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課文一藥對了，病人錯了安德里亞洛克 通常，藥房的職業(yè)水平和權(quán)威是很少受到懷疑的。然而，藥房的出錯率比人們所想的要高得多。想一想 ，要是藥房給你開錯了藥會出現(xiàn)什么后果？下面這篇文章將會告訴我們更多有關(guān)藥房錯誤的事情。 在吃早餐時，7歲的加布里埃爾亨德黎服下了將會改變她一生的兩粒藥中的第一 粒。新處方上開的藥是利他林，這是她母親佩吉在南卡羅來納州洛克山的日特愛德藥店配的藥，一種用來治療注意力缺失/過動癥的藥。 當(dāng)天，即1995年2月21日的晚些時候，在急救室里，醫(yī)生們發(fā)現(xiàn)小女孩服用的根本不是利他林，而是大劑量的格里納斯,一種治療糖尿病的藥。次年在法庭上，亨德黎的律師論證說，藥物沒有正確配發(fā)，其劑量比成人正常初服量高出16倍，使得加布里埃爾血糖急遽攀高 ，從而導(dǎo)致她腦部永久性損傷。陪審團(tuán)判決賠償亨德黎家600萬美元。日特愛德藥店提出了上訴。 藥房交易看上去非常簡單明了。它們的出錯率有多高呢？ 盡管沒有確定的全國性統(tǒng)計(jì)數(shù)據(jù)，還是有證據(jù)表明配藥錯誤比人們想象的要更常見。1997年，行業(yè)刊物藥學(xué)信息在全國范圍內(nèi)進(jìn)行的一次調(diào)查表明，53%的藥劑師承認(rèn)在前兩月里發(fā)生過差錯。1996年6月對3361位加利福尼亞和俄勒岡的藥劑師的調(diào)查顯示，出錯率為每家藥店每年324次將近每天1次。 “十年前，可接受的出錯率為每家藥店每年1次，”拉爾夫沃格爾說。他是專業(yè)藥劑師協(xié)會的主席，這家協(xié)會擁有2000名藥劑師。“我們今天看到的卻是由于人員配備不足以及配藥業(yè)出現(xiàn)的一些新的壓力所造成的混亂局面。” 配藥業(yè)堅(jiān)決認(rèn)為，對出錯率的擔(dān)憂被過分渲染。不過，有許多州的管理者、消費(fèi)者權(quán)益維護(hù)者和藥劑師們認(rèn)為，由于工作量增加，一場零售藥業(yè)的革命正在引起諸多問題。 他們指出了兩點(diǎn)：一、處方總量在不斷增長1992年到1997年增長了30%，這是衛(wèi)生保健信息公司“IMS Health”所調(diào)查的結(jié)果。二、由保險(xiǎn)公司或衛(wèi)生維護(hù)組織支付的處方百分比已由1991年的28%增長到1997年的60%。這些第三方付款者使配藥業(yè)得到的付還率持續(xù)走低，這必然造成為保持利潤增長而大量配藥。甚至四大連鎖藥房日特愛德公司，CVS，愛克德以及沃爾格林斯也受到了影響。 在這種背景下，有太多的人想當(dāng)然地看待配藥交易。實(shí)際上，在過去的九年里，美國人在回答蓋洛普民意測驗(yàn)時，都將藥劑師列為本國最誠實(shí)最有職業(yè)道德的專業(yè)人員，位于牧師之前。難怪為數(shù)眾多的人以為 ，根本不會出什么差錯。佩吉亨德黎說：“我盲目地信任了他們?！?為了保護(hù)您的家人，您需要了解以下知識： 不可完全依賴您的醫(yī)生。大多數(shù)醫(yī)生在醫(yī)學(xué)院只接受過一年的有關(guān)配方藥使用的正式培訓(xùn)。而且，一般說來，不要求他們再接受藥學(xué)方面的繼續(xù)教育。 