The medic's guide to prescribing:Minimising adverse drug reactions
How do you go about minimising the harmful effects of prescription drugs? Rachel Green and Simon Maxwell discuss
An elderly lady is admitted to the accident and emergency department after a collapse. A middle aged man presents with shock after a haematemesis and nearly loses his life. A housewife becomes pregnant despite apparently reliable use of the oral contraceptive pill. Are you puzzled by this? You may be. Slightly suspicious that these were not simply spontaneous misfortunes? You have reason to be. Are you thinking that a drug might be the cause? You should be. Would that be unusual? Not really. Adverse drug reactions (ADRs) are, in fact, very common.
A recent prospective analysis of 18820 patients admitted to two UK hospitals over a six month period showed that 6.5% of admissions were related to an ADR either directly (80%) or in part (20%)1. Many of these were considered possibly (63%) or definitely (9%) avoidable had more care been taken, and 2.3% were fatal. A further study showed