Polypharmacy is the simultaneous administration of a considerable number of procedures or drugs to the same person. Most often, this phenomenon is experienced by pregnant women, people with disabilities or the elderly. Basically, doctors recommend patients several drugs that they are required to take.
Definition
The well-known fact that the pharmaceutical business is considered one of the most profitable. Now virtually every corner of the pharmacy, often even around the clock. It should be noted that any medicine can be purchased without problems, but their prices increase by 20–25% annually, but this does not scare modern people, since the advertisement is structured in such a way that everyone can establish a diagnosis and prescribe treatment.
As a result, after a visit to a doctor prescribing therapy, a patient often prescribes a considerable amount of additional drugs for himself, and the use of oral hormonal contraceptives is also added there. The collection of so many drugs is polypharmacy in pharmacology.
Why not mix?
Many people believe that various drugs of natural origin can significantly improve the treatment process. Therefore, so often people begin to self-medicate, acquiring natural preparations. But this is not worth doing. You need to know that even plant extracts are included with other components. As a result, a combination of improperly selected drugs is sometimes similar to an unsuccessful chemical experience and can cause an “explosion” in the body. For example, if a patient takes Paracetamol and together with him decided to drink another plant extract of ginkgo biloba, then such medicinal polypharmacy will perfectly thin the blood and, naturally, will interfere with its coagulability. This can cause a serious problem in case of injury, all this will lead to serious bleeding.
The same applies to biological additives. At first glance, it will not cause anything dangerous to take several capsules that do not contain anything chemical, but when exposed to the components of the drug, they can enter into the wrong reaction.
Causes
1. Lack of knowledge and skills, uncertainty of diagnosis, lack of information on the optimal approach with an appropriate diagnosis for the person prescribing the medicine — all this ultimately leads to polypharmacy in medicine.
2. Unaesthetic and inappropriate promotion of drugs. Most prescribers receive information most often from pharmaceutical companies, rather than from independent sources. This often leads to overuse of components.
3. Profit from the sale. In many countries, retailers distribute them over-the-counter, as their income is directly related to the number of sales. It also leads to overuse by their population.
4. Unlimited quantity - in many countries, prescription drugs are dispensed without the required document, this applies primarily to antibiotics. In the future, all this leads to their excessive use and non-compliance with the dosages.
5. A large load on health workers. Many people who prescribe medication have very little time for a quality examination, which leads to an incorrect diagnosis.
6. Fairly expensive drugs. In the case when a person does not have enough funds for the prescribed medication, alternative ones, including of non-guaranteed quality, are acquired instead.
Types of Drug Interactions
Polypharmacy is the mixing of drugs, which can be both useful and not:
1. Medicines complement each other's actions.
2. Effects multiply (potentiation). For example, we can offer a combination of Warfarin and Aspirin, which can cause active bleeding.
3. Efficiency decreases or is reduced to zero after administration of the second drug (inhibition / antagonism). Some anti-heartburn medications (antacids) actively reduce the intake of antibiotics in the blood, as well as drugs that thin the blood, thereby reducing their effectiveness.
Self-medication
The main problem of state clinics is the presence of certain difficulties for getting to doctors. There are many reasons for this, but as a result, the patient does not want to wait and is self-medicating. Most often, consumers get information from the Internet, as a result of their ignorance, they themselves cause polypharmacy drugs.
The most popular medical sites become during an exacerbation of colds. Most often advised to take:
- immunomodulators;
- antiviral agents;
- antihistamines;
- preparations for the restoration of intestinal microflora.
Although basically the patient does not need any of the medicines. As a result, with a common cold, a person takes from 5 drugs or higher. This is polypharmacy, which is caused by self-medication, it can be quite problematic and carry many negative results.
disadvantages
- The risk of unwanted effects is increased by 6 times. If the patient takes more than 3 components at a time, then the likelihood of adverse reactions increases by 10 times.
- When 2 medicines are used, drug interaction is provoked in 6% of cases. If 5 drugs are taken together, this parameter reaches 50%, in the case of 10 - 100%.
- Side effects increase mortality in the elderly (over 80 years old).
