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Medications: The Good, The Bad, and The Ugly

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Posted on May 2nd, 2016 by Teri Dreher, under Prescription Drugs, Tips & Resources

Very few will argue that medications have the potential to prevent, modify, and cure disease and improve the length and qualify of life.  But are there down sides to these medications?  To quote an old Western movie title, we need to consider the good, the bad, and the ugly when contemplating whether to take a medication.

Let’s examine some recent news reports regarding a very commonly used class of heartburn/gastroesophageal reflux disease (GERD) medications that physicians refer to as proton pump inhibitors (PPI’s).  We mere mortals know these meds by common brand names such as Nexium, Prilosec, and Prevacid, or generics such as omeprazole or esomeprazole (there are many more as well).   Here’s the good:  PPI’s are extremely effective for heartburn/acid reflux and have improved the quality of life and prevented and cured serious gastrointestinal health problems for many, many people.  Over the years, they have also been thought of as safe, so they are widely used.  Their effectiveness and popularity are demonstrated by the many different PPI’s available, both by prescription and over the counter.

Now here’s the bad part:  A recent medical study published in JAMA found an association between the use of PPI’s and chronic kidney disease.  (Gulp.)  Another recent study, published in the medical journal JAMA Neurology, reports a statistical association between the use of PPI medications with a 1.4 fold increased risk for the development of dementia.   (Yikes!)  We do need to make one thing clear here, and that is that an “association” does not prove that proton pump inhibitors cause dementia or chronic kidney disease, only that there is a statistical association between their use and an increased risk for the development of these diseases.  The reason for these associations is not understood, and to study cause-and-effect, randomized clinical trials will need to be performed.  So while it’s best to pay attention to news reports regarding medications, you need to keep in mind the potential problems and limitations of  medical research and keep an open dialogue going with your physician regarding your medications.

Here’s the really ugly part:  untreated medical conditions can lead to other, more serious health problems, disability and early death, things perhaps much worse than the possible negative effects of a medication.  So, not treating conditions is most often not a good option.  Even heartburn or GERD can have some very serious complications,  and there is no disputing that PPI’s have improved qualify of life, saved lives, and prevented and treated some serious health problems for many people.  While there are alternative treatments available for GERD, they may not be right for your particular circumstances, and you should not abruptly stop you’re your PPI (or any other prescribed medication, for that matter) without first consulting your physician.

When your doctor recommends a medication, here are some questions to ask:

  1. What is the reason you are recommending this medication?
  2. What are the side effects?  (Side effects are bothersome things that may occur with a medication.  Usually not life-threatening, but annoying.  Think of drowsiness with Benadryl, or diarrhea with antibiotics.)
  3. Are there any dangers to taking this medication?  (Physicians refer to these dangers as adverse effects.)
  4. Will this medication interact with of my other medications? (Interactions can be potentially very dangerous!)
  5. Are there alternatives to taking this particular medication?
  6. What could happen if I don’t treat this condition with medication?
  7. What can I do to help myself?  Could a change in my lifestyle or habits avoid the use of this med, or allow me to possibly discontinue this medication down the road?

When you go to your physician for your annual physical or medication renewal, it’s wise to ask:

  1. Do I still need this medication?
  2. Have there been any reports I need to know about regarding the safety or effectiveness of this medication?
  3. Are there any lifestyle modifications I can make to reduce or eliminate my reliance on this medication?

 

With over 36 years of clinical experience in Critical Care nursing, home based health care and expertise as a cardiovascular nurse clinician, Teri is well acquainted with the complexities of the modern healthcare system. She has served as a nursing leader, mentor, educator, and consistent patient advocate throughout her career in some of the best hospitals across the country. Her passion to keep the patient at the center of the model of nursing care led her to incorporate NShore Patient Advocates, LLC in 2011, serving clients throughout the northern suburbs of Chicago.

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