From the Guidelines
Side effects of medications, particularly those used to treat chronic hepatitis B, can be significant and may include lactic acidosis, nephropathy, osteomalacia, and myopathy, among others. When considering the management of chronic hepatitis B, it is essential to be aware of the potential side effects associated with nucleoside analogs (NAs) therapy, as highlighted in the study by 1. The study notes that NAs are relatively safe drugs, even with long-term use, but can have clinically significant adverse effects.
Some of the common side effects associated with NA therapy include:
- Lactic acidosis
- Nephropathy
- Osteomalacia
- Fanconi syndrome
- Increasing low-density lipoprotein cholesterol
- Carnitine depletion
- Pancreatitis
- Peripheral neuropathy
- Creatinine kinase elevation
- Myopathy
It is crucial to confirm the diagnosis when NA-related adverse effects are suspected, and in cases of serious complications, immediate cessation of the drug or switching to another drug should be considered, as recommended by 1. For instance, switching to entecavir or tenofovir DF may be a reasonable option for patients experiencing myopathy associated with clevudine or telbivudine.
In contrast, the study by 1 discusses the side effects of stimulants and nonstimulants used to treat attention-deficit/hyperactivity disorder (ADHD), which are different from those associated with NA therapy for chronic hepatitis B. However, the key takeaway is that monitoring for potential side effects and adjusting treatment accordingly is essential to minimize harm and optimize patient outcomes, regardless of the medication or condition being treated.
From the FDA Drug Label
NSAIDs can cause serious side effects, including: Increased risk of a heart attack or stroke that can lead to death Increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines: new or worse high blood pressure heart failure liver problems including liver failure kidney problems including kidney failure low red blood cells (anemia) life-threatening skin reactions life-threatening allergic reactions Other side effects of NSAIDs include: stomach pain, constipation, diarrhea, gas, heartburn, nausea, vomiting and dizziness
The possible side effects of ibuprofen include serious effects such as increased risk of heart attack or stroke, bleeding, ulcers, and tears in the esophagus, stomach, and intestines. Other side effects include high blood pressure, heart failure, liver and kidney problems, anemia, life-threatening skin and allergic reactions, as well as common effects like stomach pain, constipation, diarrhea, and dizziness 2.
- Serious side effects may occur without warning symptoms and can be fatal.
- Common side effects can be managed but may require medical attention if severe.
- Patients should be monitored for signs of GI bleeding, liver disease, and renal disease while taking ibuprofen 2.
From the Research
Side Effects of Medication
- The majority of adverse drug reactions are dose-related and occur in patients taking standard doses of medications 3
- Most common adverse drug reactions are linked to pharmacology, and many medicines cause unwanted side effects in addition to their intended action, even when administered at the recommended dose 4
- The higher the number of medicines people take, the higher their risk of adverse drug reactions 4
Minimizing Side Effects
- Tailoring the dose to the patient and using individualized doses can help reduce the incidence of side effects 3
- Understanding the pharmacology of the side effects of medicines can assist in effective prevention of adverse drug reactions 4
- Using nurse-administered 'side-effect' checklists can help identify and address side effects in patients with chronic illness 5
Patient Perception of Side Effects
- Informing patients of some, but not several, side effects may optimize both medication adherence and accuracy of informed consent 6
- Side effects that are perceived as affectively and physically challenging elicit the highest levels of aversiveness in patients 7
- Understanding what side effect characteristics are most aversive may inform interventions to improve medical decisions and facilitate the translation of novel biomedical therapies into clinical practice 7