Clipping Board » Drug Poisoning ─ It is necessary to be aware of the toxic side effects before taking medication.
【2006/07/06 United Daily News】
【Shen Yanling, Xu Shijie / Pharmacists at National Taiwan University Hospital Yunlin Branch】
The World Cup is in full swing, and the most thrilling moments are the life-or-death penalty kicks and PK shootouts.
In the muscle cells of the human body, if exercise is too intense or if certain lipid-lowering drugs are taken, rhabdomyolysis, muscle disorders, and muscle cell atrophy and necrosis may occur. This releases a large amount of creatine phosphokinase, leading to symptoms such as muscle pain and weakness. In severe cases, it can cause kidney failure or even death.
Recently, a student was punished with 152 squat jumps and developed rhabdomyolysis, requiring hospitalization for over half a month. Fortunately, the student recovered. During the 921 earthquake, some victims were trapped under collapsed buildings and ultimately died from rhabdomyolysis complicated by acute kidney failure. Additionally, high-voltage electric shocks, systemic convulsions, and certain diseases are non-drug causes of rhabdomyolysis.
**Two Types of Lipid-Lowering Drugs to Use with Caution**
The drugs most likely to cause rhabdomyolysis are mainly two types of lipid-lowering medications. Lipid-lowering drugs come in many categories, with the most commonly used being Statins (HMG-CoA reductase inhibitors) and Fibrates (fibric acid derivatives).
The common side effects of these two types of drugs include abnormal liver function and muscle pain. Therefore, they are generally not recommended for combined use to avoid increasing the risk of side effects. Patients with poor liver or kidney function should also use them with caution.
The U.S. National Cholesterol Education Program (NCEP) states that for high-risk patients, the LDL (low-density lipoprotein, commonly known as "bad cholesterol") should ideally be less than 100 mg/dl (100 milligrams per deciliter). LDL is also a current indicator for predicting coronary artery disease.
**Combination Therapy Requires Long-Term Monitoring**
In recent years, to achieve better treatment outcomes, for patients with higher risk factors or those with elevated triglycerides (≥130 mg/dl) or low HDL (high-density lipoprotein, commonly known as "good cholesterol"), combination therapy with nicotinic acid or fibrates and statins is recommended.
The NCEP suggests that for such high-risk patients, the LDL treatment target should be further reduced to 70 mg/dl.
Risk factors include smoking, a family history of premature atherosclerotic disease, elevated triglycerides (≥200 mg/dl), LDL ≥160 mg/dl, and HDL <40 mg/dl. Patients with two or more of these risk factors are considered high-risk.
If a physician determines that combination therapy with statins and fibrates is necessary, long-term monitoring for adverse reactions is required to ensure effective treatment. The primary goal of combination therapy is to maximize efficacy while minimizing the risk of side effects.
**Always Clarify Medication Information**
If a patient is prescribed such combination therapy by the same physician, it is easier to manage. However, many people in Taiwan have the habit of visiting different hospitals and departments, which may lead to receiving similar or different types of lipid-lowering drugs (statins and fibrates) from different sources. This increases the risk of cross-prescription and the likelihood of side effects.
Additionally, the more medications a patient takes, the higher the chance of drug interactions.The prescriptions or medication bags that the public receive mostly display the brand names of the drugs, so it may be unclear which category your medication belongs to. Therefore, patients or caregivers should proactively inform the doctor or pharmacist about all the medications being taken, to ensure that the doctor and pharmacist have a clear understanding of the patient's medication situation.
Currently, all medical institutions provide pharmaceutical services for medication consultation. The public should make good use of this channel for complex medication regimens (including those across different specialties and medical institutions) to ensure medication safety.
The relationship between drug therapy and side effects is like two opposing teams. After a doctor prescribes medication, the patient must follow the doctor's instructions to take the medication on time and in the correct dosage, maintain good lifestyle habits, and supplement with appropriate clinical symptoms and test monitoring, in order to successfully score a goal and achieve the treatment objectives.
