Drug Side Effects Explained

From the homely aspirin to the most sophisticated prescription medicine on the market, all drugs come with side effects. Many are minor, some are just an inconvenience, a few are serious, and some are just plain strange.

Perhaps the most common set of side effects for drugs that work inside your body involves the gastrointestinal system. Nearly any drug can cause nausea or an upset stomach , though it may only happen to a handful of people. For drugs used on the outside, skin irritation is a common complaint.

To find more about a drug's side effects, look on the label of over-the-counter (OTC) products or on package inserts or printed materials that you get with prescription drugs. Because the inserts often include a long list of possibilities, you may want to also talk to your pharmacist or doctor about what to expect and watch out for.

Types of Side Effects

An allergic reaction could happen with any drug. That can range from itching and rash all the way to a life-threatening anaphylactic reaction.

Some drugs can’t help but trigger side effects because of their chemical structure. The common allergy drug diphenhydramine (also known by the brand name Benadryl ) is one. Though it eases allergy symptoms , it also blocks the chemical acetylcholine, and that leads to drowsiness and a host of other side effects, including dry mouth .

Some drugs have barely noticeable side effects at the right dose. Typically, warfarin (Coumadin, Jantoven ), used to prevent blood clots, usually works well and isn't bothersome, but serious internal bleeding can happen in the wrong situation.

Side effects may show up only when a drug is mixed with certain other things. This might be called a drug interaction. For example, drinking alcohol while you're taking narcotic painkillers can cause an accidental overdose. This has led to many deaths. Another example is grapefruit juice, which can affect the blood levels of several drugs, including some blood pressure and cholesterol medicines.

The FDA's Role

Before a drug can come on the market, the FDA must approve it. The New Drug Applications (NDAs) submitted by pharmaceutical companies have, first and foremost, evidence that the drug has the effect it’s supposed to have and is safe. This proof comes from testing the drug, first in animals and then in humans. Once the basic questions of safety and efficacy are settled, the FDA will approve the drug if it deems that its benefits outweigh its risks.

Still, sometimes testing doesn't reveal everything about a drug’s side effects, and they don't show up until after the medication enters the marketplace and more people start using it. That’s where MedWatch comes in. The FDA’s post-marketing surveillance program seeks voluntary input, mainly from healthcare professionals, on unwanted effects they see in ''the real world.'' Sometimes these reports are numerous or serious enough for the FDA to take regulatory action, such as adding warnings to a drug’s label.

This happened with the psoriasis drug Raptiva. The FDA required that the drug carry the agency's strongest warning, known as a black box warning, after it received reports of brain infections and meningitis in patients taking the drug. The drug was later taken off the market.

The FDA also wants input from consumers when it comes to side effects. All prescription drugs , and many OTC products, must be labeled with a toll-free number the agency has for letting it know about side effects with drugs, called "adverse events." You can report possible new but severe side effects through MedWatch at 1-800-FDA-1088 or through the FDA website.

Sometimes, the post-marketing information coming in to the FDA is so disturbing that a drug is discontinued. Baycol, which lowers cholesterol, was strongly linked to a breakdown of muscle tissue that could be deadly. The drug was approved in 1997, and the manufacturer stopped selling it 4 years later. The anti-inflammatory drug Duract spent just 1 year on the market. It was approved only as a short-term use product, and the FDA found serious liver problems when people took the drug for longer than recommended.

Drug companies are also required to report adverse events to the FDA. Failure to do so can lead to prosecution. In 1985, employees of two drug companies were fined or sentenced to community service for not reporting adverse events involving the blood pressure drug Selacryn and arthritis drug Oraflex. Both products were pulled from the market.

Surprising Results

Not every side effect is a bad one. Some are downright welcome.

Take finasteride . Introduced in 1992 to treat noncancerous enlargement of the prostate gland , it was found to regrow hair . Now it's marketed for that purpose under the name Propecia. Today, millions of men use a low dose of finasteride to treat male pattern baldness . Similarly, minoxidil was originally marketed as a pill for high blood pressure and found to grow hair by people who used it. Today, as a lotion or foam, it's a popular OTC remedy for baldness.

What are 5 common side effects of medications?

