clock menu more-arrow no yes

Filed under:

WARNINGS ON PRESCRIPTIONS CAN CAUSE CASE OF THE JITTERS

The scariest thing about whatever illness that happens to be going around these days isn't the illness - it's the computer-generated warning note with your little bottle of expensive pills.

For many years the big drug companies have printed limited information in very fine print on over-the-counter medicine boxes or tightly folded mini-brochures most of us discarded in our rush for relief.Then came the occasional colored stickers on the prescription bottles, advising us: Do Not Operate Machinery; or, May Cause Drowsiness; or, Take With Food.

But now we get a copyrighted Patient Information Leaflet, with enough admonition to scare a cow into clabber. Halfway down the barely legible page is the standard, boiler-plate advisory:

"BEFORE YOU BEGIN TAKING ANY NEW MEDICINE, either prescription or over-the-counter, check with your doctor or pharmacist."

The doctor's the one who wrote the prescription in the first place, right? He's got my whole medical history in that file, and he already should have advised me about this stuff.

But doctors and pharmacists have neither the time nor inclination to recite this 37-flavors list of medicinal prescription and proscription. Hence, the computer-generated sheet now stuffed in with the pills or capsules.

We, the patients, in order to form a more perfect union . . . must take an active (I think the au courant word is "pro-active") role in our medical treatment, we are advised. Which, of course, means to pay up front and take responsibility for reading the fine print that comes with the prescription.

You stuff it all in your pocket, dash next door to the supermarket for bread, orange juice ("Drink several additional glasses of water or juice daily, unless otherwise directed by your doctor.") and whatever, and then drive home before reading the little note cautioning you not to drive or operate heavy machinery while taking this medication.

Which is mild compared with the other stuff under the general heading: "CAUTIONS: DO NOT TAKE THIS MEDICINE IF YOU HAVE HAD A SEVERE ALLERGIC REACTION to this medicine or another fluoroquinolone antibiotic . . . "

Stacked above and below that are admonitions such as, "IF YOU MISS A DOSE OF THIS MEDICINE, take it as soon as possible . . . " and "AVOID LARGE AMOUNTS OF caffeine-containing foods and beverages such as coffee, tea, cocoa, cola drinks and chocolate."

Way down on the bottom is the most intriguing: "POSSIBLE SIDE EFFECTS . . . include nausea, vomiting, loss of appetite, dizziness, headache, nervousness or trouble sleeping."

It also advises you to "CHECK WITH YOUR DOCTOR AS SOON AS POSSIBLE if you experience tendon pain, joint pain or swelling, rash, swelling of throat or tongue, difficulty breathing, itching, hives or vaginal irritation or discharge."

With the interesting conclusion: "If you notice other effects not listed above, contact your doctor, nurse or pharmacist." This is no doubt a solicitation of help in making that list of side effects even longer, and scarier.

For a truly scary trip, you can look up your medication in a definitive resource such as the Physicians' Desk Reference, or PDR. It's updated annually to keep up with newly marketed drugs, as well as longer lists of possible side effects.

In the 1994 PDR, one of our family's more recent prescription drugs is described as a "synthetic, broad-spectrum antimicrobial." It also explains that youngsters shouldn't take it because tests show "erosions of cartilage of weight-bearing joints in immature animals."

At my age, all my weight-bearing joints are probably eroding, and I don't need something to push that along.

Other so-called "contraindications" of the drug, according to the PDR, include convulsions, confusion, hallucinations and moderate-to-severe phototoxicity (exag-gerated sunburn).

Sunburn in Seattle shouldn't be much of a problem. And I am already experiencing hallucinations about management instituting an attractive early buyout retirement program. But I am confused about when.

According to the PDR, more than 7 percent of almost 3,000 patients tested with the drug experienced "adverse reactions," in-cluding nausea, diarrhea, vomiting, abdominal pain, headache and restlessness.

A smaller percentage - about 1 percent - experienced angina, myo-cardial infarction, cardiopulmonary arrest and cerebral thrombosis. For those of you at the Look, See Spot Run stage of your medical education, that's heavier than exaggerated sunburn.

And you don't want to know about the "possible hyposens-itivity" i.e., fatal reactions, including cardiac arrest and respiratory failure.

People with serious, even incurable, illnesses will almost always hear a well-meant, keep-your-chin-up advisory, followed inevitably by: "Medical science is coming up with new cures every day."

Looks to me like medical science needs a cure for these scary prescription postscripts.