Ileostomy and drug treatment

People with an ileostomy always have the same worrying question: “Which medications can be taken and which cannot?” With an ileostomy, the length of the gastrointestinal tract is shorter than in a healthy person. This affects the time it takes for drugs to pass through the digestive tract. For the same reason, not all medications have time to dissolve and be absorbed into the blood before bowel movement at the usual dosage or dosage form. It follows that not all medications are indicated for use by people with an ileostomy. Loss of the large intestine (colon) means a high degree of susceptibility to dehydration, since this is the organ that plays a major role in our body. important role in the absorption of water from incoming food. Patients with ileostomy need to be extremely careful when choosing medications that may cause them to become dehydrated.

Do not stop your medication prematurely. Antibiotics are a classic example of this rule: they quickly deplete pathogens, so that the patient usually feels better soon. But there are still germs in the body that will destroy the immune system only in the next therapist. This only works if the immune system and antibiotic can work together for quite a long time. If you drop your antibiotic early, the infection will flare up again. You can also take other medications only after consulting your doctor.

Even in people with a healthy gastrointestinal tract, the absorption and dissolution patterns of drugs are different. It is therefore not surprising that such a difference is also observed in patients with ileostomy, despite the shorter length of the digestive canal and the time of passage of drugs through it.

Oral medications first dissolve and then enter the bloodstream through the intestinal mucosa. The stomach absorbs medications to a slightly lesser extent. The inner surface of the intestine, especially the small intestine, has a large area and is well supplied with blood, so it is here that the main absorption of drugs occurs. Most drugs are absorbed jejunum, located in the upper section small intestine, so they do not reach the ileostomy. Only a few types of drugs are not absorbed in this segment of the human intestine. In the colon, medicinal substances are not absorbed as actively.

If you drop the blood pressure knob from a group of beta blockers from today to tomorrow, your blood pressure will suddenly rise sharply or abnormalities occur heart rate. Each patient receives an average of 15 drugs a year from his doctor, and he buys another seven packs at his own responsibility. But are we taking drugs correctly? Do not take this medication with any of the following: If you miss a dose, take it as soon as possible.

Pharmacists estimate that 40% of patients do not take prescribed medications correctly. However, the wrong dose involves two dangers for the unwary patient: the drug may lose its effectiveness, or it may increase the risk of occurrence or even dangerous unwanted side effects.

Dosage forms and pharmacokinetics

The main factor influencing the speed and site of absorption of a drug by the gastrointestinal tract is the ability of a particular type of drug to dissolve in the stomach and intestines. Recommended dosage forms and dosages for ileostomy are presented in Table 2. The greatest preference is given to drugs that are already dissolved in liquid or are rapidly soluble. For example, various types of liquid solutions (potions, oral drops, syrups) no longer require dissolution. Some types of tablets are designed to be dissolved in the mouth or under the tongue. Medicines in the form of suspensions are absorbed just as well as solutions (however, there are a number of modified absorption suspensions; they may not have time to be absorbed by the body before being removed from the intestinal tract). Chewable tablets, uncoated tablets, gelatin capsule medications are all alternative solutions to solutions or oromucosal tablets. Film-coated tablets and pills take longer to dissolve but are acceptable for people with an ileostomy. Patients should avoid modified-release medications (see Table 3) as they will not have time to be absorbed when passing through the digestive tract. Among them, a distinction is made between controlled-release and gradual-release tablets.

Possible mistakes already begin with the choice of liquid with which the tablets fall: many medications cannot be taken with fruit juices. For example, antibiotics may lose their resistance through fruit acid and are then no longer absorbed by the body in sufficient quantities.

Milk is also wrong: there are medicines that form calcium from milk-insoluble complexes or salts. This is especially true for tetracycline preparations. However, this antibiotic also forms insoluble complexes with iron preparations or iron-containing tonics and with gastric agents containing aluminum or magnesium salts.

Controlled release tablets are created using a special technology. They are gradually absorbed over several hours, passing through the human gastrointestinal tract. The effect is achieved by gradual melting of the tablet and release of the next dose medicinal substance at certain intervals. Such tablets do not have to be taken 3-4 times a day, 1-2 doses are enough. Very relevant and convenient for forgetful people who often forget about the appointment time. The likelihood of missing a required dose of medication is reduced. However, despite the valuable benefits of this type of tablet, there may simply not be enough time for the drug to be fully absorbed once the ileostomy is reached.

Basic forms of drugs

The psyche can also influence the absorption of drugs: thus, anxiety delays gastric emptying. And even body position plays a role: emptying occurs more slowly if on the left side. When lying on the right side, the contents of the stomach reach the intestines faster.

Medicines that require slow absorption into the body should be taken during or after meals. These include blood flow medications, many medications, blood pressure, antibiotics, and psychopharmaceuticals. In addition, rheumatids, which can have an aggressive effect on the gastric mucosa, are best taken as food.

Time-release tablets have a stomach acid-resistant coating. Moreover, they dissolve only upon reaching certain segments of the human digestive tract or after a certain period of time. This includes enteric tablets. They usually have a special, durable coating that dissolves only when it reaches the intestines. With an ileostomy, however, the coating may not have time to dissolve to allow the medication to be properly absorbed by the intestines before bowel movement.

Little is known about the fact that smoking can also greatly affect the amount of certain drugs in the body. Cigarette smoke contains specific substances that can also affect the functioning of the body's enzymes. Last but not least, regular alcohol consumption can affect drug use: the enzymatic activity of the liver is accelerated by alcohol, some painkillers, sleeping pills and psychopharmaceuticals are therefore eliminated faster and do not work as prescribed by the doctor.

How to find the right dose? “What is poison and what is not poison?” Probably the most famous German physician of the Middle Ages asked Paracelsus, and found the answer for this day: “Everything is poison, and nothing is poison, but the dose makes it a poison or not.” The correct dosage of the drug requires a lot of knowledge from the doctor. In the case of many drugs, it should approach the lowest, already sufficiently effective dose from below. He must take into account the gender, age and physical characteristics of his patient.

