Right prescription

Physicians have a tendency of prescribing drugs for a certain ailment without actually delving in-depth into a patient’s medical history, with the result that despite being effective against that particular ailment, the medications often pose the risk of contraindications and side effects.

For instance, it is a common practice among doctors to prescribe antibiotics as soon as they detect infectious disease in a patient. Similarly, there is always a likelihood of those with high cholesterol levels and cardiac conditions like thickening of the arteries being prescribed blood thinning drugs like aspirins.

These drugs do facilitate smooth blood flow and pre-empt the eventuality of cardiac arrests, but according to scientists, their regular consumption also causes internal bleeding in patients who are predisposed to various other ailments. Such side effects and complications caused by a drug are often overlooked or ignored with more focus on prescribing disease-specific drugs. The same is the case with antibiotics.

Despite widespread concerns expressed by experts about the risk of promiscuous use of antibiotics, there are doctors who continue to consider these drugs as the panacea for bacterial infections. In fact, antibiotics are being prescribed not just on an indication of an infection, but also as a precaution to pre-empt onset of infectious diseases.

A study carried out on 1,500 adult patients says 20 per cent of patients who received antibiotics experienced one or more adverse effects –for each additional 10 days of antibiotics, the risk of side effects increased by 3 per cent. Gastrointestinal, kidney and blood abnormalities were the most common side effects experienced, accounting for 42 per cent, 24 per cent and 15 per cent of adverse effects experienced, respectively.

It further revealed that patients were observed for up to 90 days for the development of Clostridium difficile infection – a bacterial cause of diarrhea that can become severe – and for the development of new multidrug-resistant infections, as these often take longer to become apparent.

A total of 4 per cent and 6 per cent of patients developed C. difficile infections and potential multidrug-resistant organism infections, respectively. In India’s context, the manifestation of adverse or side-effects from drugs can be attributed to lack of comprehensive and extensive information of the patient’s medical history, apart from the ailment on which a diagnosis is sought.

While diagnosis is based on examination of the existing problem, other undiagnosed or unknown diseases lurking within are not considered while prescribing the drugs. A drug may be effective against the diagnosed problem, but at the same time it may trigger adverse reactions due to susceptibility of undiagnosed/unknown or undisclosed diseases to the prescribed medication.

Onus is not just on doctors, but also on patients who should disclose their medical history, even if they are unrelated to their existing ailment. Of course, for this to happen, awareness needs to be created among people to maintain case histories. Even if patients do not have these records, it is always advisable for patients to narrate all their previous problems to the doctor so that drugs that do not cause side effects can be prescribed accordingly.