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Jack Sisson's Life Ethics Blog

We must find new ways through many ethical issues, especially regarding bioethics, medical ethics, and criminal justice. Jack Sisson's 'Life Ethics' blog focuses on numerous areas of concern, including the philosophical and ethical dilemmas surrounding stem-cell research, abortion, medical research, and health care.

 

From Florida Today:

Mixing household cleaners can be deadly — ammonia and bleach together generate potentially lethal gas. Mixing medications can be equally dangerous, yet physicians still prescribe combinations such as Viagra and nitrate heart medicines. Such mismatches can prove fatal.

In one case, a man who had received a heart transplant was taking drugs to prevent rejection of his new organ. They included azathioprine, cyclosporine and prednisone. His primary-care physician detected high uric-acid levels and prescribed allopurinol. This landed the 52-year-old in the hospital with a life-threatening blood disorder (Pharmacy Times online, July 1, 2006).

This potentially deadly combination should never have happened. The danger of this interaction has been known for more than 40 years. But doctors don’t always recognize which drugs should never be used together. When prescribers were tested about their knowledge of drug interactions, they performed miserably (Drug Safety, June 2008). They were given 14 drug pairs to classify as forbidden, risky or not a problem. They got the right answer on fewer than half the pairs.

Any high-school student who scored below 50 percent on a test would fail. It isn’t hard to understand why doctors can’t remember dangerous drug interactions. With thousands of medicines available, the number of bad combinations could reach into the hundreds of thousands. This is beyond the capability of human memory.

That’s why there are computers and smartphones. Many physicians and all pharmacists now rely on electronic databases for writing and filling prescriptions. These tools provide warnings about drug incompatibility. But a recent study found that even when physicians had access to a wireless handheld device with interaction information, they were just as likely to prescribe a bad combination (Journal of Managed Care Pharmacy, January-February 2012).

Don’t assume the prescriber is aware of all the drugs a patient is taking or the hazards of mixing medicines. Our book “Top Screwups Doctors Make and How to Avoid Them” (online at www. peoplespharmacy.com) has tips for preventing deadly interactions. Anyone who takes more than one pill at a time should always trust, but verify.

Joe Graedon is a pharmacologist. Teresa Graedon holds a doctorate in medical anthropology and is a nutrition expert. Their syndicated radio show can be heard on public radio. In their column, Joe and Teresa Graedon answer letters from readers. Write to them via their website:www.PeoplesPharmacy.com.

Link to Florida Today.

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