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What if it's the medication?

When confronted with a health problem, it is always useful to question whether the cause might be drug-related.

A large proportion of the problems encountered in any healthcare practice are associated with adverse drug effects. So it is a good idea to investigate whether certain disorders observed might be drug-related.

Drugs are one of the possible causes to be considered. For example, nausea or vomiting, a rash, drowsiness, a cough, or renal failure can all have diverse causes, and are quite often medication-related. Sometimes there is an indirect link, for example in the case of infections in patients on immunosuppressants.

The purpose of the diagnostic approach is to identify the disorder, list its possible causes and establish the likelihood of it being drug-related, among the other possible causes.

There are several criteria to take into account in determining the link between exposure to a drug and the onset of a disorder. Factors include: any personal characteristics which may make the patient particularly vulnerable to certain adverse effects; whether or not there is a correlation between starting treatment and the development of the disorder; the drug’s known adverse effects and the drug’s pharmacological characteristics.

It is advisable to pay active attention to treatments that patients do not think to mention spontaneously: self-medication, herbal remedies, dietary supplements, etc.

The measures to be taken centre upon rapidly identifying the role of the medication in order to inform the patient, on analysing the consequences of halting the drug treatment or reducing the dose, and on avoiding certain diagnostic explorations or a string of prescriptions which could expose the patient to other adverse effects.

©Prescrire 1 August 2011

"Et si c'était le médicament ?" Rev Prescrire 2011; 31 (334): 586-589.

For more information:

Contents of  the special
issue of La Revue Prescrire
"Affections du quotidien -
Retenir les traitements utiles,
sans ou avec médicaments"