Adverse effects of medications
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Overview of Adverse Effects of Medications
Adverse effects of medications, also known as adverse drug reactions (ADRs), are unintended and harmful responses to drugs given at normal doses. These reactions are a major concern in healthcare, leading to significant patient harm, increased hospitalizations, and a heavy burden on healthcare systems worldwide 2345+3 MORE.
Common Types and Systems Affected by Adverse Drug Reactions
The most frequently reported adverse drug reactions affect the central nervous system, gastrointestinal system, and cardiovascular system. These can include symptoms such as confusion, dizziness, nausea, vomiting, diarrhea, and heart rhythm disturbances 35. In psychiatric settings, specific adverse effects like extrapyramidal symptoms (e.g., dystonia, parkinsonism, akathisia, tardive dyskinesia), neuroleptic malignant syndrome, hyperprolactinaemia, arrhythmias, and sexual dysfunction are commonly seen with psychotropic medications 17.
High-Risk Groups and Contributing Factors
Older adults are particularly vulnerable to adverse drug reactions due to age-related changes in drug metabolism, multiple chronic conditions, and the use of many medications (polypharmacy). The risk of ADRs increases with the number of medications taken, inappropriate prescribing, and insufficient monitoring 45910. Patients with impaired liver or kidney function and those with multiple comorbidities are also at higher risk 5810.
Prevalence and Impact
Adverse drug reactions are common, with studies showing that up to 17% of hospital inpatients experience them, and they are a leading cause of hospital admissions, especially among older adults 239. ADRs can lead to serious complications such as falls, bleeding, renal failure, and even death 910. Many ADRs are preventable, and between one-third to one-half could be avoided with better prescribing and monitoring practices 810.
Mechanisms and Types of Adverse Drug Reactions
ADRs can be classified as reactions that may occur in anyone (predictable, dose-related) or only in susceptible individuals (unpredictable, often immune-mediated or idiosyncratic) 23. Drug allergies are a specific type of ADR involving the immune system and can be severe or life-threatening 238.
Prevention, Detection, and Management
Preventing ADRs involves careful assessment of patient risk factors such as age, comorbidities, and potential drug interactions before prescribing. Regular medication reviews, clear therapeutic goals, and deprescribing unnecessary medications are key strategies 6810. Pharmacogenetics is an emerging field that may help tailor drug therapy to individual patients in the future . For managing ADRs, dose reduction, switching medications, behavioral interventions, and using additional medications to counteract side effects are common approaches, especially for antipsychotic-induced adverse effects 17.
Conclusion
Adverse effects of medications are a significant and ongoing challenge in healthcare, especially for older adults and those with complex medical needs. Most ADRs affect the nervous, gastrointestinal, and cardiovascular systems, and many are preventable with careful prescribing, monitoring, and regular medication review. Addressing ADRs is essential to improve patient safety, reduce hospitalizations, and lower healthcare costs 3456+3 MORE.
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