Medicines that can cause dehydration

The main function of the colon is to absorb water and electrolytes from food (sodium and potassium). In patients with ileostomy small intestine takes over some of the absorptive functions of the large intestine. However, stool with an ileostomy is liquid and almost constant, so the body constantly loses a lot of water and electrolytes. People with a normally functioning ileostomy always have mild dehydration, which can very quickly lead to dehydration, especially under a number of factors.

He must know the rate of absorption and excretion of the drug. Important: The idea of ​​"double down" can be a dangerous mistake for medications. Always follow dosage instructions and take only the prescribed amounts of the medication. It is important that children are not harmed in any way so that they can recover. It is also often not recommended to immediately go back to medications, for example, to treat a fever for the same fever.

Some complaints can often be overcome with special attention and simple home remedies such as heat, herbal teas, massage and the like. This certainly doesn't mean you should minimize it if your child has pain. And in no case does this mean delaying any necessary medical or medical treatment.

Drugs that can cause dehydration should be taken with caution or avoided altogether. Diuretics (diuretics), especially, should be used with caution - with frequent urination, too much water and electrolytes are removed from the body.

Some antibiotics cause diarrhea, which can also lead to dehydration. If taking an antibiotic cannot be avoided, you should find out whether the drug can cause diarrhea and what measures need to be taken to avoid dehydration. Drugs such as Regidron help restore salt balance during diarrhea and massive fluid loss. In severe cases, intravenous administration of salt solutions is used for this.

Enteral administration: advantages and disadvantages

For some diseases, drug treatment is important. In particular, infections caused by viruses and bacteria - such as the urinary tract, middle ear or sinuses - which are relatively common during a child's age usually require drug treatment. For some chronic diseases It even requires regular medication. . Your or your pediatrician will certainly carefully weigh when drug treatment is necessary and appropriate and which drug is best for your child.

Antacids (acid neutralizers) containing magnesium can also cause diarrhea, so patients with an ileostomy should use them with caution. Before taking a new medicine, study the side effects described in the instructions that may occur, whether diarrhea is among them. It is not recommended for ostomy patients with an ileostomy to take laxatives - dehydration can develop very quickly. (Table 3). In cases where a laxative is typically used, such as before a bowel exam or before surgery, people with an ileostomy should stop eating salty foods and drink plenty of plain water for 24 hours before the procedure.

Possible problems in contacting a doctor

Children are often reluctant to use products legal protection and feel ambivalence towards their parents very accurately. Often this combination will result in the medication not being given with sufficient frequency and duration. If you have any concerns about drug addiction treatment and care, you should discuss it when you visit your doctor. Allow yourself to explain the medicine, how and for how long they should be taken, what you should look for and what side effects may occur. If your child is taking medication, it is important that you are confident. . If your child is already suffering from an illness other than an acute one, you should be sure to tell your pediatrician or pediatrician.

Tips for people with ostomies when choosing medicines

An important thing to ensure the correct choice of medication is consultation with your doctor or other employee of a specialized medical institution.

Whenever you get a prescription, make sure the doctor knows about ileostomy and medications that may not be absorbed quickly enough when taken orally. Double check your prescription list to see if there are any modified-release tablets on your prescription list.

For example, some active substances may negatively affect pre-existing other diseases. Or there may be interactions with medications that are taken regularly, resulting in increased or decreased absorption of the active substance. This also applies to prescription and over-the-counter medications, which should never be underestimated.

Advantages and disadvantages

In addition to correct dosage, many medications also have an abundance, timing, and duration for taking them. These indications are important for the active substance to develop its optimal effectiveness, but also to avoid possible side effects or incompatibilities.

If the medicine is taken orally, use one of the following, if possible: dosage forms listed in Table 2. If the recommended forms are not available, ask if there is an alternative to the medicine you need in the same form or if the medicine can be administered by another route, such as vaginally or through a patch.

If antibiotics are used, they should not be taken with milk, as some antibiotics prevent the active substance from being taken. Some substances can significantly increase the effectiveness of medications and cause serious side effects. This may come into play when certain side effects, such as gastrointestinal effects, are to be avoided, or when absorption of the active ingredient is dependent on digestive processes. For some medications, the body must first be carefully acclimated to the active ingredient to ensure better tolerance. In this case, start with a low dose, which is gradually increased according to a specific schedule. Likewise, these medications are not usually stopped suddenly, but the dosage is gradually reduced.

• In general, all medications should be taken with plenty of water.
• No medications should be taken with grapefruit juice.
• Sometimes the question arises whether the medicine should be taken before, after or after meals.

You should not change your dosage schedule or dosage.

Pre-crushing the tablets or sprinkling the contents of the capsules into food or drinks promotes better dissolution and absorption, but should not be done without the approval of a doctor or specialist. It may not be safe. Modified-release tablets should not be crushed or crushed, and most capsules should not be opened, as too much medication can enter your blood at one time and cause serious side effects. The medicine can cause stomach upset and irritation, and may not dissolve in a timely manner. There are also unmodified release medications that should not be opened or crushed.

For example, it is very important, especially in the case of antibiotics, to strictly adhere to the prescribed ingestion period. Otherwise, the bacteria may regain the upper hand and the disease may flare up again. It is also possible to develop resistance, which means that bacteria become resistant to the antibiotic and therefore cannot fight effectively.

Don't give any medicine yourself

Drugs suitable for children must be specially adapted to the child’s body in composition and dosage. As a general rule, your child should only be given medications after consulting with your pediatrician. Exceptional cases should be limited to those you know very well, such as fever.

Take all prescribed medications exactly as directed in the prescription and follow all directions in the package insert. Tell your doctor about the missed dose. If the medicine you are taking is not effective, it may be due to more than just poor absorption. You may have taken it without following the prescription directions, or you may need to adjust the dosage differently.

Tell your prescriber if you have traces of undissolved tablets or capsules in your stool. Before you refill a new prescription or buy an over-the-counter medication, ask your doctor or pharmacist about possible side effects, including those that may affect your ileostomy.

