TAKING DRUGS WITH A HINT OF CAUTION
Everyone of us has fallen ill atleast once in our life time and we always consult our family doctor or a pharmacist or we become our own doctor and buy over the counter drugs. We may get well soon or sometimes it may take longer to treat the disease, which becomes chronic over time. Chronicity makes us pop up pills on a regular basis. But have you ever given it a thought that these drugs while benefitting may have multiple side effects. Longer the duration of drug intake greater the chances of adverse effects. Skin being the largest organ bears the brunt and side effects become obvious even to a layman with naked eye. Every side effect speaks for itself about its relationship with the causative agent.
They can appear in any age infants, young or elders and can appear immediately or over time. Any change which one notices on skin or its appendages while taking medicine can be labelled as side effect of that drug.
Drug reactions can present in myriad forms from reddish swellings, pin point itchy red eruptions, acneiform eruptions to almost complete loss of skin and body function, leading eventually to even death at times.
We often see acne like eruptions on face, neck and shoulders due to oral corticosteroid, oral or intrauterine progesterone (contraceptives), anabolic steroid like danazol (abused by body builders or athletes), lithium (used as an anti depressant) or isoniazid (used as an anti-tubercular). Judicially or non judicially prescribed steroids can lead to striae, obesity, diabetes, weakening of bones or glaucoma.
Fixed drug eruptions (FDE) are seen with over the counter drugs like pain-killers (paracetamol, ibuprofen, diclofenac, nimesulide etc), anti diarrhoeal drugs like ciprofloxacin, norfloxacin, metronidazole, tinidazole and ornidazole. FDE presents as bluish- black pigmented patches which can recur at new and old fixed sites on repeated intake of the inciting drug.
Generalised erythema (reddish discolouration of skin) with urticaria can be seen with antihypertensive drugs like captopril, lisinopril or with pain killers like ibuprofen, nimuselide, diclofenac, amoxycillin, ampicillin, ofloxacin. Urticarial rash is the most common side effect of drugs and can occur with almost any drug. Maculopapular drug rash presenting as severely itchy red pinpointed lesions, is another common presentation that can occur with pain killers, antibiotics and anti epileptics. Sometimes these rash can also involve systemic organs like liver, lungs, kidney and blood to take a more ominous turn.
People using over the counter pain killers, antifungals and other topical applications can develop photosenstivity to sunlight.
Skin pigmentation can be attributed to amiodarone, minocycline, clofazimine and chloroquine and many anti-cancer drugs.
Topical painkillers, gels or sprays may irritate the skin causing acute erythema and burning sensation.
Not only this but certain antiepileptics like carbamazapine, phenytoin, antibiotics like cotrimoxazole and anti HIV drugs ( nevirapine) may land you into life threatening conditions like steven johnson syndrome or pemphigus vulgaris, which involves partial to complete loss of skin with mucosal erosions.
Hairfall is commonly observed with oral contraceptive pills, antiepileptics like valproate, carbamazepine or with lithium. Increased facial or body hair are observed in patients using phenytoin, cyclosporine, bimatoprost (glaucoma patient), steroids. Antithyroid drugs and antiobesity drugs may also trigger hairfall while thyroid disorders and sudden weight loss can itself precipitate hair fall.
Steroids are the most commonly prescribed drugs by general practitioners for any and every problem. But its potent and fast benefits are accompanied by many dangerous side effects. From causing hypertrichosis and acne on the face to skin atrophy, glaucoma to cataract, loss of bone density in important joints to hypertension, diabetes and swelling of the body, steroids have a range of side effects to pick from. Many of the side effects are life- threatening too. Steroid dependence is another problem seen in such cases when withdrawal of the drug leads to severe flare and rebound.
While taking medicine there may be a flare up of current disease or it might be a new disease and can be become troublesome especially in extremes of ages.
Adverse drug reactions are like free items that come along with the main product for which we are paying the price. These side effects must not deter one from taking the full prescribed course with proper dosage. No one can deny the fact that every medicine has potential side effects, but medicines are only prescribed after weighing the benefits. These adverse drug reactions can hamper patient-doctor relationship. This brings to light the role of an expert eye which can easily differentiate side effects from disease.
Whatever it may be peer pressure or TV advertisement, don't succumb to it and always consult an expert before taking the medicine or an over the counter drug.
Stay fit stay healthy stay young...
