Knowing the difference between side effects and adverse drug reaction

By Dr. Okechukwu Amako, MBBS (Ibadan)
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How many times have you bothered to read the leaflet of any medications you bought over-the-counter or with a doctor's prescription? Or do you always pay attention to the explanation given by the pharmacist on the possible side effects of any drug you buy from him or her. Most of the time, people don't.

This is an unhealthy attitude because being educated about a drug's possible side effects is important in the treatment of the medical condition for which it is being taken, especially if it is a prescription medication.

Moreover, knowing the possible side effects of any medications you're taking will alert you when you begin to experience something that is totally outside the bounds of what is written on the medication's leaflet as the side effects. This totally unusual experience could be what is known as adverse drug reaction. There are differences between a medication's side effects and adverse reactions of that same medication

Side Effects

1. A drug's side effect is a possible impact such a drug may make in the body in addition to its treatment effect. Examples of side effects include vomiting, dizziness, headache, liver and kidney injuries, raising or lowering the blood pressure and so on. The process through which side effects occur is well understood by doctors. In addition, doctors and pharmacists can predict the occurrence of many of these side effects based on the person's age, weight and background disease conditions.

2. Side effects can be harmful or beneficial. A liver or kidney injury resulting from taking a drug is a harmful side effect in every form; for instance, isoniazid, one of the drugs for treating tuberculosis, causes injury to the liver, especially in those with an existing liver problem.

But when a drug's side effect is beneficial it means that side effect can be a form of treatment for another medical condition. For instance, Viagra which is used to treat impotence has lowering of blood pressure as a side effect especially when taken with drugs used in treating heart problems like chest pain. This blood pressure-lowering side effect of Viagra is used to treat a type of hypertension that occurs in the blood vessels taking blood from the heart to the lungs.

3. Side effects of a drug depend on the dose of the medications taken. Hence, overdosing of a drug such as paracetamol can cause liver damage. At the normal dose written on the medication's leaflet or prescribed by the doctor and instructed by the pharmacist, the likelihood of side effects, especially the severe ones, occurring is low.

4. A medication's side effects are more likely to cause further medical problems than death. So, a doctor may advise a person to continue taking a drug, or the doctor can reduce the dosage, despite the side effects he or she is experiencing especially when there are no alternatives for such a drug and the medical condition being treated is a very serious one such as tuberculosis.

Adverse Drug Reaction

Unlike a side effect, an adverse drug reaction is an unexpected, unintended and unpredictable impact of a medication in the body in addition to its treatment effect. It is far less common than a side effect. An example is a life-threatening allergic reaction to drugs such as penicillin which can lead to severe itching and swelling of the whole body and breathing difficulty and finally death if nothing is done.

1. They are not related to the dose of the drug being taken. This means it can occur with a normal, healthy dose of a drug.

2. People are more likely to die from an adverse drug reaction than a drug's side effect because it is unexpected and occurs at the prescribed dosage of the drug most of the time. Therefore, it is usually an emergency condition.

3. The first step in managing an adverse drug reaction is stopping the medications immediately which may not be necessary in the case of a side effect.

Next time, try to pay attention to the information being given to you on a drug's possible side effects by the doctor or pharmacist (and feel free to ask questions) and endeavour to go through a drug's leaflet to know the possible side effects.

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Published Monday, February 27th 2017

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