Conclusion

Medication absorption and unwanted side effects are a common problem for those with an ileostomy. The main factor in the absorption of tablets or solutions by the gastrointestinal tract is the dosage form. With an ileostomy, the digestive canal is shortened, so you should choose medications so that they have time to quickly dissolve and be absorbed.

With an ileostomy, the time it takes for food, liquids, etc. to pass through the digestive tract. reduced. This often prevents tablets and solutions from being completely absorbed by the body. Drugs that may cause dehydration are not recommended for ostomy patients with an ileostomy. If you have problems taking your medications, we recommend that you consult your doctor, pharmacist, or ostomy specialist.

Table 1. Characteristics of the gastrointestinal tract

	Approximate length	Average transit time	Main function
Gastrointestinal tract	17 to 29 feet	Up to 38 hours
			Passage of food from the mouth to the stomach
Stomach: - empty - filled		From 0.5 to 1.5 hours From 2 to 6 hours	Production gastric juice to digest food or medicine
Small intestine: - Duodenum - Jejunum - Ileum	12 to 21 feet: - From 8 to 12 inches - From 5 to 9 feet - From 7 to 11 feet	From 2 to 4 hours: - From 3 to 10 minutes - From 0.5 to 2 hours - From 0.5 to 2.5 hours	Absorption of food and drugs
Colon: - Cecum - Colon - Rectum	5 feet: - 3 inches - 3 to 5 feet - From 4 to 6 inches	Until 27 o'clock	The colon absorbs water, the rectum removes feces

	Alternative	Takes longer to be absorbed
Oromucosal and absorption tablets	Chewable tablets	Regular tablets
Sublingual (sublingual) tablets	Uncoated tablets
Liquids (elixirs, mixtures, syrups, suspensions)	Gelatin-coated capsules	Film-coated tablets

Laxatives – can cause rapid dehydration
Modified release drugs - poorly absorbed

Common terms for controlled-release drugs
Slow release
Sustained release
Controlled release
Continuous release
Delayed release
Periodic release

Common terms for time-release drugs
Gastro-resistant tablets (enteric-soluble)
Tablets with prolonged action (phase)

Not all modified-release drugs are marketed under the above term.

Ask your pharmacist or doctor for the exact name of the drug.

Table 4. Medicines that can cause dehydration

Antibiotics	May cause diarrhea
	May cause diarrhea
Diuretics (diuretics)	Causes increased urination and may reduce potassium levels in the body

IN Lately There is increasing talk that medications can cause or worsen the symptoms of almost any disease.

Serious scientific publications publish research data confirming the general harmful effects of drugs on sick people. Thus, scientists conducted a study which found that medications cause the death of about 100 thousand people every year, and also lead to the development of severe diseases in more than 2 million people. This phenomenon is called medicinal disease.

Scientific studies also show that in approximately half of the cases, the negative consequences of using medications occurred due to taking unreasonably high doses, which is a mistake by doctors. In addition, some patients simply do not inform their treating physicians about the presence allergic reactions for certain drugs. Often drugs are prescribed without taking into account the individual characteristics of the patient.

Thus, according to ongoing research, in the United States, for approximately half of both children and adults, doctors viral diseases that do not require the use of antibiotics, such as colds, are still prescribed.

Research conducted by scientists at the Harvard University School of Medicine has shown that about 20% of hospitalized patients take medications prescribed by a doctor to their detriment. This is often caused by overdosing. According to researchers, doctors overestimate doses to be on the safe side. None of the patients studied died, but about 30% of them suffered complications after hospital therapy.

The most common complications caused by unnecessary medication use are diarrhea, dehydration and weakness. These consequences could have been avoided in approximately 60% of cases if medical personnel had been more attentive to patients.

[!] The word "medicine" comes from Greek word“pharmakeia”, which translates both as “medicine” and “poison”.

Doctors prescribe medications too quickly. Thus, when complaining of insomnia, more than 60% of doctors prescribed sleeping pills to patients, while the cause of this condition could be strong tea or coffee at night, nap, lack of physical exercise, etc. When people complain of abdominal pain and data endoscopic examination, talking about diffuse irritation of the stomach walls, about 65% of doctors prescribe them drugs from the group of H2-histamine blockers, for example ranitidine. However, in many cases, the cause of pain in the abdomen is the same coffee, smoking, stress, uncontrolled use of aspirin, etc. In all of these cases, it would be more correct to identify and try to eliminate the real causes or at least reduce their influence.

There are also frequent cases in medical practice when a disease occurs as a reaction to taking some medicine. In this case, prescribing another drug to eliminate the existing disease is fraught with negative consequences. Unfortunately, doctors spend little time finding out all the factors that led to the occurrence of a particular disease. Too often, people take medications in situations in which drug treatment could be avoided by using other treatments or at least significantly reducing the number of medications taken during treatment.

[!] 10 times more people die from drug-related side effects than from surgical errors.

Researchers from the Universities of Toronto and Harvard discovered a phenomenon they called the prescription cascade. It lies in the fact that when a person experiences a side effect after taking a drug, the doctor mistakenly interprets it as a symptom of a new disease and prescribes another drug to treat it, which can also cause side effects and can be interpreted in his own way. turn, as a sign of another disease. Thus, in a cascade, medications are prescribed that are not so much effective for the patient as they are harmful.

For example, the use of antidepressants, antipsychotics and antihistamines may impair intestinal motility, prompting the doctor to prescribe laxatives. The use of cardiotropic drugs can lead to symptoms similar to those of Parkinson's disease, as a result of which drugs are prescribed to treat parkinsonism. Common symptoms such as depression, insomnia, sexual dysfunction, arrhythmias, heart disorders and blood pressure changes can also be caused by medications. At the same time, tranquilizers and sleeping pills used to treat these symptoms cause severe side effects, negatively affecting the functioning of the central nervous system. nervous system(CNS). Antihypertensive medications and drugs used to treat cardiac arrhythmias and gastrointestinal disorders can also lead to serious side effects.

[!] The Old Russian word "potion" means both a medicinal and a poisonous drink.

