WHILE there is always a shortage of medicines, including the life-saving ones, there is another related dilemma which hardly gets noticed despite being life-threatening. The ill-advised tendency towards self-medication receives little attention in society even though it has serious health risks. The use of medicines without proper understanding or super-vision can quietly disturb the heart’s rhythm and, in rare cases, trigger sudden cardiac events.
Many would be surprised to know that several widely used drugs have the potential to prolong the heart’s QT interval, which represents the part of the heartbeat’s electrical cycle that must reset properly for the heart to function normally. When this interval becomes excessively long, the heart can slip into dangerous arrhythmias.
In Pakistan, some of the most frequently used medicines have the potential to cause such harm. Antibiotics commonly used for sore throat, chest infections, fever and suspected typhoid can affect the heart, especially in older adults, dehydrated patients, or those already taking other contra-indicated medicines.
Similarly, antibiotics often used for urinary tract infections and abdominal discomfort can increase cardiac risk when combined with certain other drugs. Unfortunately, these antibiotics are often taken without prescription, dose guidance, or awareness of drug interactions.
Psychiatric medicines present another concern. This is a serious concern because some of these medicines are frequently used in Pakistan incorrectly as sleep aids for the elderly. When taken without medical supervision, these medicines can disturb the heart’s rhythm, or cause sudden drop in blood pressure, putting vulnerable individuals at risk. Even common painkillers, which every household relies upon, deserve caution. Regular high-dose use of such drugs for joint pain or backache can raise blood pressure, strain the kidneys, and indirectly burden the heart, particularly among individuals with diabetes or hypertension. Many patients who arrive in emergency rooms with heart failure have a history of prolonged painkiller use without medical monitoring.
Over-the-counter (OTC) cold and flu medicines pose yet another hidden risk. Preparations marketed for blocked nose or quick relief can sharply increase heart rate and blood pressure. A person with undiagnosed hypertension, dehydration, or an underlying heart condition may experience palpitations, chest pain or even collapse after taking these seemingly harmless remedies. Electrolyte-disturbing medicines also require attention. Diuretics, commonly taken without prescription for swelling or ‘water reduction’, can dangerously lower potassium and magnesium levels. These minerals are vital for the heart’s electrical stability. Many sudden collapses in older patients, especially during hot weather, are linked to preventable electrolyte disturbances caused by unmonitored use of diuretics.
While patients and their caregivers can protect themselves by being a little more prudent in this regard, healthcare professionals have a major role to play. Doctors can reduce the risk by spreading awareness among their patients regarding drug interactions, and, more critically, by avoiding writing unnecessary prescriptions themselves. Medicines are life-saving tools when used wisely, but when taken carelessly without due guidance, even common drugs can become silent threats, slowly pushing one towards a grave health crisis. Awareness, careful prescribing, and responsible use of medications can protect countless lives.
ROOHI BANO OBAID
KARACHI
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