Thursday, February 05, 2009

Side Effects of Drugs?

Saw a patient presented with uncontrolled hypertension. He has been hypertensive for almost a year, but admitted that he's not compliant to medications. He showed me the medications that he's on: Perindopril, Atenolol, Amlodipine and Lovastatin.

Me: "So why are you not taking the medications? Is it that you find them too many and difficult to remember?"

Pt: "Not really...hmm I don't know how to say..."

Me: "It's ok, you can let me know your concern so that I can help, maybe to cut down the number of medications..."

Pt: "Hmm. Ok. Actually it's the side effect of the drugs that made me uncomfortable..."

Me: "Oh I see. What kind of side effect?"

Pt: "I get erectile dysfunction..."

Me: "Oh...you should have told the doc earlier. The particular medication could be discontinued or substituted with another one..."

Pt: "BUT, actually I'm not defaulting all medications. I still do take one..."

Me: "Which is?"

Pt: "Err...I think it's the one called Atenolol..."

Me: "......"

Gosh, out of all his medications, the one he "choose" to take is the one causing erectile dysfunction!

I think this is what will happen if you do not really counsel patient properly before you start them on a new drug - what side effects they might get. And because of his non-compliance, his medications have been added up due to blood pressure seemed not controlled during each clinic visit. So more drugs lead to more side effects and end result: less compliance!

Another example on importance of patient education!;)

6 comments:

peanut said...

at least he did mention it to you.. and got saved. hehe

Joo Joo said...

luckily the patient told the truth, and i sincerely hope dr & pharmacist could work hand in hand in counselling pt..=)

Anonymous said...

Yeah, thankfully the patient was honest. I suppose if the dr hv mentioned to him of the side effect, he will not even start on the medication. It's gonna be a tough job for the dr or pharmacist, don't you reckon?
Dr/Pharmacists "Shld I tell or shld I not? Tell -> They won't take the med, Don't tell -> I'm "harming" the patient
Patients "Shld I eat or shld I not? Eat -> ED, Don't eat -> HBP :S"
LOL

phm said...

not all male patients will get ed isnt it?

there's this interesting study performed where pts on atenolol who knew of the chance of getting ED is more higher. ahahah..there's also issues of compliance and all.. would u take it if u knew it'll cause ed?

what i would do is to inform the pt that if he does experience any side effects, he could come back and probly we'll see if its due to any of his drugs

Darren Lee said...

Honestly, I think a man won't think of taking the medication at all if he's told about the side effect which could be ED. But in fact most of the male patients tolerate the medication quite well, without really complain of any SE. Ya I think the counseling part is a tough job for the docs as well as pharmacists;)

Jazline said...

tat's the importance of a pharmacy.. hehe... doctor and pharmacy should work together in Malaysia!!!

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