Against the backdrop of widespread advertising of therapy exclusively with drugs, even doctors themselves, when seeing a patient, are in a hurry to decide what should be prescribed to him, and not how to help him at all. As a result, in most cases other treatment methods, such as lifestyle changes or a therapeutic diet, are not taken into account.

The reason for the problem of drug disease is that in the modern world powerful chemicals are used as medicines. Their high biological activity sometimes makes it impossible to determine the boundary between the maximum effective and toxic doses; sometimes the difference between them is too small.

In addition, every drug without exception has at least some side effect, and there are contraindications to it. So, even the most seemingly safe drugs are actually harmful. For example, aspirin can cause a lot of trouble for those who are prone to bleeding or suffer from peptic ulcer stomach or intestines. In such people, taking aspirin can cause serious illness and sometimes cause death.

Aspirin may also trigger asthma attacks in people predisposed to the disease. In children, aspirin can cause Reye's syndrome, especially during infections, when parents most often give the drug to relieve fever. Meanwhile, Reye's syndrome very often leads to death. This list of contraindications refers to a drug that is considered more or less safe!

[!] From 3 to 5% of all hospital admissions are caused by side effects of medications.

Likewise, any other drug can not only cause side effects, but also lead to fatal outcome. However, drug annotations do not always write about side effects. This mainly concerns small drug manufacturers. So it is advisable to purchase drugs from large, well-known pharmaceutical companies that, as a rule, try to provide complete information about their products.

But the danger of taking the drug incorrectly lies in the fact that the side effect is not always associated with exceeding the dose. Side effects can be different, for example in the form of allergic reactions. Even a minimal amount of the drug can lead to severe consequences. An overdose usually causes toxic reactions, which become more severe the more a person exceeds the dose allowed for treatment.

The reason for the occurrence of drug disease is also that many drugs are often incompatible with each other. The chemicals that make up drugs, when they enter the body and mix, begin to interact with each other, leading to unpredictable consequences. Various drugs interact to change the effect of other drugs. But in hospitals they often prescribe 5–10, and sometimes up to 40 medical supplies. The effect of so many drugs is simply impossible to describe.

It is not always possible to do without medications, especially with serious illnesses, but any person should know the rules of “medicine safety.”

Rules for taking medications

If a person is already taking any medications, it is recommended to write down in a separate notebook for each drug the dosage, frequency of use, indications for use, negative reactions of the body that the patient experienced, and other information given in the annotation for the drug.

After this, it is recommended to consult with your doctor about the possibility of reducing the dose of medications taken and the frequency of their use. At the same time, the possibility of excluding those drugs that are not absolutely necessary or are particularly dangerous should be discussed. Patients should not be afraid to contact their doctor with such suggestions. Reducing the number of drugs taken will lead to a decrease in the number of negative reactions of the body, and will also make it possible to significantly reduce the number of drugs used. Meanwhile, the drugs that are truly important for treatment will be used more effectively. The use of a large number of medications leads to disruption of their dosage regimen.

[!] Any medicine must be accompanied by an insert with information about the disadvantages and advantages in an understandable format. The annotation should describe in detail the rules for taking the drug. Along with the prescription, the doctor must provide information on the use of the drug.

You should not buy drugs that have been on the market for no more than 5 years. New drugs have not yet been studied enough, including for safety. Before entering the market, all drugs are tested on small groups of volunteers, which makes it possible to quickly determine their effectiveness. However, these tests are not enough to determine the safety of the drug. However, information about the effectiveness of the drug is also insufficient to compare it with existing drugs.

To determine what side effects a particular drug may cause, and whether it is safe to combine with other medications, it must be tested on hundreds of thousands of people. During the first 5 years after the release of a drug on the market, its properties are revealed, as a result of which the drug either remains on the market or is withdrawn from sale.

To avoid becoming a victim of a cascade of prescriptions, if any new symptom appears after starting to take the medicine, you should immediately inform your doctor about it.

Before changing your treatment regimen, you should consult your doctor. At the same time, you must try to be frank in order to help him draw the right conclusions about the effectiveness of the dosage. Concealing information about the medications you are taking from your doctor can lead to negative results.

There is no need to try to get new prescriptions from your doctor. It is better to discuss with him the possibility of using non-drug methods of therapy.

[!] Any medications prescribed by other specialists should be discussed with your personal physician.

The diseases that a person suffers from should not be hidden from the doctor so that the doctor can prescribe drugs that will not be dangerous. It is also necessary to evaluate all the negative effects of the prescribed drug in comparison with its beneficial effect. Perhaps the side effect will be much more serious than the disease itself. Thus, a common mistake is to prescribe to elderly people suffering from a mild form of hypertension, excessive medications. An asymptomatic disease may not lead to any negative changes in health, but taking a large number of medications, as a rule, has a negative impact on health. general condition body.

When choosing a medicine from a number of drugs with the same effect, it is better to give preference to single-component ones over combined ones. The more components a medicine contains, the greater the risk of it negative influence on the body.

All old, expired medications should be thrown away rather than stored for months or even years and then used. Under no circumstances should you recommend or even offer medications that have proven effective to your friends. Any prescription of medications must be made by a doctor. It is better to throw away unused drugs immediately after completing the course of therapy.

You should not unconditionally trust the recommendations given by a pharmacy worker who is not able to assess the condition of a random buyer and correctly prescribe him the right medicine. In such cases, you should always contact your attending physician, who knows about all past illnesses, can conduct an examination and correctly assess the patient’s condition.

Unfortunately, not all doctors are willing to work with the patient. Some of them turn out to be simply incompetent. They often do not even try to understand the essence of the disease, do not try to understand its causes, but immediately write out prescriptions in accordance with common features suspected illness. In such cases, doctors begin to treat the patient for something completely different from what he is sick with.

Doctors are increasingly advising their patients to take dietary supplements along with medications. Thanks to the natural components they contain, they are designed to help the body cope with the disease. However, many doctors cannot choose the right set of dietary supplements due to their incompetence. Nevertheless, many of them confidently prescribe a variety of dietary supplements to their patients, assuring them of their necessity, which is often not true.

