MEDICAL

COMPLICATIONS OF
DRUG TAKING
Chapter # 4
INTRODUCTION
 Medical complication is an unfavourable
evolution of a disease, a health condition or
a therapy.

 The disease can become worse in its severity

or show a higher number of signs, symptoms
or new pathological changes, become
widespread throughout the body or affect
other organ systems.
CONT...
 A new disease may also appear as a
complication to a previous existing disease.

 A medical treatment, such as drugs or

surgery may produce adverse effects and
produce new health problems by itself.

 In this case, it is referred as medical

complication of drug taking.
CONT...
 Generally a drug reaction appears when
conc. of a given drug exceeds certain
threshold in the body.

 However drug interactions or idiosyncratic

reactions may turn a normal dose into an
overdose leading to toxicity.
MECHANISMS OF DRUG COMPLICATIONS
 The various means by which a drug may
induce diseases are:

 Overdose
 Drug interactions
 Secondary effects
 Idiosyncrasy
 Hypersensitivity
OVERDOSE
 The term drug overdose describes the
ingestion or application of a drug in
quantities greater than are recommended.

 An overdose may result in a toxic state or

death.

 However, some people may be more

sensitive to certain medications so that the
high end of the therapeutic range of a drug
may be toxic for them.
CONT...
 The word "overdose" implies that there is a
common safe dosage and usage for the drug.

 Therefore the term is commonly only applied

to drugs, not poisons.

 Drug overdoses are sometimes caused

intentionally to commit suicide or as self-
harm, but many drug overdoses are
accidental.
DRUG INTERACTIONS
 A drug interaction is a situation in which a
substance (usually another drug) affects the
activity of a drug when both are
administered together.

 This action can be synergistic or

antagonistic or a new effect can be
produced that neither produces on its own.

 Typically, interactions between drugs come

to mind (drug-drug interaction).
CONT...
 However, interactions may also exist between
drugs and foods (drug-food interactions), as
well as drugs and medicinal plants or herbs
(drug-plant interactions).

 Drug interactions may be the result of various

processes.

 These processes may include alterations in the

pharmacokinetics of the drug, such as
alterations in the absorption, distribution,
metabolism and excretion of a drug.
CONT...
 Alternatively, drug interactions may be the
result of the pharmacodynamic properties of
the drug.

 For example, the co-administration of a

receptor antagonist and an agonist for the
same receptor.
SECONDARY EFFECTS
 In medicine, an adverse effect or secondary
effect is a harmful and undesired effect
resulting from a medication or other
intervention such as surgery.

 Drugs are used for one or more of their

beneficial effects.

 While those undesirable effects that cannot

be avoided are often considered to be side
effects or secondary effects.
IDIOSYNCRASY
 Idiosyncrasy is an abnormal reaction of an
individual to specific foods, drugs, or other
agents.

 Idiosyncratic drug reactions:

1. occur in a small fraction of people exposed to
the drug (usually less than 5%).
2. typically unrelated to the drug’s pharmacologic
effect.
3. demonstrate no obvious relationship to dose or
duration of therapy.
HYPERSENSITIVITY
 Hypersensitivity refers to undesirable
reactions produced by the normal immune
system, including allergies and
autoimmunity.

 These reactions may be damaging,

uncomfortable, or occasionally fatal.

 Hypersensitivity reactions require a pre-

sensitized (immune) state of the host.
EXAMPLES OF COMPLICATIONS
(A) Narcotic analgesics cause significant
respiratory depression in patients even at
low doses.

 This is due to decrease responsiveness of

brain stem to increase in CO2 conc.

 They also cause nausea and vomiting due to

direct stimulation of chemoreceptor trigger
zone.
CONT...
(B) There are enormous medical complications
associated with cocaine use.
 Some of the most frequent complications are:
 cardiovascular effects, including disturbances in
heart rhythm and heart attacks;
 respiratory effects, including chest pain and
respiratory failure;
 neurological effects, including strokes, seizure,
and headaches;
 gastrointestinal complications, including
abdominal pain and nausea.
CONT...
(C) The therapeutic doses of salicylates can
reduce blood glucose level in both diabetics
and non-diabetics.

 It is due to increased utilization of glucose by

peripheral tissues and a decrease in
carbohydrate synthesis.
CONT...
(D) Another example of drug induced medical
complication is diphenyl hydramin induced
folic acid deficiency leading to metabolic
anaemia.

(E) Due to the penicillin hypersensitivity,

anaphylactic shock occur.

(F) Similarly penicillin antibiotics may also

cause diarrhoea due to wash out of normal
flora.
CONT...
(G) An example of idiosyncratic reaction is
induction of haemolytic anaemia by drug like
chloroquine in patients having a deficiency of
glucose-6-phosphate dehydrogenase (G-6-
PD).

(H) High-dose aspirin has the potential of a

life-threatening side effect of severe
gastrointestinal bleeding, as well as other
side effects.
CONT...
(I) Medical complications of chronic heroin
abuse include:

 collapsed veins
 bacterial infections of the blood vessels and
heart valves
 soft-tissue infections
 liver or kidney disease
 lung complications (pneumonia and TB)
SOCIOECONOMIC ASPECTS OF MEDICAL
COMPLICATIONS OF DRUG TAKING

 As far as socioeconomic aspects are

concerned, it is clear that if the drug cause
any complication then the patient may lack
motivation.

 This will not only require extra money to

treat the condition, thus becoming burden
on the economy of family but also face
problems for adjustment in the society.
CONT...
 The people of our country are very poor and
even some fail to pay high consultation fee of
the physician.

 Such people are thus reluctant to visit the

physician due to poor economic background
and so start their treatment by uneven
prescription which give them nothing but
waste of money.

 So money is spent but patient is getting worse.

CONT...
 Such patients are then subjected to social
isolation because their friends and relatives
possess no time for them.

 As a result the patient may develop mental

problems.

 Such patients are then considered misfit for

the society.
CONT...
 On the other hand many alcoholics create
problems in the form of road accidents.

 The establishment of various rehabilitation

centres for addicted patients require
greater proportion of investment.

 Thus it is also a burden on government

assets.
CONT...
 If the country is free from addicted persons
then the money which is spent for the
construction of rehabilitation centres can be
utilized for various welfare programs.
CONCLUSION
 At the end it is concluded that the drug must
be used according to the recommended
schedule for specific duration of time.

 In this way one can protect himself/herself

from various hazards and life may become
quite easy.