritation, and it can not dissolve in time. There are also non-modified release drugs that should not be opened or crushed.

For example, it is very important, especially in the case of antibiotics, to strictly adhere to the prescribed period of ingestion. Otherwise, the bacteria can rebuild the "top" and the disease can flare up again. It is also possible to develop resistance, which means that the bacteria become resistant to the antibiotic and therefore cannot be effectively controlled.

Do not give any medication on your own

Preparations suitable for children must be specially adapted to the child's body in composition and dosage. As a general rule, your child should only be given medication after consulting with your pediatrician. Exceptional cases should be limited to those you know very well, such as fevers.

Take all prescribed medicines exactly as directed on the prescription and follow all directions in the package insert that comes with them. Tell your doctor about the missed dose. If the medication you're taking isn't effective, it could be more than just poor absorption. You may have taken it without following the directions in the prescription, or you may need to set a different dosage.

Notify your prescribing physician if there are traces of undissolved tablets or capsules in your stool. Before writing a new prescription or buying an over-the-counter drug, ask your doctor or pharmacist about possible side effects, including those that may affect the ileostomy.

Conclusion

Drug absorption and unwanted side effects are a common problem for those who have an ileostomy. The main factor in the absorption of tablets or solutions by the gastrointestinal tract is dosage form. With an ileostomy alimentary canal shortened, so you should choose drugs so that they have time to quickly dissolve and be absorbed.

With an ileostomy, the time it takes for food, liquids, etc. to pass through the digestive tract. reduced. This often prevents the complete absorption of tablets and solutions by the body. Drugs, due to which dehydration may occur, are not recommended to be taken by an ostomy with an ileostomy. If you have any problems taking your medications, we recommend that you talk to your doctor, pharmacist or ostomy specialist.

Table 1. Characteristics gastrointestinal tract

	Approximate length	Average travel time	main function
Gastrointestinal tract	17 to 29 feet	Up to 38 hours
			The passage of food from the mouth to the stomach
Stomach: - empty - filled		0.5 to 1.5 hours 2 to 6 hours	Production gastric juice to digest food or medicine
Small intestine: - Duodenum - jejunum - ileum	12 to 21 feet: - 8 to 12 inches - 5 to 9 feet - 7 to 11 feet	2 to 4 hours: - 3 to 10 minutes - From 0.5 to 2 hours - 0.5 to 2.5 hours	Absorption of food and drugs
Colon: - Cecum - Colon - rectum	5 feet: - 3 inches - 3 to 5 feet - 4 to 6 inches	Up to 27 hours	Colon absorbs water, rectum expels feces

	Alternative	Absorbed longer
Oromucosal and oral tablets	Chewable tablets	regular pills
Sublingual (sublingual) tablets	uncoated tablets
Liquids (elixirs, potions, syrups, suspensions)	Capsules in a gelatin shell	Film-coated tablets

Laxatives – can cause rapid dehydration
Modified release drugs - poorly absorbed

General terms for controlled release drugs
slow release
sustained release
Controlled release
Continuous release
Delayed release
Intermittent release

Generic Time Release Drug Terms
Tablets, gastro-resistant (enteric-soluble)
Tablets with prolonged action (phase)

Not all modified release drugs are marketed under the above term.

Ask your pharmacist or your doctor for the exact name of the drug.

Table 4. Medications that can cause dehydration

Antibiotics	May cause diarrhea
	May cause diarrhea
Diuretics (water pills)	Causes increased urination, may lower potassium levels in the body

Recently, there has been increasing talk about the fact that drugs can cause or exacerbate the symptoms of almost any disease.

In serious scientific publications, research data is published confirming the general harmful effects of drugs on sick people. So, scientists conducted a study, as a result of which it turned out that drugs every year cause the death of about 100 thousand people, and also lead to the development of serious diseases in more than 2 million people. This phenomenon is called drug disease.

Scientific studies also show that in about half of the cases, the negative effects of the use of drugs appeared due to the intake of unreasonably high doses, which is the mistake of doctors. In addition, some patients simply do not inform their physicians about the presence allergic reactions for certain drugs. Often drugs are prescribed without taking into account the individual characteristics of the patient.

So, according to ongoing studies, in the United States, about half of both children and adults, doctors with viral diseases that do not require the use of antibiotics, for example, for a cold, they are still prescribed.

