SUMMARY OF ADVERSE REACTIONS TO DRUGS

Modern clinical pharmacology aims to replace empiricism in the use of drugs with therapy based on in-depth understanding of factor(s) that determine an individual’s response to drug treatment. Molecular pharmacology, pharmacokinetics, genetics, clinical trials, and the educated prescriber all contribute to this process. No drug response should ever be termed “idiosyncratic”; all responses have a mechanism whose understanding will help guide further therapy with that drug or successors. This rapidly expanding understanding of variability in drug actions makes the process of prescribing drugs increasingly daunting

for the practitioner. However, fundamental principles should guide this process:

• The benefits of drug therapy, however defined, should always outweigh the risk.

• The smallest dosage necessary to produce the desired effect should be used.

• The number of medications and doses per day should be minimized.

• Although the literature is rapidly expanding, accessing it is becoming easier; tools such as computers and hand-held devices to search databases of literature and unbiased opinion will become increasingly commonplace.

• Genetics play a role in determining variability in drug response and may become a part of clinical practice

• Prescribers should be particularly wary when adding or stopping specific drugs that are especially liable to provoke interactions and adverse reactions.

• Prescribers should use only a limited number of drugs, with which they are thoroughly familiar.

Source: Harrison_s_Principles_of_Internal_Medicine_16th_Edition