Abstract

PIP: The term ''iatrogenic disease'' means disease caused by therapy prescribed by doctors. Most such diseases are drug induced. Adverse effects of drugs have been more common in seriously ill patients who have received many drugs. Drug interaction has often been the cause. Most have been dose-related from cumulative pharmacologic effects. Reported data have been incomplete. Individual variability due to a genetic basis has been a factor. Environmental influences, such as smoking, atmospheric pollution, and hardness of the water supply may be involved. Sometimes the patient's metabolism has been impaired by concomitant liver or kidney malfunction. In such cases the drug, or its metabolites, may build up to a toxic level. A lowered threshold to the normal action of a drug is frequent among the very old and the very young. Geriatric patients have a considerable reduction in the reserve capacity of many organs. Hypersensitivity to a drug may be present. Skin rashes and eruptions are most common in this type of allergic reaction although jaundice and hemolytic anemia have followed. Polypharmacy increases the risk. Some patients make errors in taking prescribed drugs. Also, additional self-medication is common. Drug-food interactions may occur. Needed vitamins may be absorbed and eliminated by the use of liquid paraffin as a laxative. Intestinal flora-destroying antibiotics permit other organisms to grow. Alcohol is an additional hazard. Oral contraceptive use may be followed by anemia, and may react with other drugs. A list of such known reactions is given. Delayed iatrogenic neoplasia is being considered. Effects on the progeny have been shown with several drugs. Forewarning creates awareness and caution.