Drugs are chemicals or substances used with the intention of providing relief or cure in any health problem. Different drugs act by different mechanisms in the body to provide respite. But along with the desired effect they also produce some harmful effects in the body, known as adverse effects. 

Many people tend to take medicines directly from the pharmacy, even when they have a small problem like a mild headache or running nose.  People do not realise that although they get relief in their ailment, they are exposed to risk of potential adverse effect.

Some of the harmful effects of drugs are expectable. Like anybody using pain killer tablets can get burning pain in the stomach or middle of the chest.  But, some are unpredictable. For example, Penicillin injection is known to cause life threatening allergic reaction. But who will get it, is difficult to predict. 

Therefore it is ideally given initially in a very small amount as test dose, before actual full dose is given. Pain killer medicines commonly cause inflammation and even ulcers of the gastrointestinal tract, which manifests as burning pain in abdomen or chest. Drugs used for gastritis when taken for a long time suppress the production of gastric acid, which forms a protective layer over the inner lining of stomach. 

 Over time, this makes the stomach prone to infection and gastric cancer. Corticosteroids reduce the immunity of the body, soften the bones and cause retention of fluid. Even vitamin supplements are known to produce allergies and toxicity. 

Antibiotics are known to deplete the helpful bacteria which are normally present in the intestines and protect the inner layer. This can result in diarrhea and ulcers within the oral cavity. They can also cause secondary localized fungal infections. Many anti-infective drugs like sulphur drugs, can cause anemia. 

Antiviral drugs are known to cause abnormal sensations in the hands and feet. 

 Anti-hypertensive drugs can cause low blood pressure, dry cough, swelling over feet, among many other adverse effects. Similarly drugs used for diabetes, also have undesirable side effects in body-like low blood glucose levels and loss of appetite. 

It is not only the drugs used in modern system of medicine causing harmful effects, but also those used in traditional medicine. Occasionally, a patient presents anemia, kidney and or liver toxicity occurring after taking traditional medicine.  Apart from these, there are many herbal/ indigenous treatments taken globally.   Those chronic problems tend to use these medicines in the hope of getting cured. But instead they may end up having multiple toxicities. Each and every drug after entering the body can produce some adverse effect along with main pharmacological action. 

 Prevention lies in, avoiding taking medicines unnecessarily. Every healthy person can tolerate mild pain, nausea, among other problems. Here, it is better to find the cause and treat it instead of taking medicines. Simple measures like hot saline gargles or steam inhalation can help in mild cough and cold and one can avoid medicines unless problem is severe. 

Non pharmacological measures like exercise, nebulisation, hot compression, can be used more for chronic problems. Medicines should be used only when absolutely needed. One has to be aware about the medicine he/ she takes and the likely side effects.  

Previously known side effects with a drug   or drug allergy should be reported to the doctor.  In case of any side effects developing, the treating doctor should be informed so that the medicine can be changed or dose reduced. 

Steps taken by Ministry of health Rwanda, regarding adverse effects of drugs are commendable. All the guidelines issued by Ministry, for treating HIV/AIDS or T.B  Malaria, diseases have information about possible drug allergies and harmful effects.  The alternate treatment options are also mentioned.  This ensures that patients are benefitted, while keeping harmful effects minimal.

Prudence lies in taking   medicines for improvement of health but not to suffer from side effects. 

Dr Rachna Pande is a specialist in internal medicine 

E-mail rachna212002@yahoo.co.uk