Monday, March 19, 2007

Drug Safety

A man wakes up in the middle of the night with diarrhea, gropes around and takes what he thinks are anti-diarrheal tablets. Next thing you know, he is trying to kill his wife.

Over in Cavite province, men have started making decoctions out of a popular ornamental called coral plant, supposedly to enhance their virility. Yet, as early as 1921, Leon Maria Guerrero, an authority on Philippine medicinal plants, already wrote about the plant being a dangerous cathartic, meaning it causes severe diarrhea. In another botany book, "Burkill's Dictionary of Economic Products of the Malay Peninsula," I found out that the plant was used for "criminal poisoning" in Latin America.

The US Food and Drug Administration (FDA) estimates that there are some 2 million serious adverse drug reactions (ADRs) each year in the United States, leading to about 100,000 fatalities and making ADRs the fourth leading cause of death in the country.

We don't have estimates on such cases and fatalities in the Philippines, but I am certain they are quite high. There are probably cases where people die of the medicines they were taking, without the family ever realizing it. Many medicinal plants, for example, have low levels of the dangerous substances, but these can accumulate; so even the persons taking the decoctions may not know they are being slowly poisoned.

The causes of ADRs in the country include carelessness among health professionals, a lack of health literacy among Filipinos, inadequate instructions on drug products, and unclear advice from health providers. I'd say, even the barrage of drug advertising, by proclaiming particular medicines as safe­when in fact, no drug, not even your "ordinary" pain-killers, not even your medicinal plants, is truly safe­contributes to ADRs.

By Michael L. Tan, Pinoy Kasi colum in the Philippine Daily Inquirer, March 16, 2007

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