Common minor side effects of prescription drugs:

• Diarrhea.
• Dizziness.
• Drowsiness.
• Fatigue.
• Heart issues (palpitations, irregular heartbeats)
• Hives.
• Nausea and vomiting.
• Rash.

How do you recognize adverse effects of medication? What are the signs and symptoms of an adverse drug reaction?

• Mild symptoms include red, itchy, flaky, or swollen skin. ...
• Severe symptoms include skin that blisters or peels, vision problems, and severe swelling or itching. ...
• Anaphylaxis symptoms include throat tightness, trouble breathing, tingling, dizziness, and wheezing.

Adverse Drug Reaction

What is an adverse drug reaction?

An adverse drug reaction is a harmful reaction to a medicine given at the correct dose. The reaction can start soon after you take the medicine, or up to 2 weeks after you stop. An adverse drug reaction can cause serious conditions such toxic epidermal necrolysis (TEN) and anaphylaxis. TEN can cause severe skin damage. Anaphylaxis is a sudden, life-threatening reaction that needs immediate treatment. Ask your healthcare provider for more information on TEN, anaphylaxis, and other serious reactions.

Adverse Drug Reaction

Medically reviewed by Drugs.com. Last updated on Jun 6, 2023.

What is an adverse drug reaction?

An adverse drug reaction is a harmful reaction to a medicine given at the correct dose. The reaction can start soon after you take the medicine, or up to 2 weeks after you stop. An adverse drug reaction can cause serious conditions such toxic epidermal necrolysis (TEN) and anaphylaxis. TEN can cause severe skin damage. Anaphylaxis is a sudden, life-threatening reaction that needs immediate treatment. Ask your healthcare provider for more information on TEN, anaphylaxis, and other serious reactions.

What are the signs and symptoms of an adverse drug reaction?

• Mild symptoms include red, itchy, flaky, or swollen skin. You may have a flat, red area on your skin that is covered with small bumps. You may also have hives.
• Severe symptoms include skin that blisters or peels, vision problems, and severe swelling or itching. Severe reactions include conditions such as toxic epidermal necrolysis (TEN). Ask your healthcare provider for more information on TEN and other serious conditions.
• Anaphylaxis symptoms include throat tightness, trouble breathing, tingling, dizziness, and wheezing. Anaphylaxis is a sudden, life-threatening reaction that needs immediate treatment. Anaphylaxis may occur if you exercise after exposure to another trigger, such as after you take an antibiotic.

How is an adverse drug reaction diagnosed?

Your healthcare provider will ask about your medical history and allergies. You may need additional testing if you developed anaphylaxis after you were exposed to a trigger and then exercised. This is called exercise-induced anaphylaxis. Medicines can be a trigger. You may also need any of the following:

• A patch test means a small amount of the drug is put on your skin. The area is covered with a patch that stays on for 2 days. Then your healthcare provider will check your skin for a reaction.
• A skin prick test means a small drop of the drug is put on your forearm and your skin is pricked with a needle. Your healthcare provider will watch for a reaction.
• An intradermal test means a small amount of liquid containing the drug is put under the surface of your skin. Your healthcare provider will watch for a reaction.
• A drug provocation test is also known as a challenge test. Your healthcare provider gives you increasing doses of the drug and watches for a reaction.

How is an adverse drug reaction treated?

• Antihistamines decrease mild symptoms such as itching or a rash.
• Epinephrine is medicine used to treat severe allergic reactions such as anaphylaxis.
• Steroids reduce inflammation.
• Desensitization may be done after you have a reaction, if you need to be treated with the drug again. Your healthcare provider will give you small doses of the drug over a few hours. The provider will treat any allergic reaction that you have. The dose is increased a little at a time until the full dose is reached and the drug stops causing an allergic reaction.

What steps do I need to take for signs or symptoms of anaphylaxis?

• Immediately give 1 shot of epinephrine only into the outer thigh muscle.
• Leave the shot in place as directed. Your healthcare provider may recommend you leave it in place for up to 10 seconds before you remove it. This helps make sure all of the epinephrine is delivered.
• Call 911 and go to the emergency department, even if the shot improved symptoms. Do not drive yourself. Bring the used epinephrine shot with you.

What safety precautions do I need to take if I am at risk for anaphylaxis?