Harmful drugs

Independent groups of experts from the World Health Organization (WHO) conducted studies that identified the most harmful drugs. These studies included reviewing and evaluating numerous statistics and studies on the harmfulness of drugs. The need for such research arose due to the fact that the problem of the harmful effects of medications on the human body is becoming increasingly acute throughout the world. Every day new drugs appear that have an increasingly stronger effect.

Independent experts first decided to identify the most harmful drugs among already well-known drugs, and then work on new ones. Based on the data received, the following list of drugs hazardous to health was compiled:

– thalidomide – depressant, prescribed to pregnant women to normalize sleep. It turned out that this drug causes developmental disorders (underdevelopment of limbs, deafness, blindness, cleft palate, etc.) in many thousands of children;

- anti-obesity medications. Drugs in this group are constantly withdrawn from sale. Many of them contain amphetamine, which is addictive and bad for the heart. Others contain fenfluramine, which can cause serious problems such as damage to the heart valves that require surgery to treat. New drugs containing dexfluramine-isolipane contribute to the development of pathological changes in the lungs;

[!] Currently, thalidomide is used to treat leprosy, or leprosy, since the drug has been shown to lower the level of tumor necrosis factor (a biologically active substance that increases inflammation) in the body.

- a growth hormone. This drug is advertised as a miracle cure for children who have little or no growth. It was produced in France from the pituitary glands of deceased people, some of whom were infected with the fatal degenerative Creutzfeldt-Jakob disease. As a result, in 1984–1986. More than a thousand children, in fact, received an infection along with the hormone, from which many of them died. The parents of some of them sued the Pasteur Institute and France Hypophyse, the producers of the hormone, as well as the doctors who prescribed the drug;

– the anticholesterol drug Lipobay (cerivastatin) from Bayer was withdrawn from the market due to identified life-threatening side effects. According to statistics, 52 people died from this drug in the United States alone, and more than a thousand patients had severe muscle damage. The drug also causes kidney dysfunction. In France, about 20 life-threatening cases have been reported in people who used both cerivastatin and gemfibrozil, drugs that lower blood cholesterol. Around the world, about 6 million people took the drugs in a similar combination.

In addition to the listed drugs, such well-known and widespread drugs as analgin and sedatives are harmful.

According to the latest scientific data, analgin causes changes in the composition of the blood and can lead to severe allergic reactions. Meanwhile, it is very popular as a pain reliever and is sold without a prescription in any pharmacy.

[!] Every day about 50 new chemical compounds are synthesized around the world

Currently, analgin is prohibited from being prescribed to children, pregnant and breastfeeding women. It is allowed to be prescribed only for certain diseases. You should not use analgin for diseases such as migraine. It is better to use other painkillers, such as paracetamol. One tablet of analgin may be enough to cause serious reactions in the body. In most European countries, analgin has not been used for treatment for a long time.

Sedatives are especially harmful to older people, who are most likely to take them. Such people have a very high risk of side effects. Dizziness, disorientation in space, loss of balance, and weight gain are often observed. The consequence of such symptoms is falls, which can lead to tragic results. The risk of side effects in older people increases by 2 times compared to younger patients.

Doctors advise dealing with insomnia in simpler ways, for example, taking a short walk every evening.

Medicines and pregnancy

Medicines whose long-term effects are unknown can be especially dangerous for pregnant women. During pregnancy, a woman’s body becomes very sensitive to chemicals, its defenses are significantly weakened due to internal changes. During this period, the load on the liver and kidneys, as well as the endocrine system, increases. Active cell division of the fetus occurs in the uterus, due to which it develops and grows.

During pregnancy, the bodies of a woman and her developing baby react differently to medications. Negative effects can occur at any stage of pregnancy. Medicines weaken blood flow in the placenta and disrupt the metabolism between the mother and child.

However, the most dangerous period for the fetus is the first 3 months. At this time, the main organs and systems of the new organism are formed. There are drugs that affect the growth rate of cells, tissues and organs of the embryo, slowing down or speeding up these processes. As a result, various defects arise that lead to disability or death of the child.

The ability of drugs to cause deformities and defects in the fetus is called teratogenicity.

The instructions for foreign drugs often contain the letters A, B, C, D and X. They indicate the degree of teratogenicity. These letters have the following meaning:

A – during special studies harmful effects the fetus has not been established;

B – during experiments on animals, no harmful effects on the fetus were detected, no special studies were conducted on humans, there is no data on the effect on humans;

C – during experiments on animals, a harmful effect on the fetus was discovered, but it has not been proven for humans;

D – special studies prove the existence of harmful effects on the fetus, but in special cases the drug can be prescribed to a pregnant woman, despite the risk;

X is an absolutely harmful drug for the fetus, its harmful effects exceed any possible benefit for the woman's body.

From the above classification of drugs it is clear that it is permissible for pregnant women to take drugs of groups A and B. Drugs of group C can be prescribed only if the beneficial effect of their use far outweighs the risk of harmful side effects. Group D drugs can be prescribed to pregnant women only in situations where life-threatening, and also when serious illnesses, in which less harmful drugs no longer help.

Group X medications are absolutely contraindicated for pregnant women, as well as for those women who are planning a pregnancy in the near future.

Sometimes the name of the drug is followed by not one, but two letters. They talk about different damaging effects at different stages of pregnancy. For example, aspirin early stages pregnancy is not as dangerous as in the last trimester. At this time, it is able to influence fetal blood clotting.

Below is a list of specific drugs that belong to one or another teratogenicity group.

Antimicrobial and antifungal drugs: amikacin C, amoxicillin B, amphotericin B, benzylpenicillin B, gentamicin C, griseofulvin C, dactinomycin D, doxycycline D, kanamycin D, carbenicillin B, kefzol B, claforan B, clindamycin B, clotrimazole B, chloramphenicol C, lincomycin B, metronidazole C, nystatin B, oleandomycin C, polymyxin B, rifampicin C, streptomycin D, sulfomethoxazole (part of Biseptol) B D, tetracycline D, trimethoprim (part of Biseptol) C, erythromycin B, furazolidone C, ciprofloxacin D .

