Dangerous drug cocktail

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Almost half of those over 65 swallow at least five different pills a day. But one thing is often forgotten: the mixture can be dangerous. Because often there are interactions between the individual drugs - especially in pain therapy.

Pain is the number one reason people see a doctor. And in pain management, it is common practice to prescribe more than one medicine. This can lead to dangerous drug interactions. Doctors from science and research discussed this problem at the German Pain Congress 2015 in Mannheim.

No clear medication plan

"As a family doctor, I have to be able to evaluate all of a patient's medication," emphasizes Dr. Stefan F. Reger, general practitioner internist from Mainz. So-called multimedia often posed a challenge, especially for general practitioners. But even in everyday clinical practice there are often undesirable interactions. “We have a large treatment team with a high turnover. And every ward doctor has his own ideas, the implementation of which is not always properly documented due to lack of time, ”explains hospital doctor Dr. Markus Faust. In order to optimize the medication, he recommends attempting to omit the medication - so basically to check again whether all medication is really needed. The patient should never do this on their own, but always in consultation with the doctor.

Often, when talking to a doctor, patients no longer remember which medication they were actually taking. Especially often if they do not require a prescription. But sleeping pills or St. John's wort can also interact with painkillers, for example.

As a result, five to ten percent of all hospital admissions are caused by adverse drug reactions.And drug interactions account for 20 to 30 percent of all drug-related deaths.

Paracetamol bags the liver

Irina Cazacu and her colleagues from the Hatieganu University of Medicine and Pharmacy in Cluj-Napoca, Romania, have summarized the study situation on drug interactions with the most important painkillers. Some examples: Paracetamol is one of the most commonly used pain relievers. It should not be combined with so-called NSAIDs (non-steroidal anti-inflammatory drugs). The two painkillers together attack the gastrointestinal tract. Paracetamol affects the liver if you take drugs that activate certain liver enzymes at the same time. These include medicines with the active substances rifampicin, phenytoin, carbamazepine or barbiturates.

No metamizole in heart disease

Metamizole, which is often used to manage pain after surgery, or NSAIDs can block the effects of other drugs. This becomes dangerous, for example, when acetylsalicylic acid is used in people with heart disease to thin the blood. This can lead to blood clots that block a coronary artery and cause a heart attack. The effectiveness of antihypertensive drugs, such as beta blockers, is also reduced by the pain relievers.

Provide comprehensive information to doctors

Those who take different drugs should be aware of the risk of interactions, according to the experts. So when the doctor asks you about your medicines, be sure to list them all. If necessary, make an appropriate list before you visit your doctor. Whenever you take new medication, watch out for changes in your health and inform your doctor immediately of any possible negative effects.

Source:

CAZACU, IRINA, CRISTINA MOGOSAN, and FELICIA LOGHIN. "Safety Issues of Current Analgesics: An Update." Clujul Medical 88.2: 128-136. PMC. Web. 8 Dec 2015.

Symposium on drug interactions in pain therapy as part of the German Pain Congress 2015, Mannheim.

Tags:  drugs therapies alcohol drugs