• Keep 2 shots of epinephrine with you at all times. You may need a second shot, because epinephrine only works for about 20 minutes and symptoms may return. Your healthcare provider can show you and family members how to give the shot. Check the expiration date every month and replace it before it expires.
• Create an action plan. Your healthcare provider can help you create a written plan that explains the allergy and an emergency plan to treat a reaction. The plan explains when to give a second epinephrine shot if symptoms return or do not improve after the first. Give copies of the action plan and emergency instructions to family members, work and school staff, and daycare providers. Show them how to give a shot of epinephrine.
• Be careful when you exercise. If you have had exercise-induced anaphylaxis, do not exercise right after you eat. Stop exercising right away if you start to develop any signs or symptoms of anaphylaxis. You may first feel tired, warm, or have itchy skin. Hives, swelling, and severe breathing problems may develop if you continue to exercise.
• Carry medical alert identification. Wear medical alert jewelry or carry a card that explains the medication allergy. Healthcare providers need to know that they should not give you this medicine. Ask your healthcare provider where to get these items.
• Read medicine labels before you use any medicine. Do not take anything that contains the medicine you are allergic to. This includes topical medicines that you put on your skin. Ask a pharmacist if you are not sure.
• Tell all healthcare providers about your allergy. Always tell your healthcare providers the names of medicines that you are allergic to and the symptoms of your allergic reactions.
• Ask if you need to avoid other medicines. You may be allergic to other medicines if you had an adverse reaction. Make sure you know the names of other medicines that you should not take.

Call 911 for signs or symptoms of Anaphylaxis,

such as trouble breathing, swelling in your mouth or throat, or wheezing. You may also have itching, a rash, hives, or feel like you are going to faint.

When should I seek immediate care?

• You have a rash with itchy, swollen, red spots.
• You have blisters, or your skin is peeling.
• You have trouble swallowing or your voice sounds hoarse.
• You have a fast or pounding heartbeat.
• Your skin or the whites of your eyes turn yellow.

When should I contact my healthcare provider?

• You think you are having an allergic reaction. Contact your healthcare provider before you take another dose of the drug.
• You have a rash.
• You have a fever.
• You have a sore throat or swollen glands. You will feel hard lumps when you touch your throat if your glands are swollen.
• Your skin itches and becomes red when you are in sunlight.
• You have questions or concerns about your condition, allergy, or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© Copyright Merative 2023 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

Learn more about Adverse Drug Reaction

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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

adverse effects. If you have questions about the substances you are taking, check with your doctor, nurse, or pharmacist.

Unexpected Side Effects Of An Epidural

An epidural is a type of pain management that, although it is most typically used for the control of childbirth pains, has also been used to assist in the management of chronic pain and to offer pain relief during certain surgical operations (via Cleveland Clinic). The epidural space, which is the fluid that surrounds the spinal cord, is the area that will be treated during this treatment. When an anesthetic is administered into the epidural area, it numbs the nerves, preventing the transmission of pain signals.

According to the Birth Injury Help Center, giving birth is one of the most difficult experiences a person can go through. Consequently, epidurals are utilized in more than 71 percent of births throughout the United States to control labor pain.

One of the benefits of having an epidural is that it numbs just the lower half of the body, which allows the birthing parent to maintain consciousness and awareness during the labor and delivery process.

Additionally, it is beneficial in the event of a crisis. Because the lower body has already been anesthetized, if the labor takes an unexpected turn and the doctor has to perform a C-section as soon as possible, he or she will be able to do so instantly.

Epidural Side Effects Are Rare

Due to the drug, some more typical adverse reactions to epidurals include feeling sick, throwing up, and having itchy skin. This information comes from Healthline. Those who have an epidural during childbirth are more likely to develop a fever than those who do not receive one; those who do not receive an epidural are only seven percent likely to develop a temperature during labor and delivery.

In addition, a study conducted in 2006 by the Institute for Quality and Efficiency in Healthcare revealed that one-fourth of individuals who were given epidurals had a dip in their blood pressure. Still, it was not to a worrisome degree.

According to the American Society of Anesthesiologists , in more extreme circumstances, the membrane surrounding the spinal cord might mistakenly be perforated during the treatment, resulting in a severe headache. This is one of the risks associated with spinal procedures.

In certain instances, when oral pain medication is insufficient, your doctor may recommend a blood patch operation, in which the patient’s blood is injected into the region to cover the hole produced by the puncture. This procedure is often called a “blood plug” (via Jefferson Radiology).