Means to combat high blood pressure: apressin B, verapamil C, verospiron D, hypothiazide D, diacarb C, captopril C, methyldopa C, reserpine D.

Antipyretic and anti-inflammatory drugs: aspirin C D, acetaminophen (paracetamol) B, ibuprofen B D, indomethacin B D.

Hormonal drugs: betamethasone C, hydroxyprogesterone X, dexamethasone C, prednisolone B, estrogens X.

Antispasmodics, sedatives and hypnotics: aminophylline C, haloperidol C, droperidol C, caffeine B, morphine B D, (relanium) D, theophylline C, terbutaline B, phenobarbital B.

Anticoagulants (drugs that prevent blood clotting): aminocaproic acid C, heparin C, dipyridamole C.

Cardiac drugs: digoxin B, isoptin C, nitroglycerin C, nitrong C, epinephrine C.

Drugs for the treatment of stomach and intestinal disorders: cuprenil D, imodium C, piperazine B, pyrantel C, cimetidine B.

Hormonal contraceptives, some antibiotics, antidepressants, analgesics, antihypertensive drugs, vitamin A in doses exceeding 10,000 IU per day are absolutely contraindicated during pregnancy.

There are also the following groups of drugs:

– the risk from the use of which has not been proven, but its absence has not been proven either;

– the effect of which does not always manifest itself, but only in the presence of certain unfavorable factors;

– drugs that can cause side effects, but they are still prescribed to pregnant women in cases where their positive effect (for example, cure for a dangerous disease) outweighs the risk of a harmful effect.

Pregnant women should not receive some vaccinations, despite the fact that they are generally harmful. modern vaccines not proven during pregnancy.

When taking medications, not only do they affect pregnancy, but pregnancy itself changes the effect of the medications. For example, the absorption, distribution and excretion of a drug may change, resulting in changes in its effect on the body.

During pregnancy, the volume of extracellular fluid, as well as the concentration of proteins and other substances in cells, change. Towards the end of pregnancy, a woman’s load on the liver and kidneys, which are involved in the elimination and processing of drugs, increases.

For many women during pregnancy, the use of certain drugs is contraindicated. medicinal plants, such as comfrey, cassia, stephania, magnolia, jasmine, coltsfoot, juniper, etc.

When planning a pregnancy, it is advisable to stop taking medications in advance without a doctor’s prescription. Moreover, this rule should be followed not only by the woman, but also by the future father of the child.

If medications cannot be avoided, a pregnant woman should definitely consult a doctor. Sometimes medications need to be prescribed during pregnancy. In this case, you must strictly follow the doctor's recommendations. Unauthorized or uncontrolled use of medications should be excluded.

Very often, drugs cause harm to people because they begin to use them in excessive quantities and often at the same time as other drugs. For example, a therapist wrote in a prescription a whole list of medications, from which the patient must choose only one to take. However, the patient buys all prescribed drugs at the pharmacy with the intention of using them, assuming that the more quantity he takes, the more effective the treatment will be. There is even a special term in medicine - polypharmacy - meaning the simultaneous prescription of a large number of medications. Such cases are not rare.

When prescribing a drug to a patient, the doctor must be guided by the rule evidence-based medicine, requiring that the effectiveness of the prescribed medicine be proven, and its side effects verified. The therapist and his patient must know what result will be achieved at the end of the course of treatment. The use of medications must be justified.

Advertising contributes to the misconception about the use of medicines. Information about medications, their amazing properties and wonderful effects not only expands the listener’s “knowledge”, but also encourages him to take action.

By regularly watching TV or listening to the radio, a person acquires a clear understanding of what he should do in case of diarrhea, constipation, dandruff on the head or fungus on the legs, sore throat and nasal congestion. Medicines are advertised that cure everything from a runny nose to complex cardiac diseases, treatment methods for which should only be prescribed by a specialist. Accordingly, only a professional doctor can understand the effect of drugs.

However, should you trust advertising and the information obtained from it and prescribe medications to yourself without consulting a doctor? The doctors themselves will undoubtedly answer negatively in most cases. Any therapy, even for mild diseases, always requires an individual approach to the patient. Only a professional doctor can evaluate all the factors by putting them together. He knows the material composition of drugs and can choose the drug that is suitable for a particular person and will cause the least harm.

It should be noted that commercials often serve to promote drugs on the market that are not highly effective, but for which a lot of material resources have been spent. With this in mind, some expensive drugs may be much less effective than cheaper and less well-known analogues.

There is already a well-known factor that works for advertising – saving time. Men in modern society so used to being busy that they prefer the most quick methods treatment, which also includes self-medication, since it does not require time to go to the clinic or sit in lines waiting for an appointment. It is much easier to deal with not very serious diseases yourself by running to the pharmacy after work and buying everything you need for treatment, according to advertising or the opinion of the pharmacist working at the pharmacy.

Still, you should not blindly trust advertising. You especially need to beware of purchasing medications that have appeared on the market recently, but are too actively advertised. Ineffective products that nevertheless need to be marketed can also be vigorously advertised.

Remedies presented by the press as a sensation or revolution in the field of medicine should not be taken into account at all. All advertised remedies for diseases such as AIDS or cancer, as well as those described as a panacea for all diseases, the elixir of life, giving immortality and eternal youth, do not deserve any trust at all. If such drugs were invented, they would be reported not in advertising, but in more official sources.

If a drug is presented as “superior in characteristics to foreign analogs,” but at the same time its price is significantly lower, then this information about it is false. You should not expect much effect from such a drug.

It is now very fashionable to set up “hotlines” whose operators will tell you about all the benefits of the drug they sell. If at the same time they are not even interested in the diagnosis of the caller, his age, the names of the medications previously taken, but desperately assure that the drug will definitely help, they are most likely trying to force the listener to buy an absolutely useless medicine.

You should also not trust those operators who claim that treatment with the proposed drug does not require consultation with doctors at all.

Very often advertised drugs turn out to be biologically active additives, that is, they are not medicines. An example is Inolta, which is not only expensive, but has such a weak therapeutic effect that it can only manifest itself after several years of regular use of the drug.

