Medicine: Drug Dangers

Throughout history, patients have been made sick, and some have been killed, by the medicines they took. But these were incidental or (as doctors call them) “side” effects. Relatively uncommon, such cases had to be weighed against the usefulness of the drug for the majority. Now, with chemical laboratories brewing up ever more potent drugs, more and more diseases are directly caused by drugs. Unlike most old-fashioned side effects, they do not necessarily disappear obligingly when medication is stopped. In Postgraduate Medicine, the University of Kansas’ Dr. Jesse D. Rising lists an alarming catalogue:

¶ As many as 10% of patients with high blood pressure, after intensive treatment for several months with hydralazine (trade name: Apresoline), develop symptoms resembling those of rheumatoid arthritis or disseminated lupus erythematosus; stubborn cases may need treatment with ACTH or cortisone-type hormones—which can also be dangerous (see below).

¶ Other victims of high blood pressure, under treatment with hexamethonium, may have “a dramatic type of respiratory disturbance,” with breathing difficulties, fever, cough and chest pain, and turn blue. This, though rare, can be fatal within a month.

¶ A third drug for dropping the blood pressure, mecamylamine (trade name: Inversine), sometimes causes severe anxiety or depression and is suspected of having triggered disabling mental illnesses. Other patients have developed chorea (muscular twitching), with tremor, slurred speech, and difficulty in controlling the joints; in some cases the symptoms have resembled multiple sclerosis; in others there have been severe epileptoid seizures.

¶ A fourth hypotensive, reserpine, may speed the appearance of peptic ulcers or worsen those already developed. It also commonly causes depression, often severe, and sometimes marked by delusions of persecution and suicidal impulses. And reserpine can hasten the death of patients with damaged hearts.

¶ The ataraxics (tranquilizers) built around the phenothiazine molecule (trade names: Thorazine, Compazine, Sparine, Pacatal) are so potent “that it is surprising they do not cause more undesired side effects.” One of the commonest is Parkinsonism, with rigidity, tremor, pill-rolling motion of the hands, disturbances of all movements, and drooling. Symptoms may persist two or three months after medication is stopped. Thorazine can also cause severe liver damage—sometimes fatal.

¶ Cortisone-type hormones stimulate peptic ulcers—despite combinations with antacids—sometimes to the point of perforation. Some patients experience extreme mood changes like the manic and depressive phases of manic-depressive psychosis. Especially in children, the hormones can touch off grand mal epilepsy; in oldsters, they may weaken the bones to the point of spontaneous fracture.

¶ The diuretic acetazolamide (trade name: Diamox), often given to heart patients to help flush the brine out of their systems, can so upset a congested liver as to cause hepatic coma—especially when it is given in combination with ammonium chloride.

¶ Antibiotics, especially the “broad-spectrum” family (best-known trade names: Achromycin, Aureomycin, Terramycin) kill so many of the harmless bacteria normally found in the digestive tract that they let the more harmful bacteria run riot. A resulting inflammation of the intestines, which may be “a deadly disease”—is usually the doctor’s fault.

¶ Cycloserine, an antibiotic used against tuberculosis, has such a narrow safety margin that a slight overdose can cause grand mal seizures. It is also blamed for severe emotional reactions and is dangerous for patients with kidney damage.

¶ Isoniazid, wonder drug of 1952 against TB, may set off inflammation of the peripheral nerves, causing phantom sensations, numbness, burning pain and weakness. Unless caught early and treated with vitamin B6, this neuritis becomes permanent.

¶ Worst of all, Dr. Rising warns, a doctor treating a woman during pregnancy with anesthetics, X rays, ACTH or cortisone-type hormones, may subject the fetus to oxygen shortage or some other threat. The result: “Physicians now face the horrible possibility that they, in addition to certain ‘acts of God,’ are responsible for many developmental defects.” He lists babies born with one eye, abnormal hearts, cleft palate or mongolism, and Siamese twins.

“The thoughtful physician,” Dr. Rising concludes, will not think of abandoning these useful (and often lifesaving) drugs, but he “will not lightly prescribe [them, and] will exert every effort to understand . . .the harmful effects that may result from their use.”