Talk To Your Doctor About Potential Side Effects

Occasionally, an epidural may lead to some extremely significant consequences, but they are quite uncommon (via Cleveland Clinic). One of these consequences is an injury to the nerve root or spinal cord, both of which may lead to troubles with the nervous system.

According to the National Health Service, this nerve injury may lead the patient to lose sensation or even the ability to move their lower body; however, it’s more normal for the damage to be restricted to numbness in a small region and to cure up within a few months at most. If you are still feeling numb after your epidural is meant to have worn off, you need to let your anesthesiologist know about it.

According to the Cleveland Clinic, there have also been cases of nerve damage that does not heal or, even more gravely, paralysis due to an epidural. This is a very significant side effect.

If, on the other hand, you are apprehensive about receiving an epidural, whether during childbirth or for another operation, you must take the time to chat with your doctor about your worries and figure out what would make you feel the most at ease.

Coping With Common Multiple Myeloma Side Effects

If you or a loved one is living with multiple myeloma, common side effects and symptoms include bone pain, weakness, fatigue, weight loss, and even kidney ...

Although it’s considered a rare cancer, African-Americans are twice as likely to be diagnosed with multiple myeloma. Multiple myeloma is a cancer which forms as the result of an overgrowth of malignant plasma cells in the bone marrow.

While no one knows for sure what causes multiple myeloma, you’re more likely to get it if:

• You are older than 65
• You are African-American
• You have a family member with it

If you or a loved one is living with multiple myeloma, common side effects and symptoms include bone pain, weakness, fatigue, weight loss, and even kidney damage. According to “Living Well With Myeloma Your Essential Guide,” there are several ways one can cope with the side effects and symptoms associated with the uncommon cancer.

Pain

For relief, you can try the following:

• Take painkillers (bisphosphonates) as prescribed, regularly.
• If you’re taking painkillers as prescribed, but find that they’re not effective, tell your doctor or nurse, who can perform a case of trial and error to find the best treatment for you.
• Avoid non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac (Voltarol®) as they can damage the kidneys.

Fatigue

Extreme tiredness is a very common problem for myeloma patients. It can leave you unable to perform daily tasks or unable to think straight.

For relief, you can try the following:

• Eat a well-balanced diet. Poor nutrition can increase fatigue.
• Make getting enough sleep a priority. Go to bed and get up at the same time every day.
• Get exercise every day. This can improve your energy levels.

Nausea and Vomiting

Tummy troubles like nausea and vomiting are two main side effects caused by popular myeloma treatments. While anti-sickness (anti-emetic) drugs are available to prevent and control both, there are several ways to bypass queasiness and the urge to hurl.

For relief, you can try the following:

• Avoid cooking foods like curries and keep the window open a little during food preparation.
• Try to take your mind off thinking about sickness – talk to people, watch a film or listen to soothing music to distract yourself.
• Get some fresh air.

Hair loss/Thinning

With some forms of treatment, such as chemotherapy, patients may experience thinning of hair or lose it altogether.

Dry Mouth

Some chemotherapy drugs can cause dry mouth or soreness – caused by small ulcers developing on the roof or inside of your cheeks — making eating difficult.

For relief, you can try the following:

• Avoid spicy, salty or tangy foods.
• Avoid mouthwashes that contain alcohol.
• Drink cold drinks (through a straw) to soothe a sore mouth.
• Try sucking on ice cubes or popsicles.

With proper medication and these helpful tips, it is possible to manage living with multiple myeloma. Be sure to speak with your doctor to create the best plan of care for yourself or a loved one.

August 21, 2017 by Ruthie Hawkins, BlackDoctor.org Contributor

3 Side Effects Of Too Much Apple Cider Vinegar

Find out the side effects of apple cider vinegar. Too much intake of apple cider vinegar can cause toothache, blood sugar, loss of potassium.

Many of us already know that apple cider vinegar is great for a number of things. It can do a lot of good inside and outside of your body from your skin to weight loss, etc.

But some of us take the healing power of apple cider vinegar a little too literally and take too much of it. Remember that age-old saying that “too much of a good thing is bad for you”? Well, it’s true with apple cider vinegar too. Take a look at what happens when you have too much of it.

