We live in the age of the prescription. Turn on the television, and you’re likely to see a commercial recommending the latest, greatest pill or injection for everything from psoriasis to bladder spasm. Furthermore, the ads clearly suggest that many of our prescriptions have potential side effects and interactions that are just terrible. Smiling actors and actresses frolic, while the announcer reminds us that the newest drug might cause horrible death or disability. While I don’t think that “direct to consumer” pharmaceutical ads are a good idea, it’s clearly in response to the demand. We like to think that pills solve almost everything.
Sir William Osler, considered the father of modern internal medicine, famously said, “One of the first duties of the physician is to educate the masses not to take medicine.” He would probably view our modern era as a striking failure on that front. On the other hand, we have incredible medicines that he wouldn’t even have imagined, and we survive illnesses and infections that in his era would have involved far more undertakers than medical doctors.
I’m not suggesting that medicines are all bad. But I do think that it’s important for physicians, and patients, to take as few medications as possible. However, since medications aren’t going away and we seem to be taking more of them, it’s important to be very careful about side effects and interactions. A lot of the problems I see as a physician are just as likely to be due to pharmaceutical agents as they are due to the problems the drugs themselves treat.
Medications can cause sedation, kidney problems, upset stomach, dizziness, nausea, lung fibrosis, headaches, and almost any other symptom imaginable. When we combine them, it gets even more complicated. One drug keeps another prescription from working properly, another makes another work more potently. Blood thinners are a good example, as medications may make these important pills work more or less effectively — both of which can be dangerous.
It’s important to periodically go through one’s medication list and discuss it with a physician and a pharmacist. Especially when new symptoms emerge, a look through the prescription list with a trusted professional (other than Dr. Google) can be revealing.