Tablets should not be chewed, tablets and capsules should not be broken, crushed or dissolved in water unless specifically instructed to do so. It is preferable to buy medications in the dosage prescribed by your doctor, rather than splitting a higher dose tablet into several doses or taking several lower dose tablets at the same time. If not special instructions, and not the esophagus (problems with the esophagus may occur and the effect of the medicine may be reduced). When prescribing medications, be sure to check with your doctor about the dose, frequency of administration, dependence on food intake, withdrawal conditions (can you stop taking it immediately or should you gradually reduce the dose), possible side effects of the drugs.

If you need to take multiple medications at the same time, list them by hour to avoid confusion.

Discuss with your doctor in advance what to do if you forget to take your medicine on time. You should not take a forgotten dose as a supplement to the next one, as this can lead to an overdose and serious complications.

With age, not only the number of ailments that plague us increases, but also the list of medications that help counteract these ailments.

To ensure that the effect of the medications taken is maximum and that no side effects occur, it is important to follow basic rules for taking medications.

Rule 1. Instructions for medications: must be read!

No matter how long you have taken medication, take 5 minutes to read the instructions again.

You can find a lot of useful information in the instructions for the medicine.

Yes, they are usually not very convenient to read: the font is too small, the line spacing is minimal, the paper quality is poor, and plus a bunch of incomprehensible medical terms. However, this unsightly piece of information contains information that will help you follow all the rules for taking the medicine and achieve a positive effect of treatment in the shortest possible time.

When purchasing a new medicine at the pharmacy, write down on the package:

dosage. In large letters, indicate the time of taking the medication, dosage, and duration of treatment. Thus, all the most necessary information will be right before your eyes, and you will not need to look for it in the instructions every other day;

contraindications. Brief notes on the packaging such as “No more than 2 tablets per day”, “Causes drowsiness”, “Do not take with ...”, again, will greatly facilitate the treatment process. This is especially necessary to do if the medicine was purchased for elderly relatives and you do not have the ability to control its intake.

If you don’t have a good relationship with the manufacturer’s instructions for the medicine, print your own. Just find information about the drug on the manufacturer’s website and print it out in large font. Then, using colored markers, highlight the main data (time of taking the medicine, dosage, contraindications).

Rule 2. Take medications strictly according to the clock

It is advisable to take the medicine at strictly defined hours in order to maintain its concentration at the required level.

Having found on your prescription the entry “take 2 r. per day,” know that by day the doctor did not mean daylight hours, but days. This means that this drug must be taken at intervals of 12 hours. For example, at 10:00 and 22:00, or 8:00 and 20:00, or 9:30 and 21:30 (usually the time of the first dose of the drug does not matter much).

Emergency medications can be taken at any time of the day without following a strict schedule.

What to do if you miss the time to take your medication? If you remember the drug an hour or two after the recommended time, you can safely take the medicine. If more time has passed, simply skip this technique. Never take a double dose to make up for a missed dose.: the consequences of such an experiment can be unpredictable.

Rule 3. No amateur performances, please.

If your doctor has prescribed you to take medications for 3 weeks, take them for 21 days, neither a day less nor a day more.

Of course, sticking to a treatment regimen, especially if it is long-term, is difficult: sometimes you skip a dose in a hurry, or, on the contrary, you forget to take the same drug twice. However, your health and well-being are at stake, so it's worth taking the time to Special attention taking medications.

A convenient pill holder will help you remember to take your medications

There are several ways to keep your medications under control. So, you can buy a pill bottle at the pharmacy, which will be convenient to take with you to work. daily dose tablets. You can mark your calendar or set reminders mobile phone. Choose the method that is most convenient for you.

Rule 4. Observe storage conditions and expiration dates of medications

Poisoning from expired medications is not that uncommon. You should not save on your health, believing that the pills that were purchased and taken off acute attack 3 years ago, they still retained their healing properties. At best, taking them will not bring any effect, at worst, they will harm the body.

Only 20% of patients correctly take medications prescribed by a doctor.

By the way, the choice of storage location for medicines at home must be approached with special care. Drugs must be inaccessible to children and animals. You should not keep the medicine near heat sources (radiator, oven, microwave), or in direct sunlight (window sill). The best place is a first aid kit in a closet in the living room, and not in the bath or on the balcony (under the influence of dampness, the tablets quickly become wet).

If the instructions for the medicine indicate that it should be stored “in a cool, dry place” or “at a temperature not exceeding 5°C”, then the best place storage for it is a refrigerator.

Rule 5. If it says “swallow”, then swallow it

It is not without reason that pharmacists make some medications in the form of tablets, others in capsules, and others in lozenges. And there are also powders, granules, dragees, ointments, suppositories, solutions... The form of release of drugs is determined primarily by their composition and characteristics of behavior when they enter the human body.

All medications must be taken separately. If you need to take several medications, take one of them, wait 30 minutes, take the second, and after another half hour, take the third. Usually 30 minutes is enough for the medicine to completely dissolve in the blood.

In order for the drug to act quickly and effectively, follow the rules for taking it. So, capsules should be swallowed whole, and not broken, and lollipops should be sucked, not swallowed.

Rule 6. Medicines should be taken with water, not just anything.

All medications, with rare exceptions, can only be taken with clean water. And no coffee, tea, juice, milk, and especially alcohol.

So, if you decide to take a pill with a glass of grapefruit juice, you risk increasing the concentration of the drug in the blood by 3 (!) times. Milk, on the contrary, reduces the concentration of drugs when they enter the body; tea does not allow iron-containing drugs to be normally absorbed into the blood, and a mixture of drugs and alcohol is a real poison.

In order for the medicine to bring maximum benefit to your body, do not be too lazy to go to the kitchen for a glass of filtered or boiled water.

Rule 7. Think about what you are eating.

When taking medications, be careful in choosing foods: it is reliably known that some of them can change the effect of medications.