Side Effects of Apple Cider Vinegar

1. It Can Burn Your Esophagus

Because apple cider vinegar is so acidic, it could lead to throat irritation. (9) In an extreme example, it could even lead to a burn in the esophagus. One study outlined what happened when an apple cider vinegar tablet got stuck in a woman’s throat for about half an hour: It led to pain, trouble swallowing, and possibly an injury to her esophagus. The study authors concluded that apple cider vinegar could be responsible for acid burns.

While it’s unclear how common these episodes are, many experts, including Dr. Katz and Michelle Jaelin, RD, president of Nutrition Artist in Ontario, Canada, still recommend diluting apple cider vinegar in water before drinking. “It is an acid and can damage the lining of the esophagus if taken straight like a shot,” Jaelin says.

2. It Affects Your Blood Sugar

Apple cider vinegar can also have an anti-glycemic effect on blood sugar, meaning it can lower glucose levels in the bloodstream. This may benefit the management of type 2 diabetes and insulin resistance, but people with uncontrolled blood sugar levels could find its use problematic.

Blood sugar may drop to the point of diabetic hypoglycemia. This could cause seizures and loss of consciousness. If you have type 2 diabetes or insulin resistance, talk to your doctor before taking apple cider vinegar in any amount.

3. Loss of Potassium

The body uses potassium to maintain proper functioning of the nerves and muscles. Without it, problems occur. Apple cider vinegar can adversely interact with your prescription and lead to low potassium levels. Low potassium, medically referred to as hypokalemia, can cause constipation, weakness, muscle cramps and even abnormal heart rhythms.

There is one case study where this did occur and the pattern was believed to cause osteoporosis because of the apple cider vinegar leaching minerals from the bones.

In this particular case, the amount of apple cider vinegar consumed was excessive (around 250 ml or 8.5 fl oz), which is much more than anybody should be drinking in a day. Furthermore, the patient had been consuming apple cider vinegar at that level for around 6 years.

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BONUS #4: Skin Irritation

If you have inflamed or scaly skin or a dry scalp, the low pH content in ACV may cause further irritation and in some cases has caused skin discoloration.

While many claim that ACV is good for the skin because of its pectin, beta-carotene, and vitamin C content, a USDA report confirms that it does not contain such nutrients in detectable amounts.

BONUS #5 Tooth Enamel

Too much apple cider vinegar can erode tooth enamel. The acetic acid can damage the enamel on your teeth, making them more susceptible to tooth decay. Diluting the vinegar before use can help, but it’s wise to talk to your dentist before you consume apple cider vinegar.

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For example, in one reported case a teenager was consuming a glass of apple cider vinegar (undiluted) each day, in an effort to lose weight.

That behavior resulted in significant damage to her teeth. Research has also indicated that vinegar can lead to a loss of minerals in teeth, which could contribute to tooth decay.

Now, this issue is likely to be most significant when you’re drinking apple cider vinegar straight, especially as vinegar is acidic and fairly harsh on the body.

Nevertheless, the potential side effects of apple cider vinegar on potassium levels are something to be aware of, especially if your potassium levels are likely to be low for any other reason.

October 28, 2022 by Dr. P. Gould

How To Manage Hepatitis C Side Effects

Stomach pain; Loss of appetite; Flu-like symptoms; Hair loss; Fatigue; Depression; Chills. So who is at risk HVC infection? The CDC reports ...

Though hepatitis C – an infection of the liver – can be treated and in rare cases cured, the side effects can be daunting. According to the CDC, about 3.5 million people in the U.S. have contracted the disease. And while the illness which appears in several forms – mainly type 1 — causes few symptoms, those plagued by them experience:

• Jaundice (a condition that causes yellowing of the skin, eyes, as well as dark urine)
• Stomach pain
• Loss of appetite
• Flu-like symptoms
• Hair loss
• Fatigue
• Depression
• Chills

So who is at risk HVC infection?

The CDC reports that the following persons are at an increased risk for HCV infection:

• Received blood from a donor who had the disease
• Have ever injected drugs
• Had a blood transfusion or an organ transplant before July 1992
• Received a blood product used to treat clotting problems before 1987
• Were born between 1945 and 1965
• Have been on long-term kidney dialysis
• Persons with HIV infection
• Children born to HCV-positive mothers

How does one manage their symptoms?