Studies conducted by scientists from the Medical Department of Harvard University have shown that about 20% of hospitalized patients take drugs prescribed by a doctor to their detriment. The reason for this is often an overdose. According to the researchers, doctors overestimate the doses to play it safe. Of the patients studied, none died, but about 30% of them received complications after treatment in the hospital.

The most common complications caused by inappropriate medication are diarrhea, dehydration, and weakness. These consequences could be avoided in about 60% of cases, if medical staff more attentive to patients.

[!] The word "medicine" comes from the Greek word "pharmakeia", which is also translated as " remedy", and as "poison".

Doctors are too quick to prescribe medicines. So, with complaints of insomnia, more than 60% of doctors prescribed sleeping pills to patients, while the cause of this condition could be strong tea or coffee at night, daytime sleep, absence exercise etc. When people complain about abdominal pain and endoscopic examination data indicating diffuse irritation of the stomach walls, about 65% of doctors prescribe drugs from the group of H2-histamine blockers, such as ranitidine. However, in many cases, the same coffee, smoking, stress, uncontrolled intake of aspirin, etc. are the cause of pain in the abdomen. In all these cases, it would be more correct to identify and try to eliminate the real causes, or at least reduce their influence.

It is not uncommon in medical practice that there are cases when a disease occurs as a reaction to taking some medicine. In this case, the appointment of another drug to eliminate the disease that has arisen is fraught with negative consequences. Unfortunately, doctors spend little time on finding out all the factors that led to the onset of a particular disease. Too often people take medications in situations that could have been avoided. drug treatment, by prescribing other methods of therapy or, at least, significantly reducing the number of drugs taken in the treatment.

[!] 10 times more people die from drug side effects than from surgical errors.

Researchers at the Universities of Toronto and Harvard have discovered a phenomenon they call the appointment cascade. It consists in the fact that when a side effect occurs in a person after taking a drug, the doctor erroneously interprets it as a symptom of a new disease and prescribes another drug for its treatment, which can also cause side effects and be interpreted in his own way. turn, as a sign of another disease. Thus, drugs are prescribed in a cascade that are not so much effective for the patient as harmful.

For example, the use of antidepressants, antipsychotics and antihistamines may impair bowel motility, prompting the physician to prescribe laxatives. The use of cardiotropic drugs can lead to symptoms similar to those of Parkinson's disease, resulting in the prescription of drugs to treat parkinsonism. Common symptoms such as depression, insomnia, sexual dysfunction, arrhythmias, heart problems and pressure drops can also be caused by medication. At the same time, tranquilizers and sleeping pills used to treat these symptoms cause severe side effects, negatively affecting the work of the central nervous system(CNS). Antihypertensive drugs and agents used to treat cardiac arrhythmias and gastrointestinal disorders can also lead to severe side effects.

[!] The old Russian word "potion" means both a medicinal and a poisonous drink.

Against the backdrop of widespread advertising of therapy exclusively with drugs, even the doctors themselves, taking the patient, are in a hurry to decide what should be prescribed to him, and not how to help at all. As a result, in most cases, other treatments, such as lifestyle changes or a therapeutic diet, are not taken into account.

The reason for the problem of drug disease is that in the modern world, powerful chemicals are used as medicines. Their high biological activity sometimes makes it impossible to determine the boundary between the maximum effective and toxic doses, sometimes the difference between them is too small.

In addition, every drug without exception has at least some side effect, and there are contraindications to it. So, even the most seemingly safe drugs are actually harmful. For example, aspirin can cause a lot of trouble for those who are prone to bleeding or suffer from peptic ulcer stomach or intestines. In these people, aspirin use can cause serious illness and sometimes death.

Aspirin can also provoke asthma attacks in people who are predisposed to this disease. In children, aspirin can cause Reye's syndrome, especially in infections where parents most often give the drug to relieve fever. Meanwhile, Reye's syndrome very often leads to death. This list of contraindications refers to a drug that is considered more or less safe!

[!] From 3 to 5% of all admissions of patients to hospitals are caused by side effects of drugs.

Similarly, any other drug can not only cause side effects, but also lead to death. However, in the annotations to medicines, they do not always write about side effects. This mainly applies to small drug manufacturers. So it is advisable to purchase preparations of large, well-known pharmaceutical companies, who try to give, as a rule, complete information about their products.