Thus, foods rich in fiber (cereals, bread, oatmeal) slow down the absorption of antidepressants, and those containing a lot of carbohydrates (sweets, pasta) slow down the absorption of some antibiotics. Consuming large amounts of dairy products will counteract the positive effects of medications for the upper respiratory tract. Spicy dishes, marinades, pickles “conflict” with painkillers.

Not all drugs are compatible with herbs. The latter can enhance or neutralize the effect of drugs. Therefore, if you decide to diversify your treatment with traditional medicine, be sure to consult your doctor.

Rule 8. Before, during or after eating - this is important

The effectiveness of the medicine will largely depend on when you take it: before, during or after a meal. A tablet that, according to medical prescriptions, should be taken before meals, but due to forgetfulness or inattention, taken after lunch, will have minimal healing effect. It’s easy to explain: food has a direct impact on the speed at which drugs pass through the digestive tract and enter the bloodstream.

Most medications are taken around meals

If the instructions for your medicine say “take before meals", this means that the drug should be taken on an empty stomach, when there is a minimum amount of gastric juice in it. Even a sip of sweet tea and a single candy can significantly reduce the effectiveness of the mixture you drink. Therefore, before taking such a medicine, it is better to refrain from eating for 2-3 hours and start eating food only 30 minutes (minimum - 15) after taking the drug.

With medication while eating everything is much simpler and clearer. The only thing is, if the time of taking the drug does not coincide with the meal schedule, you should not arrange a second one for the sake of the medication. full lunch or dinner. Just drink a glass of milk, eat a cracker, and then take your pills.

Note! If the instructions do not indicate the time of taking the drug, and the doctor has not indicated it in any way, take the medicine 30 minutes before meals.

For the effect of taking the medicine you need to take after meal, was the maximum, drink it two hours after eating. Immediately after eating, you can take medications that are irritants to the gastric mucosa and have a beneficial effect on the functioning of the digestive tract.

Taking medications correctly is a science. However, if you set a goal, mastering it will not take much effort and time, but the benefits you will bring to your body by following the listed rules will be enormous.

Good health to you!

Antibiotics

Remember! Antibiotics do not affect viruses and are therefore useless in treating diseases caused by viruses (for example, influenza, hepatitis A, B, C, chicken pox, herpes, rubella, measles). Do not forget to read the instructions carefully (please note that when long-term use the antibiotic is used with an antifungal drug, nystatin).

Antibiotics used to prevent and treat inflammatory processes caused by bacterial microflora. The huge variety of antibiotics and the types of their effects on the human body was the reason for the division of antibiotics into groups.

Based on the nature of their effect on bacterial cells, antibiotics are divided into 3 groups:

1. bactericidal antibiotics(bacteria die, but remain physically present in the environment)
2. bacteriostatic antibiotics(bacteria are alive but unable to reproduce)
3. bacteriolytic antibiotics(bacteria die and bacterial cell walls are destroyed)

Based on their chemical structure, antibiotics are divided into the following groups:

1. Beta-lactam antibiotics, which in turn are divided into 2 subgroups:

Penicillins - produced by colonies of the mold Penicillium
- Cephalosporins - have a similar structure to penicillins. Used against penicillin-resistant bacteria.

2. Macrolides(bacteriostatic effect, i.e. the death of microorganisms does not occur, but only the cessation of their growth and reproduction is observed) - antibiotics with a complex cyclic structure.
3. Tetracyclines(bacteriostatic effect) - used to treat respiratory and urinary tract, treatment of severe infections such as anthrax, tularemia, brucellosis.
4. Aminoglycosides(bactericidal effect - characterized by the fact that under the influence of an antibiotic, the death of microorganisms occurs. Achieving a bactericidal effect is especially important when treating weakened patients) - are highly toxic. Used to treat severe infections such as blood poisoning or peritonitis.
5. Levomycetins(bactericidal effect) - use is limited due to the increased risk of serious complications - damage bone marrow, producing blood cells.
6. Glycopeptides- disrupt the synthesis of the bacterial cell wall. They have a bactericidal effect, but are bacteriostatic against enterococci, some streptococci and staphylococci.
7. Lincosamides- have a bacteriostatic effect, which is due to inhibition of protein synthesis by ribosomes. In high concentrations, they can exhibit a bactericidal effect against highly sensitive microorganisms.
8. Antifungal antibiotics(lytic effect - destructive effect on cell membranes) - destroy the membrane of fungal cells and cause their death. Antifungal antibiotics are gradually being replaced by highly effective synthetic antifungal drugs.

Antishock and anti-inflammatory drugs

The most common remedy in this series is analgin, but it should be borne in mind that it has a rather weak and short-lived effect. It is better to use ketonal (ketoprofen), which is comparable in strength to analgin, but is more harmless (one ampoule 1-2 times, maximum 3 times per day).
Ketans (ketorolac) have an even stronger effect; they are administered up to 3 ampoules per day, but not more than 5 days, due to the risk of developing gastrointestinal bleeding.

Local anesthetics

The use of these drugs is the best option for pain relief of serious injuries. Anesthetics such as lidocaine and bupivacaine last the longest (novocaine may not be used, since it is more weak drug by duration of action).

Remember! Some people may be allergic to local anesthetics. If a person was treated by a dentist and no problems arose during treatment, then most likely there should not be an allergy.

If a person has spent quite a long time in the cold, then, as a rule, to warm him up, drugs that stimulate breathing and heart contractions are used - caffeine, cordiamine, sulfocamphocaine and others. However, if possible, it is better to limit their use or even eliminate them, since they cause too much harm to the body.

Ampoule preparations

Used as painkillers in the form of injections for very severe pain, for example, in cases of serious injuries (traumatic brain injuries, severe hip fractures, etc.). The use of tablets in severe situations will be too slow and ineffective, so in these cases intravenous or intramuscular administration of drugs is used.

If you are going on a long hike, then you need to take a sufficient number of disposable syringes (volume 5 ml - for intramuscular injections, volume 2 ml - for subcutaneous injections) and a bottle of ammonia (to give to sniff in case of fainting and loss of consciousness).

To defuse the atmosphere of meticulous selection of medications for a hike, watch a video from a humorous program with the participation of a famous showman.