Common medications taken by hepatitis patients include Harvoni, Incivek, Interferon, Ribavirin and Solvadi with Interferon and Ribavirin. Hepatitis C patients may also manage their symptoms by doing the following

For flu-like symptoms:

• Take an over-the-counter medication such as acetaminophen (pain killer) or ibuprofen before each injection and as needed while the symptoms last — with a doctor’s approval of course.
• Drink plenty of fluids.
• Get sufficient rest.
• Avoid strong sunlight and bright indoor lights to prevent headache.
• For body aches, apply moist heat.

For depression:

• Talk to your doctor about whether taking an antidepressant throughout treatment is right for you.
• Avoid caffeine if you’re feeling anxious or irritable.
• Exercise regularly.

For fatigue:

• Consult with your doctor about scheduling interferon injections for days when you can take it easy.
• Cut back on work hours, if possible.
• Nap during the day.
• To increase your alertness and promote better sleep, take a walk.
• Drink a caffeinated beverage in the morning.
• If depression is a factor, consider therapy or medication.

For more information on hepatitis C symptoms, treatments, and stats, click here.

November 21, 2016 by Ruthie Hawkins, BlackDoctor.org Contributor

COVID Vaccine Side Effects May Mirror Breast Cancer ...

Researchers and doctors have found that some COVID vaccine side effects can mimic breast cancer symptoms including.

One of the leading symptoms of breast cancer is lumps. Lumps in or around the breast are the first signs that have women (and men) concerned. That’s why it’s often pushed that we should self-check our breasts often. But what if those lumps are not caused by breast cancer and could be a good sign for something else?

Researchers found that both the Pfizer and Moderna vaccines can cause lymph nodes to swell, particularly those in the armpit on the side where the shot was received. But that swelling or “lumps” are actually a good thing, experts say.

Some women are feeling these armpit lymph nodes and mistaking them for breast lumps, according to a recent report.

Further, these swollen lymph nodes can show up in a mammogram even if women can’t feel them. That prompted the Society of Breast Imaging to recommend that women postpone any mammography scheduled within four weeks after their final COVID-19 shot.

Marshall says breast radiologists have encountered axillary adenopathy, also known as swollen lymph nodes, on screening mammograms of patients who have been vaccinated.

It’s a surprising side effect that could be mistaken for breast cancer.

“It’s actually a normal response that the body has to the vaccine,” said Marshall.

Marshall says the swollen lymph nodes are on the same side as the placement of the vaccine.

AstraZeneca’s COVID-19 vaccine may reduce virus transmission, study finds
“We also see swollen lymph nodes in patients with breast cancer, so that’s the concern there. So we are asking everybody who is having a mammogram if they had the COVID-19 vaccine, what dose, when, and what side?” said Marshall.

Marshall says UH’s Radiology and Breast Cancer Imaging Department has received increased calls from women concerned over the signs.

“It means that the body is making antibodies to fight the COVID-19 infection,” said Marshall.

True Breast Cancer Symptoms

COVID Vaccine Side Effects May Mirror Breast Cancer Symptoms

• New lump in the breast or underarm (armpit).
• Thickening or swelling of part of the breast.
• Irritation or dimpling of breast skin.
• Redness or flaky skin in the nipple area or the breast.
• Pulling in of the nipple or pain in the nipple area.
• Nipple discharge other than breast milk, including blood.
• Any change in the size or the shape of the breast.
• Pain in any area of the breast.

Keep in mind that these symptoms can happen with other conditions that are not cancer.

Assistant professor of radiology at the Hospital of the University of Pennsylvania, Dr. Christine Edmonds says, it could even be taken as a reassuring sign that the vaccine is doing what it’s supposed to! In this case, both Dr. Edmonds recommend giving the lymph nodes time to subside before you call your doctor. If, after four weeks time, your lymph nodes still feel enlarged or painful, definitely get in touch.

According to data from the Centers for Disease Control & Prevention, over 11 percent of vaccine recipients experience swollen lymph nodes after one dose, and 16 percent do so after the second dose.

These “reactive” nodes, as they’re called, vary in size and location. When they form in the underarm region, they appear very similar to a cancer from the breast that has traveled to other parts of the body. According to the National Breast Cancer Foundation, when breast cancer spreads, it goes through a customary path, out from the tumor and first into the surrounding lymph nodes, before progressing throughout the body.

