Topic Resources
Adverse drug reactions (adverse effects) are any unwanted effects of a drug.
In the early 1900s, German scientist Paul Ehrlich described an
ideal drug as a "magic bullet." Such a drug would be aimed precisely at a
disease site and would not harm healthy tissues. Although many new
drugs are aimed more accurately than their predecessors, none of them,
as of yet, hit the target exclusively.
Most drugs produce several effects, but usually only one
effect—the therapeutic effect—is wanted for the treatment of a disorder.
The other effects may be regarded as unwanted, whether they are
intrinsically harmful or not. For example, certain antihistamines cause
drowsiness as well as control the symptoms of allergies. When an
over-the-counter sleep aid containing an antihistamine is taken,
drowsiness is considered a therapeutic effect. But when an antihistamine
is taken to control allergy symptoms during the daytime, drowsiness is
considered an annoying, unwanted effect.
Most people, including health care practitioners, refer to
unwanted effects as side effects; another term used is adverse drug
effect. However, the term adverse drug reaction is technically more appropriate for drug effects that are unwanted, unpleasant, noxious, or potentially harmful.
Prevalence of adverse drug reactions
Not surprisingly, adverse drug reactions are common. Most adverse
drug reactions are relatively mild, and many disappear when the drug is
stopped or the dose is changed. Some gradually subside as the body
adjusts to the drug. Other adverse drug reactions are more serious and
last longer. About 3 to 7% of all hospital admissions in the United
States are for treatment of adverse drug reactions. Adverse drug
reactions occur during 10 to 20% of hospital admissions, and about 10 to
20% of these reactions are severe. These statistics do not include the
number of adverse drug reactions that occur in people who live in
nursing homes and other care facilities.
Although the exact number of adverse drug reactions is not
certain, they clearly represent a significant public health problem that
is often preventable.
Common adverse drug reactions
Digestive disturbances—loss of appetite, nausea, a bloating
sensation, constipation, and diarrhea—are particularly common adverse
drug reactions, because most drugs are taken by mouth and pass through
the digestive tract. However, almost any organ system can be affected.
In older people (see Aging and Drugs), the brain is commonly affected, often resulting in drowsiness and confusion.
Identification and reporting of adverse drug reactions
Many adverse drug reactions are identified when a drug is being
tested before it is submitted to the Food and Drug Administration (FDA)
for approval. Other adverse drug reactions, typically those that are
uncommon, are not detected until the drug has been on the market long
enough to be used by a large number of people. Thus, doctors are
required to report suspected adverse drug reactions to the FDA.
More Information
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American Association of Poison Control Centers: Emergency. Information. Prevention. 1-800-222-1222
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