But the danger of improper use of the drug also lies in the fact that the side effect is not always associated with an excess of the dose. Side effects are different, for example in the form of allergic reactions. Even the smallest amount of the drug can lead to serious consequences. An overdose usually causes toxic reactions, which are more pronounced, the more a person exceeds the allowable dose for treatment.

The reason for the emergence of drug disease is also the fact that many drugs are often incompatible with each other. The chemicals that make up the drugs, entering the body and mixing, begin to interact with each other, leading to unpredictable consequences. Different drugs, when interacting, change the effect of other drugs. But in hospitals they often prescribe 5–10, and sometimes up to 40 medical preparations. The effect of so many drugs is simply impossible to describe.

It is not always possible to do without drugs, especially when serious illnesses, however, any person should know the rules of "drug safety".

Rules for taking medications

If a person is already taking any medications, it is recommended to write down in a separate notebook for each drug the dosage, frequency of administration, indications for use, negative reactions of the body that manifested in the patient, and other information given in the annotation to the drug.

After that, it is recommended to consult with your doctor about the possibility of reducing the dose of the drugs taken and the frequency of their intake. At the same time, the possibility of excluding those drugs that are not absolutely necessary or are particularly dangerous should be discussed. Patients should not be afraid to contact the doctor with such suggestions. Reducing the number of drugs taken will lead to a decrease in the number of negative reactions of the body, and will also make it possible to significantly reduce the number of drugs used. Meanwhile, drugs that are really important for treatment will be used more effectively. The use of a large number of medications leads to a violation of the scheme of their administration.

[!] Any medicine should be accompanied by a leaflet with information about the disadvantages and advantages in an understandable presentation. The annotation should describe in detail the rules for taking the drug. Together with the prescription, the doctor must provide instructions for the use of the drug.

You should not buy drugs that have been on the market for no more than 5 years. New drugs are still little studied, including for safety. Before entering the market, all drugs are tested on small groups of volunteers, which allows you to quickly determine their effectiveness. However, these tests are not enough to determine the safety of a drug. However, information on the effectiveness of the drug is also insufficient to compare it with existing drugs.

To determine what side effects a certain drug can cause, as well as how safe it is to combine it with other medicines, it is necessary to test it on hundreds of thousands of people. During the first 5 years after the release of the drug on the market, its properties are precisely revealed, as a result of which the drug either remains on the market or is withdrawn from sale.

In order not to become a victim of a cascade of prescriptions, if a new symptom appears after starting the medication, you should immediately inform your doctor about it.

Before changing your treatment regimen, you should consult your doctor. At the same time, one should try to be frank in order to help him draw the right conclusions about the effectiveness of the dosage. Withholding information about the medications you are taking from your doctor can lead to negative results.

No need to try to get new prescriptions from the doctor. It is better to discuss with him the possibility of using non-drug methods of therapy.

[!] Any medications prescribed by other specialists should be discussed with your personal physician.

You should not hide from the doctor the diseases that a person suffers from, so that the doctor can prescribe those drugs that will not be dangerous. It is also necessary to evaluate all the negative effects of the prescribed drug in comparison with its beneficial effect. Perhaps the side effect will be much more serious than the disease itself. So, a common mistake is to prescribe to elderly people suffering from a mild form hypertension, an excessive amount of medication. An asymptomatic disease may not lead to any negative changes in health, but taking a large number of drugs, as a rule, negatively affects general condition organism.

When choosing a drug from a number of drugs of the same action, it is better to give preference to single-component ones over combined ones. The more ingredients a drug contains, the greater the risk of it negative impact on the body.

All old, expired drugs should be thrown away, not stored for months or even years and then used. In no case should you recommend or even offer medicines that have proven effective to your acquaintances. Any prescription of drugs should be made by a doctor. And it is better to throw away unused drugs immediately after the end of the course of therapy.

You should not unconditionally trust the recommendations given by a pharmacy worker who is not able to assess the condition of a random buyer and correctly prescribe him the right medicine. In such cases, you should always contact the attending physician, who knows about all the past illnesses, can conduct an examination and correctly assess the patient's condition.