The 3 Medications Most Likely To Send Older Patients To The ER

An estimated one in 250 Americans lands in the hospital emergency department each year because of a medication-related reaction or problem, a new federal study finds.

Among adults 65 and older, the rate is about one in 100, the study authors said.

Remarkably, the medicines causing the most trouble haven’t changed in a decade, the researchers noted.

The drugs that top the list account for 47 percent of emergency department visits for adverse drug events in 2013 and 2014, according to the analysis.

Among older adults, blood thinners, diabetes medicines and opioid painkillers are implicated in nearly 60 percent of emergency department visits for adverse drug events.

“The same drugs are causing the most problems,” said study co-author Dr. Daniel Budnitz.

The study doesn’t tease out what went wrong. The reasons likely vary from one drug to the next, said Budnitz, director of the medication safety program at the U.S. Centers for Disease Control and Prevention.

1. Blood Thinners

People on the blood thinner warfarin (Coumadin), for example, must have their blood levels checked regularly due to the major risk of internal bleeding. Problems arise when there is insufficient monitoring or dose adjustment of these so-called anticoagulants, or when drug interactions occur, Budnitz explained.

2. Diabetes Medication

Diabetic patients taking insulin run into trouble when their blood-sugar levels fall too low, he added. If they forget to eat or accidentally administer the wrong dose, they can pass out, fall and break a hip, he said.

“It’s hard, often, to do the right thing every single time,” Budnitz said.

While medication safety has improved in hospitals, reducing harm from the medicines people take outside of the hospital remains a challenge, the study authors noted.

Ninety percent of U.S. prescription spending occurs in outpatient settings, they said.

Older patients often have multiple health conditions requiring complex medication regimens prescribed by different clinicians. This makes them particularly vulnerable, the study suggests.

Illness such as diabetes and heart disease become more common with age and are treated with drugs commonly linked to…

… emergency department visits, Budnitz explained. Also, “having chronic illnesses can make adverse events more serious when they do occur,” he said.

Michael Cohen, president of the nonprofit Institute for Safe Medication Practices, said it’s important to document trends in adverse drug events.

3. Opioids

“They’ve been focusing on opioids, anticoagulants and antidiabetic drugs like insulin or the oral drugs that people take because these are the ones that are most likely to harm people,” Cohen said.

Budnitz, along with study lead author Nadine Shehab of the CDC and colleagues, examined data involving more than 42,000 emergency department visits in 2013 and 2014.

These cases involved prescription or over-the-counter medicines, dietary supplements, homeopathic products or vaccines identified as the reason for the visit.

Adverse drug events included allergic reactions to medicines, taking too much medication, or a child’s accidental ingestion of a medicine.

Twenty-seven percent of trips to the ER for drug-related reactions and other health problems were serious enough to require hospitalization, the researchers found.

Roughly one-third of visits to the emergency department for adverse drug events occurred among adults 65 and older in 2013-2014, versus one-quarter in 2005-2006. Older adults also had the highest hospitalization rates.

Among kids, antibiotics accounted for 56 percent of emergency visits for adverse drug events among children 5 years and under. For kids ages 6 to 19, antibiotics were the most common drugs followed by antipsychotic drugs (4.5 percent), often prescribed for children with disruptive behaviors, the researchers reported.

Overall, an estimated 1.3 million emergency department visits for adverse drug events occurred each year of the two-year study period, Budnitz said. That’s up from about 700,000 visits per year in 2005 and 2006, he said.

But “it’s hard to say that the rate changed or didn’t change” because the research team wasn’t able to study how much more these medicines are being used, he explained.

Budnitz said new Medicare payment incentives may help reduce future adverse events by encouraging doctors to perform specific requirements, such as having patients on blood thinners participate in anticoagulation management programs.

Results of the government-funded study were published Nov. 22 in the Journal of the American Medical Association.

Dr. Chad Kessler, of the Durham Veterans Affairs Medical Center in North Carolina, said collaboration is key to reducing these adverse events.

“When administrators, physicians and other health care personnel as well as the public recognize how large a problem this is, only then can we take the needed steps to remedy this,” said Kessler, co-author of an editorial accompanying the study.

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