When d***s do more harm than good to one’s health
Medicine is meant to heal, but what happens when it leaves you with more negative costly effects?
Mary Nyakio, 76, is not a happy patient. The drugs she has been taking for diabetes for the last three months have left her with an itchy neck, as demonstrated by the blackish rings on her throat.
She has come here to request the doctor to prescribe a different drug, preferably a topical ointment — not a tablet.
She has been coming to the Gatundu Level Five Hospital for the last two months. “Around six months ago I was given three drugs, and when the doctor realised I reacted negatively to them, he did away with one,” Nyakio says.
She adds that the new drug is currently working well. “Before that, whenever I took one of the drugs, I would develop severe stomachache. The only problem now is the pain on my neck,” she explains.
Also at the hospital is Daniel Muturi, another patient experiencing reaction to prescription drug. He is taking medication for both high blood pressure and diabetes.
He thinks taking both the drugs at once affects his eyesight, so he came to the hospital for advice on how to balance the drugs.
Towards the end of the consultation session, the doctor explains the negative effects are caused by an overdose. Apparently, Muturi had unknowingly been overdosing on high blood pressure drugs by taking two different brands.
The doctor advised Muturi to do away with one of the drugs and prescribed three other drugs to further fight the effects.
For Teresia Njeri, 60, the drugs she had been taking had been causing headache and causing her inflamation of the legs. “These drugs would make me dizzy and I would nauseated,” she says.
Njeri had been using the drug since 2009, nine years after she was diagnosed with breast cancer. After the diagnosis, she was shocked to see her blood pressure shoot.
“My journey with high blood pressure and drugs began then, when the doctor told me my condition was in the first stage,” she explains.
Poor understanding of drugs
Nyakio, Muturi and Njeri share one thing: adverse drug reaction (ADR). Dr Kagwa Gichuki of Gatundu Level Five Hospital defines ADR as harmful, unintended occurrences that take place after taking a drug.
The Pharmacy and Poisons Board says the harmful effects are associated with use of drugs including following a normal dose, an overdose, misuse or error.
In some cases, if the reaction is mild, patients can continue with the medication but in other cases, the reactions are so severe that medication is changed or patients given additional medical treatment.
Noting that all the above patients are older, Kagwa says hypertension and diabetes rarely affect young people. “Young people don’t use medication as frequently as older ones, whose immune system has been weakened by prolonged use of drugs,” he says.
He adds: “Patients with diabetes will likely be on two or three drugs. Diabetes drugs cause complicationsuch as itchiness. A patient with arthritis, hypertension and diabetes will be prescribed a minimum of seven drugs.”
Kagwa attributes ADR to the advanced age of most of the patients, which means some would likely not understand the drugs and the prescription.
He admits any drug can cause ADR. “For diabetes, the most notorious drug with ADR is called Gibenclamide, whose purpose is to lower a patient’s blood sugar, but if not used well, can cause hypoglycaemia, (low blood sugar levels). Side effects of the drug include fainting, shaking and dizziness,” he explains.
Dr Daniella Munene, a registered pharmacist and the chief executive of Pharmaceutical Society of Kenya (PSK), says there is no increase in ADR cases in Kenya.
“The perceived increase is a good thing because there is more awareness amongst patients and health care professionals who report them,” she says.
She confirms that because our bodies react differently to drugs, any medicine can cause ADR.
“The important thing is to minimise their occurrence by proper compliance to instructions, with respect to dosing, timing, concomitant herbs, foods and other medicine,” she adds.
Reporting mechanisms
To put things into perspective, Munene debunks ADR, Adverse Drug Event (ADE) and drug allergies: “An adverse event is any unexpected effect after taking medicines. The effect is associated with taking the medicine.
Once you investigate what caused the event then you can say it was an adverse drug reaction, including drug allergies—which are also drug reactions,” she says.
Once someone has an effect, it is referred to as an effect, we just call it an adverse effect since doctors do not know if it’s caused by the drug or a combination of the drug or herb or diet or maybe something else totally unrelated.
“Initially they are all called Adverse Events ( AE). Then after establishing that the drug truly contributed to the effect then we call it an ADR.
It includes drug allergies, but also includes lack of effect such as persistent or increased pain after taking a painkiller,” she says.
If you have ADR issues or suspect any drug side effects, Munene insists you must report directly to the regulator or to the website of the Poisons and Pharmacy Board.
“If the website is too complex, the patient can report directly to the pharmacist. They can also go back to the doctor and explain their experiences.
The pharmacists are trained on reporting such information to the regulator, who then collates all data and determine any associating trends, she explains.
All that information is then collected into a global database by the World Health Organisation, which then gives professionals new information to combat ADR issues.