Unfortunately, not all doctors are willing to work with the patient. Some of them are simply incompetent. They often do not even try to understand the essence of the disease, do not try to understand its causes, but immediately write out prescriptions in accordance with the general signs of the alleged disease. In such cases, doctors begin to treat the patient not at all from what he is ill with.

Doctors are increasingly advising their patients to take dietary supplements along with medications. Thanks to the natural components contained in them, they are designed to help the body cope with the disease. However, many doctors cannot choose the right complex of dietary supplements due to their incompetence. Nevertheless, many of them confidently prescribe a lot of supplements to their patients, assuring them that they are necessary, which is often not true.

Harmful drugs

Independent panels of experts from the World Health Organization (WHO) have conducted studies that have identified the most harmful medicines. These studies included reviewing and evaluating numerous statistical data and ongoing studies on the harmfulness of drugs. The need for such studies arose due to the fact that the problem of the harmful effects of medicines on the human body is becoming more and more acute all over the world. Every day there are new drugs with more and more powerful effect.

Independent experts first of all decided to identify the most harmful drugs among the already well-known drugs, and then work on new ones. Based on the data received, the following list of drugs hazardous to health was compiled:

- thalidomide - a sedative prescribed for pregnant women to normalize sleep. It turned out that this drug causes developmental disorders (underdevelopment of limbs, deafness, blindness, cleft palate, etc.) in many thousands of children;

- anti-obesity drugs. Drugs in this group are constantly withdrawn from the market. Many of them contain amphetamine, which is addictive and bad for the heart. Other products contain fenfluramine, which causes the development of such a serious disease as damage to the heart valves, which requires surgery. New drugs, which include dexfluramine-isolipane, contribute to the development of pathological changes in the lungs;

[!] Currently, thalidomide is used to treat leprosy, or leprosy, since the drug has been found to lower the level of tumor necrosis factor (a biologically active substance that increases inflammation) in the body.

- a growth hormone. This drug is touted as a miracle cure for children who are growing poorly or not at all. It was produced in France from the pituitary glands of deceased people, some of whom were infected with the deadly degenerative Creutzfeldt-Jakob disease. As a result, in 1984-1986. more than a thousand children, in fact, along with the hormone received an infection from which many of them died. The parents of some of them sued the Institut Pasteur and France Hypophyse, the producers of the hormone, as well as the doctors who prescribed it;

- the anti-cholesterol drug Lipobay (cerivastatin) from Bayer was withdrawn from the market due to life-threatening side effects. According to statistics, 52 people died from this drug in the United States alone, and more than a thousand patients had severely affected muscles. The drug also causes impaired renal function. In France, about 20 life-threatening cases have been reported in people who used both cerivastatin and gemfibrozil, cholesterol-lowering drugs. About 6 million people around the world took drugs in a similar combination.

In addition to these drugs, such well-known and widespread drugs as analgin and sedatives are harmful.

According to the latest scientific data, analgin causes a change in the composition of the blood and can lead to severe allergic reactions. Meanwhile, it is very popular as a pain reliever and is sold without a prescription in any pharmacy.

[!] About 50 new chemical compounds are synthesized every day in the world.

Currently, analgin is prohibited from prescribing to children, pregnant and breastfeeding women. Its appointment is allowed only for certain diseases. It is not worth using analgin for diseases such as migraine. It is better to use other painkillers, such as paracetamol. One tablet of analgin may be enough for serious reactions to occur in the body. In most European countries, analgin has not been used for treatment for a long time.

Anti-anxiety medications are especially harmful to the elderly, who are the most likely to take them. These people have a very high risk of side effects. Dizziness, disorientation in space, loss of balance, weight gain are often observed. The consequence of the manifestation of such symptoms are falls, which can lead to tragic results. The risk of side effects in the elderly is 2 times higher than in younger patients.

Doctors advise to fight insomnia in simpler ways, for example, take a short walk every evening.

Medications and pregnancy

Medicines, the long-term effects of which are unknown, can be especially dangerous for pregnant women. During pregnancy, a woman's body becomes very sensitive to chemicals, its defenses are significantly weakened due to ongoing internal changes. During this period, the load on the liver and kidneys increases, as well as endocrine system. In the uterus, there is an active division of fetal cells, due to which it develops and grows.

During pregnancy, a woman's body and a developing baby's body react differently to medications. Negative influence may appear at any stage of pregnancy. Medicines weaken the blood flow in the placenta, disrupt the metabolism between the body of the mother and child.