Polypharmacy in the elderly
Very often, this situation is forced when such patients have several diseases. In this case, the doctor tries to cure all illnesses at the same time and prevent possible complications. But they rarely take into account the decrease in the therapeutic result against the background of a change in the metabolism of drugs due to age-related changes in the body.
Most drugs are obtained by synthetic conversion from various chemical components. However, with improper use of drugs, unexpected drug interactions are provoked. As a result, chemical reactions occur not only between the starting drugs, but also their active metabolites. Due to this, the formation of highly allergenic complexes is caused, which can provoke severe bullous generalized dermatitis and epidermal necrolysis, especially in old age.
Combination therapy and polypharmacy in this case is one and the same and arises due to the wrong choice of medicinal components when optional and unidirectional medications are prescribed to the patient. And also among senior citizens of society there is such a problem as pharmacomania. This condition is a habit of using certain medications, even if they are not currently needed or simply ineffective.
Risk category, pregnant women and children
Prescribing a considerable amount of drugs to older people is easy to explain. Usually, those who have reached a respectable age have several chronic diseases at once, each of which requires therapy. But how to explain polypharmacy in pharmacology, which affects pregnant women and children? After contacting the children's clinic with ARVI, parents receive a list of five or even more drugs on hand. Antipyretic, antiviral, interferons, expectorants, local anesthetics, vitamins, and there is no limit to the end of the list.
The situation in obstetrics is not much better. Despite the fact that the influence of most drugs at the time of pregnancy is not well understood, medications are prescribed without stint. Over the past 30 years, the number of pregnant women who take more than four drugs at a time has increased by more than 30%. Already in the first trimester, most women with a normal pregnancy use multivitamins, progesterone, calcium preparations, antispasmodics and sedatives. On more serious terms, the absorption of tablets only increases. It should be noted that leading experts recommend folic acid only, the remaining components are taken only according to indications.
Rules for taking drugs
Polypharmacy and combination therapy in pharmacology are two similar concepts, between which it is sometimes very difficult to trace the line. Such conditions do not always have a positive effect on human health, so proper medication is very important for patients:
- It is necessary to strictly follow the doctor’s recommendations and the instructions for the drug.
- Do not self-medicate, health articles or TV ads are no reason to prescribe treatment yourself. Consultation with a doctor is required.
- The effect of the drug will only be when it is taken at the same time, in which case the concentration of the components will be uniform throughout the day.
- It is necessary to pay attention to what time it is required to take the drug, since different drugs do not have a pronounced therapeutic effect at any time of the day or night. Pain medications are recommended for use at night, as pain usually increases at this time, and vasodilators in the morning. Antihistamines are used in the evening, since at night less hormone is formed that inhibits allergic reactions.
- Initiated treatment must always be completed, even if the symptoms of the disease are no longer present and the health condition has improved.
- When several medications are prescribed, you need to take them separately, with a short time interval.
- Chewed tablets are recommended to be chewed, since their action will begin already in the oral cavity.
- Polypharmacy of diseases of the gastrointestinal tract is very common, therefore, in the treatment of such ailments, it is necessary to consult a doctor.
- All medicines must be washed down.
- It is strictly forbidden to use products that have expired. An ineffective treatment will be a harmless result, and the worst thing is irreparable harm to health.
WHO activities
Polypharmacy is a serious problem at the moment. Therefore, to improve the use of drugs, WHO (World Health Organization ) carries out the following activities:
- monitors the global use of drug components;
- provides and supports countries in the field of control over the use of medicines, as well as new developments in the proper use of medicines;
- distributes and develops training programs for national healthcare professionals in improving and monitoring tablet use at all levels.
Conclusion
Today, the problem of polypharmacy is very acute. You need to know that treatment will be successful only if you use as few drugs as possible and strictly as directed by your doctor. Studies have shown that elderly people who have pronounced manifestations of ailments, with the abolition of all drugs there is a significant improvement.
No wonder WHO supports a healthy lifestyle and physical activity. It is noted that athletes and people who monitor their physical health consume much less drugs, and the older they get, the more their number decreases.