|Too often the medical community lends a deaf ear to patients who
have vague complaints of adverse reactions to prescribed medications.
In no population is this more common than in the treatment of the
elderly. How can we comprehend this skepticism? One bias may be
due to the tremendous attention given to the normal aging process
and the knowledge that as one gets older we tend to heal slower,
ache more and find ourselves associated with a decline in various
physiological and cognitive functioning. Because of our defensive
nature of doubting that our recommendations of therapy could
actually be associated with a decline in various bodily functionings.
|As a Clinical Pharmacist and Prescription Safety Advocate I
challenge every Researcher, Physician, Pharmacist, Journalist, and
Patient to keep an open mind with regards to balancing possible
benefits and consequences associated with pharmacologic therapies.
The revelation that patients are often harmed from medication
treatments should not be a surprise to many. Finger pointing
is not necessary. Together we all need to develop effective data
collections and monitoring techniques to help detect and analyze and
complications from these panaceas.
|One such medication that is prescribed at an incredibly
high incidence includes the statins. Also known as 3-hydroxy-
3-methlglutaryl coenzyme A reductase inhibitors are commonly
prescribed for patients who have hyperlipidemia without any
evidence of cardiovascular disease (CVD). Most physicians and
patients would gladly trade any minimal adverse effect of their use because of a perceived tremendous cardiovascular benefit to its longterm
use. The literature today demonstrates the disparity between the
true incidence of complications and the minimal benefit in primary
prevention of heath disease. What are the consequences of using a
therapy that may prevent a future disease? No harm no foul?
|The idea that a therapy may prevent a dire health condition in the
future is complicated by the fact that over twenty years has passed
since widespread use of this class of medications came to market
without any epidemiologic proof that it they are working for primary
prevention. Patient complaints often described as muscle pain or
weakness, fatigue, impotence, loss of libido and erectile dysfunction
(E.D.), and memory loss are seldom characterized as associated drug
induced complications. Objective laboratory results that indicate
increases in blood sugar or hepatic complications including significant
elevations of liver enzyme levels are rarely considered justifications to
stop statin therapy. This is remarkable when one considers that these
drugs have the potential for rhabdomyolysis and death exists.
|To be considered is the limited evidence showing that primary
prevention with statins can improve patient quality of life among
people at low cardiovascular risk. Without cost effectiveness
consensus or consideration of the minimal reporting of adverse
effects to the U.S. Food and Drug Administration (FDA), it is very
unlikely that physicians and researchers are being provided with full
information about the complications related to this class of drugs.
|Recognition and awareness of medications ability to compromise
a patientís well being along with improved efforts to develop
comprehensive and straightforward knowledge about risks and
benefits would improve health care and the quality of care for all who
utilize pharmacologic therapies.
|It is my hope that the Journal of Drug Intoxication & Detoxification : Novel Approaches , can examine the many classes of medications that due to the lack of knowledge or recognition of toxicity continues to infect patients with an impaired quality of life.
pdf version of this article