However, the most dangerous period for the fetus are the first 3 months. At this time, the main organs and systems of the new organism are formed. There are drugs that affect the growth rate of cells, tissues and organs of the embryo, slowing down or accelerating these processes. As a result, various defects arise, leading to disability or death of the child.

The ability of drugs to cause deformities and defects in the fetus is called teratogenicity.

In the instructions for foreign drugs letters often appear - A, B, C, D and X. They mean the degree of teratogenicity. These letters have the following meaning:

A - during special studies, no harmful effects on the fetus were established;

B - during experiments on animals, no harmful effects on the fetus were found, special studies on humans were not conducted, there are no data on the effect on humans;

C - during experiments on animals, a harmful effect on the fetus was found, but for humans it has not been proven;

D - special studies prove the existence of a harmful effect on the fetus, however, in special cases, the drug can be prescribed to a pregnant woman, despite the risk;

X is a drug that is definitely harmful to the fetus, its harmful effects exceed any possible benefit to the woman's body.

From the above classification of medicines, it can be seen that it is acceptable for pregnant women to take drugs of groups A and B. Medicines of group C can be prescribed only if the beneficial effect of their use far exceeds the risk of harmful side effects. Group D drugs can be prescribed to pregnant women only in life-threatening situations, as well as serious illnesses in which less harmful drugs no longer help.

Group X medications are absolutely contraindicated for pregnant women, as well as for those women who are planning a pregnancy in the near future.

Sometimes after the name of the drug is not one, but two letters. They talk about a different damaging effect at different stages of pregnancy. For example, aspirin early dates pregnancy is not as dangerous as the last trimester. At this time, it is able to influence the coagulability of the blood of the fetus.

Below is a list of specific drugs that belong to a particular group of teratogenicity.

Antimicrobial and antifungal drugs: amikacin C, amoxicillin B, amphotericin B, benzylpenicillin B, gentamicin C, griseofulvin C, dactinomycin D, doxycycline D, kanamycin D, carbenicillin B, kefzol B, claforan B, clindamycin B, clotrimazole B, chloramphenicol C, lincomycin B, metronidazole C, nystatin B, oleandomycin C, polymyxin B, rifampicin C, streptomycin D, sulfamethoxazole (part of biseptol) B D, tetracycline D, trimethoprim (part of biseptol) C, erythromycin B, furazolidone C, ciprofloxacin D.

Means to combat high blood pressure: apressin B, verapamil C, veroshpiron D, hypothiazide D, diacarb C, captopril C, methyldopa C, reserpine D.

Antipyretic and anti-inflammatory drugs: aspirin C D, acetaminophen (paracetamol) B, ibuprofen B D, indomethacin B D.

Hormonal drugs: betamethasone C, hydroxyprogesterone X, dexamethasone C, prednisolone B, estrogens X.

Antispasmodics, sedatives and hypnotics: aminophylline C, haloperidol C, droperidol C, caffeine B, morphine B D, (relanium) D, theophylline C, terbutaline B, phenobarbital B.

Anticoagulants (drugs that prevent blood clotting): aminocaproic acid C, heparin C, dipyridamole C.

Cardiacs: Digoxin B, Isoptin C, Nitroglycerin C, Nitrong C, Epinephrine C.

Drugs for the treatment of disorders of the stomach and intestines: cuprenil D, imodium C, piperazine B, pyrantel C, cimetidine B.

Hormonal contraceptives, some antibiotics, antidepressants, analgesics, antihypertensive drugs, vitamin A in doses over 10,000 IU per day are absolutely contraindicated during pregnancy.

There are also the following groups of drugs:

- the risk from the use of which has not been proven, but its absence has not been proven either;

- the action of which is not always manifested, but only in the presence of certain adverse factors;

- drugs that can cause side effects, but they are still prescribed to pregnant women in cases where they positive impact(for example, curing a dangerous disease) outweighs the risk of a harmful effect.

Pregnant women should not receive certain vaccinations, despite the fact that in general there is no proven harm from the use of modern vaccines during pregnancy.

When using drugs, not only do they affect pregnancy, but pregnancy itself changes the effect of drugs. For example, the absorption, distribution, and excretion of a drug may change, resulting in a change in its effect on the body.

