Beware of taking too many drugs

Chemotherapy and cancer drugs

Now falling ill can be a drug side-effect.

Taking a cocktail of prescription drugs has been much in the news in 2009 and 2010 as several stars of Holywood and music succumbed to a cocktail of drug side-effects.

But it is not just a famous people phenomenon. Taking a cocktail of prescription drugs is now the number 1 cause of death in Florida. Illnesses and deaths from such cocktails have increased seven fold in the last 5 years in the USA.

Unfortunately the reasons are all too simple. But first let us tell the story we printed in icon magazine:

A 78-year old New York lady was found unconscious on the floor of her apartment by a neighbour. She had blacked out and fallen and Doctors were a little puzzled as to why. Until they looked at her medical history.

Our lady had had a number of heart ailments in the past, but recently had been suffering from a cold and cough. Doctors found that she was currently taking:-


  •  Lopressor to control high blood pressure

  •  Digitalis to help heart rhythm

  •  Coumadin to prevent strokes from blood clots

  •  Furosemide to lower blood pressure

  •  Lipitor to lower serum cholesterol

  •  Baby aspirin to reduce cardiac risk from blood clots

  •  Celebrex  - for arthritis pain

  •  Paxil for depression

  •  Vallium to help her sleep

  •  Levofloxacin antibiotic for her cough

  •  Ibuprofen for the cold

  •  Cough medicine

This lady is not alone in New York the average ’older adult’ takes 4.5 prescription drugs and 2.1 over-the-counter items at any one time. Indeed being poisoned by your cocktail of drugs is so common that Doctors even have a name for it: Polypharmacy. 

The new illness drug cocktails

Dr Michael Stern, writing in the June 2007 issue of Emergency Medicine says that Polypharmacy is now responsible for 28 per cent of all hospital admissions, and if it were classified as an official disease it would be the fifth leading cause of death in America.

As it is Prescription drug related death has increased by 68 per cent in the last 5 years and is the second largest cause of avoidable death in America.

Stern as a specialist in Geriatric Emergency Medicine in the New York Presbyterian Hospital knows the problem only too well. Stern points to the fact that many of these drugs can use the same biochemical pathways, causing system overload..

Older people just don’t handle the drugs as well as younger adults do

But that’s not the real problem. One major factor is that the elderly take about 40 per cent of all the prescribed drugs; almost twice the volume the young take. Yet all too often the clinical trials used young healthy adults for their research. Age related changes in physiology as people age can significantly alter the way the body handles these drugs, even if just two or three drugs are taken. Just as a child is not the same as a small adult , neither is an old age pensioner an older, young healthy adult. It is quite clear that major organs, hormone systems and the circulation system function less well. Drugs are less easily absorbed through the gut, the liver detoxes the body less well, the kidneys excrete less well too. Senior citizens have less lean body mass, and more fat and fat is an excellent solvent and will ’hold’ the drugs longer. All in all, the elderly just find it harder to deal with drugs, than those healthy young guinea pigs in the tests.

Of course it all may be different when taking cancer drugs with 80 or more per cent of cancers developing in the over 65 generation you would expect the clinical trials to be 80 per cent or more biased towards this group of people.

But as the Hospitals in New York report Polypharmacy is a serious and deadly problem.

Maybe Doctors in the UK should be paying closer attention to drug interactions that haven’t been tested in clinical trials. To date we only seem to hear their incessant worries about supplements or herbs and how they might interact with the cancer drugs. Certainly it is not unusual for a cancer patient to be taking seven or eight drugs simultaneously by the time the steroids, pain-killers and antibiotics are added into the total. If they have other ailments it can be more. Certainly in the 100 or more Personal Prescriptions I’ve seen this year half the people have at least one other illness and are taking two or three drugs for that with the cancer drugs on top..

Our lady on the floor? The drug cocktail gave her a stomach ulcer  - she passed out because of the bleeding (she remembers having a stomach ache). She needed a blood transfusion and was told to stop taking the Celebrex, Ibuprofen and aspirin!

Comment

Various experts will of course tell you that all cancer drugs have been through extensive clinical trials and thus imply that they are therefore trusted and safe.

This is simply not true. For example:

1 All drugs have side effects.

2 Many drugs have had less than 30 people involved in the clinical trial, had the trial cut short because of euphoria over the results and/or are not even the drug that was put into the trial, but a cheaper generic copy.

15 per cent of all US drugs are branded and 85 are generic copies. According to the head of the Generic Drug Association on Bloomberg, the former small group take 80 per cent of the US Healthcare budget, so the push to switch earlier and earlier from branded drugs that have been through full clinical trials to cheaper alternatives, is increasing. 

3 Whilst individual drugs are put through clinical trials and sometimes two at the same time (maybe), never are six or seven. Yet, whilst prescribing another drug, the same experts will happily tell you to avoid taking vitamin pills and so on because they are contra-indicated.

4 Most drugs are trialled on younger, fitter (even healthy) humans. (The exception being cancer drugs.) Unfortunately most drugs are taken by older people whose circulation, heart, liver and other bodily systems just are not as strong.

It has gotten out of hand. The patients suffer, the Pharma companies make more profit. And the issue - until Stern gave it a name - is just swept under the carpet.

Chemotherapy and cancer drugs
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