Drugs Vs. Side Effects: A Life-and-Death Battle
【Shen Yanling, Xu Shijie / Pharmacists at National Taiwan University Hospital Yunlin Branch】
The World Cup is in full swing, and the most thrilling moments are the life-or-death penalty kicks and PK shootouts.
In the muscle cells of the human body, if exercise is too intense or if certain lipid-lowering drugs are taken, rhabdomyolysis, muscle disorders, and muscle cell atrophy and necrosis may occur. This releases a large amount of creatine phosphokinase, leading to symptoms such as muscle pain and weakness. In severe cases, it can cause kidney failure or even death.
Recently, a student was punished with 152 squat jumps and developed rhabdomyolysis, requiring hospitalization for over half a month. Fortunately, the student recovered. During the 921 earthquake, some victims were trapped under collapsed buildings and ultimately died from rhabdomyolysis complicated by acute kidney failure. Additionally, high-voltage electric shocks, systemic convulsions, and certain diseases are non-drug causes of rhabdomyolysis.
**Two Types of Lipid-Lowering Drugs to Use with Caution**
The drugs most likely to cause rhabdomyolysis are mainly two types of lipid-lowering medications. Lipid-lowering drugs come in many categories, with the most commonly used being Statins (HMG-CoA reductase inhibitors) and Fibrates (fibric acid derivatives).
The common side effects of these two types of drugs include abnormal liver function and muscle pain. Therefore, they are generally not recommended for combined use to avoid increasing the risk of side effects. Patients with poor liver or kidney function should also use them with caution.
The U.S. National Cholesterol Education Program (NCEP) states that for high-risk patients, the LDL (low-density lipoprotein, commonly known as "bad cholesterol") should ideally be less than 100 mg/dl (100 milligrams per deciliter). LDL is also a current indicator for predicting coronary artery disease.
**Combination Therapy Requires Long-Term Monitoring**
In recent years, to achieve better treatment outcomes, for patients with higher risk factors or those with elevated triglycerides (≥130 mg/dl) or low HDL (high-density lipoprotein, commonly known as "good cholesterol"), combination therapy with nicotinic acid or fibrates and statins is recommended.
The NCEP suggests that for such high-risk patients, the LDL treatment target should be further reduced to 70 mg/dl.
Risk factors include smoking, a family history of premature atherosclerotic disease, elevated triglycerides (≥200 mg/dl), LDL ≥160 mg/dl, and HDL <40 mg/dl. Patients with two or more of these risk factors are considered high-risk.
If a physician determines that combination therapy with statins and fibrates is necessary, long-term monitoring for adverse reactions is required to ensure effective treatment. The primary goal of combination therapy is to maximize efficacy while minimizing the risk of side effects.
**Always Clarify Medication Information**
If a patient is prescribed such combination therapy by the same physician, it is easier to manage. However, many people in Taiwan have the habit of visiting different hospitals and departments, which may lead to receiving similar or different types of lipid-lowering drugs (statins and fibrates) from different sources. This increases the risk of cross-prescription and the likelihood of side effects.
Additionally, the more medications a patient takes, the higher the chance of drug interactions.The prescriptions or medication bags that the public receive mostly display the brand names of the drugs, so it may be unclear which category your medication belongs to. Therefore, patients or caregivers should proactively inform the doctor or pharmacist about all the medications being taken, to ensure that the doctor and pharmacist have a clear understanding of the patient's medication situation.
Currently, all medical institutions provide pharmaceutical services for medication consultation. The public should make good use of this channel for complex medication regimens (including those across different specialties and medical institutions) to ensure medication safety.
The relationship between drug therapy and side effects is like two opposing teams. After a doctor prescribes medication, the patient must follow the doctor's instructions to take the medication on time and in the correct dosage, maintain good lifestyle habits, and supplement with appropriate clinical symptoms and test monitoring, in order to successfully score a goal and achieve the treatment objectives.