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The word iatrogenic mean adverse effects caused by the actions of medical (including prescription drugs) and surgical procedures.

Nobody really knows how many people suffer adverse reactions from prescription drugs. In an article published in the medical journal JAMA, says that in the U.S. occur each year 2,000,000 of adverse drug reactions, killing more than 180,000 people. This makes them the fourth leading cause of death in the U.S., after heart disease, cancer and stroke (JAMA 1998, 279:1200-1205).

In Great Britain, assuming that 10% of adverse drug reactions are recognized and reported, the number of serious drug reactions should be about 47.000 per year. The incidence of serious drug reactions prescription drugs has been estimated as 180,000 cases per year (Medavar C: Power and Dependence: Social Audit on the Safety of Medicine. Social Audit Ltd. London, UK, 1992).

Some estimate that 2 out of 5 people receiving drugs experience side effects that are in many cases, more serious than the disease they are trying (and MacEoin Thompson C: The Health Crisis. The Natural Medicines Society, UK, 1988).
Moreover, the number of hospitalizations in Britain due to collateral effects of the drugs is estimated at about 240,000 cases each year.

After the tragedy of the thalidomide disaster, when thousands of women gave birth to babies with congenital malformations were asked pharmaceutical companies to provide safety standards becoming more stringent.

Many believe the reason of these reactions is due to the initial test methods, which are carried out on animals. Animal metabolism can not be compared with human metabolism. Not only are there large differences in the overall structure, but also between the composition and size of body organs.

Do not forget that the basic biochemistry, including enzyme activity, may differ greatly between animal species and human. This is also a reason why the animals hardly ever respond to toxic substances in the same way humans do and vice versa (Coleman V: Betrayal of Trust, European Medical Journal, Devon, UK, 1994).

We can see some examples, morphine silk humans but stimulates cats, penicillin acts as an antibiotic for humans, but which is poisonous to hamsters and, insulin causes deformities in laboratory animals but not people , arsenic kills humans but not whose, chickens and monkeys, the digital blood pressure rises in dogs but low in humans The Pharmaceutical Drug Racket: Campaign Against Fraudulent Medical Research, Australia).

There are several reasons why the testing of drugs in animals can not just transpose to humans and considered valid immediately.

Conventional drugs are usually tested first to see its toxicity in animals well fed and healthy, while in real life, the same drug is consumed by humans who are already sick and weak (Tuula E Tuormaa, Int Jour of Alter and Complem Medi , March 1998, pp 26-28).

However, these laboratory animals are given a single drug, but again, in real life, most human patients do not take a single drug but a combination. This will surely change the pharmacological effect.

Returning to the impressive gathering of the 100,000 annual deaths due to drug reactions, the figures could be worse if you include administrative errors and overdoses (WYDDY, July 1998, p. 9).

According to Dr. Bruce Pomeranz, Head of the University of Toronto, the figures are much higher than expected.

About 76% of adverse drug reactions are caused by highly toxic drugs, while others may be caused by inadequate monitoring and therapy doses.

Canadian researchers of this study believe that these numbers are similar in any other developed country.

To avoid the possible adverse reaction to medication, one should a) take the least possible prescription drugs at the same time, b) stop taking the medication as soon as possible, according to doctor's instructions and c) ask your doctor about possible adverse reactions that could cause the medication prescribed for him.

In France, conducted a study which asked a group of doctors to report all reactions to drugs to investigators and then compared with the actual number of reports received by the official agencies of surveillance. The incredible truth, only one of every 24,000 adverse reactions reported by health care is the appropriate monitoring agency. Physicians in this study reported an average of 2 per day adverse reactions. A very strange drug use is the marketed as an antihistamine diphenhydramine. This medicine causes drowsiness so many people no longer in use. However, companies are very clever and is now used as an aid for insomnia (Second Review, December 1998, pp 2-3).

On May 4, 1998, the medical journal called Modern Healthcare, Volume 28, Number 18 published an editorial titled "Hospitals need a definitive plan to reduce adverse drug reactions." In this editorial suggests a series of measures. This demonstrates the importance and impact of adverse drug reactions.

Several studies have shown that 20% to 36% of patients admitted to a university hospital suffered an iatrogenic and 20% to 25% of these injuries were serious or fatal. An analysis of cardiac arrests in a teaching hospital revealed that 64% of them were preventable (LeapPad LL et al. Error in Medicine, JAMA 1994, 272:1851-1857). It can be argued that some patients who suffered iatrogenic injury, were already seriously ill and that the treatment and risky procedures were the only opportunity they had to recover. However, the heroic treatments need not be automatically dangerous. Perhaps the best example is the intravenous nutritional therapy. There are case reports of patients with acute asthma attacks that were recovered with IV injections of magnesium. Another example is that of patients with pneumonia who did not respond to conventional antibiotic treatment and cure was achieved with a nutritional therapy based on an infusion of megadoses of vitamin C.

By Dr. Hector E. Solorzano del Rio.

CUCS Professor of Pharmacology at the University of Guadalajara and President of the Medical Society of Enzyme Research, AC

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