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---------------------------------------------------------------------- As many as 1 of 4 patients may have bad reaction to drugs ---------------------------------------------------------------------- (December 10, 1997 00:54 a.m. EST) - Adverse reactions to drugs and biologic agents may affect up to 30 percent of all hospitalized patients, according to a new study published Wednesday. "Few, if any, medications produce beneficial effects alone," said Drs. Richard deShazo and Stephen Kemp of the University of South Alabama, Mobile. Their overview of potential problems, published in The Journal of the American Medical Association, is based on four months of computer-assisted searches of medical literature. "Reports suggest that between 15 and 30 percent of hospitalized patients experience adverse drug reactions, and between 0.2 percent and 29.3 percent of outpatients require hospitalization for adverse drug reactions," the researchers said. "The national reporting system for these events has been in place since the late 1960s, and the estimates of how often they occur has held pretty steady over that time," Kemp said in an interview. The vast majority of the reactions are mild and predictable, however. "Eighty percent of the problems involve the patient getting too large a dose, or suffering an already documented side effect, or an interaction between two or more medications, " Kemp said. Physicians should routinely advise patients about the most common side effects they might experience from a drug they're prescribing, and find out what other drugs the patient may be taking. "This is particularly a problem with over-the-counter drugs and increasingly with herbal therapies, which can have powerful pharmaceutical properties but aren't regulated or approved as drugs,and many physicians don't know what impact many of these self-proscribed drugs might have," said Kemp. Rarer, but often more serious, are allergic reactions and other uncharacteristic responses to drugs. Allergic reactions affect a small number of patients, and occur after an initial exposure to the same or a chemically similar drug. Because the immune system produces antibodies more readily against a substance that recently challenged it, patients are more likely to develop allergic reactions to a drug they've taken frequently than to treatments separated by several years. Doctors can test patients for sensitivity to only a few drugs that frequently produce allergic reactions, so drug allergies usually are not discovered until patients start taking the medication. The researchers said the risk of allergic reaction for most drugs range from 1 percent to 8 percent. If patients feel they're having a reaction every time they take a dose of a medicine, they need to tell their doctor promptly. "Usually, the solution is to switch drugs, but it is possible that a drug is so important to the patient that they need to continue to take it with physicians standing by to take countermeasures," Kemp said. In the most extreme situation, a patient may go into anaphylactic shock, a rapidly developing response that includes redness of the skin, itching, hives, narrowing of airways in the lungs, low blood pressure, abnormal heart rate, swelling of the skin, larynx and other areas. Usually, this life-threatening condition can by countered by the use of epinephrine, or artificial adrenaline. Kemp cautioned, however, that information about side effects and other reactions from drugs usually is based on initial clinical trials that involve only a few hundred patients. "It's really important for patients to tell their doctors if they think they're having a bad reaction," he said, "and imperative that the doctor advise the drug manufacturer and the Food and Drug Administration of the incidents." By LEE BOWMAN, Scripps Howard News Service Copyright 1997 Nando.net Copyright 1997 Scripps Howard <http://www.nando.net/newsroom/ntn/health/121097/health13_21789_noframes.html> ---------------------------------------------------------------------- janet [log in to unmask]