During pregnancy, the volume of extracellular fluid, as well as the concentration of proteins and other substances in the cells, change. By the end of pregnancy, a woman has an increased load on the liver and kidneys involved in the excretion and processing of drugs.

Many women during pregnancy contraindicated the use of certain medicinal plants, such as comfrey, cassia, stephania, magnolia, lamb, coltsfoot, juniper, etc.

When planning a pregnancy, it is advisable to stop taking medications in advance without a doctor's prescription. Moreover, this rule should be followed not only by the woman, but also by the future father of the child.

If you can not do without drugs, a pregnant woman should definitely consult a doctor. Sometimes medications need to be prescribed during pregnancy. In this case, you must strictly follow the doctor's recommendations. Unauthorized or uncontrolled intake of drugs should be excluded.

Very often drugs cause harm to people because they begin to use them in excessive amounts and often at the same time as other drugs. So, for example, the therapist in the prescription wrote a whole list of drugs, of which the patient must choose to take only one. However, the patient buys all prescribed drugs at the pharmacy with the intention of using them, assuming that what large quantity he will take, the more effective the treatment will be. There is even a special term in medicine - polypharmacy - meaning the simultaneous administration of a large number of drugs. Such cases are not rare.

When prescribing a drug to a patient, the doctor must be guided by the rule of evidence-based medicine, which requires that the effectiveness of the prescribed drug be proven and its side effects verified. The therapist and his patient must know what result will be achieved at the end of the course of treatment. The use of drugs must be justified.

Advertising contributes to the misconception about the use of medicines. Information about medicines, their amazing properties and miraculous effects not only expands the "knowledge" of the listener, but also encourages him to act.

By regularly watching TV or listening to the radio, a person gets a clear idea of ​​​​what he should do in case of diarrhea, constipation, dandruff on the head or fungus on the legs, a scratchy throat and nasal congestion. Drugs are advertised that cure everything from the common cold to complex cardiac diseases, the methods of treatment of which should only be prescribed by a specialist. Accordingly, only a professional doctor can understand the effect of drugs.

However, is it worth trusting advertising and the information received from it and without consulting a doctor to prescribe medications to oneself? Doctors themselves will undoubtedly answer in the negative in most cases. Any therapy, even for mild diseases, always requires an individual approach to the patient. Only a professional doctor can evaluate all the factors by bringing them together. He knows the material composition of drugs and can choose a drug that is suitable for a particular person, which will bring the least harm.

It should be noted that commercials often serve to promote medicines on the market that are not highly effective, but for which a lot of material resources have been spent. With this in mind, some expensive drugs may turn out to be much less effective than cheaper and less well-known counterparts.

A well-known factor works for advertising - saving time. People in modern society are so accustomed to being busy that they prefer the most quick methods treatments, which include self-treatment, since it does not require time to go to the clinic, sitting in queues waiting for an appointment. It is much easier to cope with not very serious diseases on your own by running to the pharmacy after a working day and buying everything you need for treatment, according to advertising or the opinion of a pharmacist working in a pharmacy.

However, advertising should not be blindly trusted. You should especially beware of buying drugs that have appeared on the market quite recently, but are too actively advertised. Ineffective means, which nevertheless need to be sold, can also be diligently advertised.

Means presented by the press as a sensation or a revolution in the field of medicine should not be taken into account at all. All advertised drugs for the treatment of diseases such as AIDS or cancer, as well as painted as a panacea for all diseases, the elixir of life, which gives immortality and eternal youth, do not deserve any trust at all. If such drugs were invented, then they would be reported not in advertising, but in more official sources.

If the drug is presented as “superior in characteristics to foreign analogues”, but at the same time its price is much lower, then this information about it is false. Do not expect a big effect from such a drug.

Now it is very fashionable to arrange "hot lines", the operators of which will tell about all the advantages of the drug they sell. If at the same time they are not even interested in the diagnosis of the caller, his age, the names of the drugs taken earlier, but desperately assure that the drug will definitely help, the listener is most likely trying to force him to buy an absolutely useless medicine.

You should also not trust those operators who claim that treatment with the proposed drug does not require consultation with doctors at all.

Very often advertised drugs turn out to be biologically active additives i.e. they are not drugs. An example is Inolta, which is not only expensive, but has such a weak therapeutic effect that it can manifest itself only after several years of regular use of the drug.