相對而言，許多州政府要求藥劑師每年平均完成15小時的繼續(xù)教育。而且，額外的準(zhǔn)備工作也不會少：1992年，由于美國食品和藥物管理局縮減了藥品批準(zhǔn)時間，新的藥品就如洪水般涌入了市場。在過去的兩年里，92種新藥涌進(jìn)市場，而在此之前的五年里只批準(zhǔn)了125種。 因此，不要以為自己從不會拿著有問題的配方離開醫(yī)生的辦公室。來自內(nèi)華達(dá)州達(dá)頓的44歲的路斯帕克斯頓，在1992年7月請自己的醫(yī)生治療竇炎，當(dāng)時，她對他信任無疑。 此前幾年，帕克斯頓曾經(jīng)因?yàn)槭褂每股乇P尼西林和基弗萊克斯而發(fā)生過嚴(yán)重的過敏反應(yīng)。在對她的過敏史不了解的情況下，醫(yī)生開出了抗生素西福辛。對于使用以上兩種藥中的任何一種都極度敏感的患者來說，這種藥可以引起致命的過敏反應(yīng)。 在服用西福辛二十分鐘之后，帕克斯頓的咽喉腫脹起來，并隨之呼吸困難。由于迅速用抗組胺藥自救才中止了這種反應(yīng)。 內(nèi)華達(dá)配藥業(yè)委員會對帕克斯頓的藥劑師進(jìn)行了批評，認(rèn)為他應(yīng)該警告病人此藥有可能導(dǎo)致過敏反應(yīng)。 穿白大褂的未必是藥劑師。了解藥物潛在的危險(xiǎn)反應(yīng)這項(xiàng)重任，是藥劑師們必須完成五或六年專業(yè)培訓(xùn)的原因之一。不過，越來越常見的現(xiàn)象是，穿著白大褂配藥的人根本不是藥劑師，而是藥店的技工。根據(jù)各州的情況，這樣的技工或許只有高中學(xué)歷，僅僅受過在職訓(xùn)練。 配藥連鎖店由于利潤幅度緊縮，使用的技工越來越多。為什么會這樣呢？技工每小時的酬金為5-12美金，比較而言，注冊藥劑師每小時的酬金則達(dá)30-39美金。 當(dāng)然，藥劑師應(yīng)當(dāng)核查技工的工作。藥學(xué)信息的調(diào)查認(rèn)為，將近三分之一的藥劑師犯配藥錯誤主要是由于沒有核查。 拿到正確的藥，但劑量不對。伊利諾斯州克雷特的海澤爾凡哈特姆說，1995年5月30日，她去為丈夫恩尼斯特配強(qiáng)效治療血管收縮的藥香豆定時，有兩位藥劑師和三名技工當(dāng)班。“在審訊時，他們說拿不準(zhǔn)是誰配的這張藥方，”海澤爾在談到訴訟卡馬特的案件時說。她的律師論證說，無論是誰配的這張藥方，他確實(shí)配了含5毫克香豆定的藥劑，而不是恩尼斯特的正常用量2毫克劑量過大引起大出血而導(dǎo)致了他的死亡。陪審團(tuán)判決藥店賠償81萬美金。卡馬特的發(fā)言人說公司將提起上述。 某些配藥錯誤可歸咎于不合理的工作量。三項(xiàng)持續(xù)11年之久的醫(yī)學(xué)研究，發(fā)現(xiàn)了藥劑師的工作量與錯誤率之間的關(guān)系：“在人們想讓藥劑師每小時配的藥方超過24張時，發(fā)生錯誤率的風(fēng)險(xiǎn)確實(shí)要高，”奧本大學(xué)配藥學(xué)院的伊麗薩白艾倫福林說。藥劑師們說，配藥超過那個速度越來越常見，并不是什么稀奇事。 安全網(wǎng)絡(luò)有漏洞。多數(shù)藥劑師依靠電腦裝置，他們以為有關(guān)新藥或現(xiàn)有藥品的新危險(xiǎn)的內(nèi)容會被定期更新。然而這些系統(tǒng)并非總是發(fā)揮作用。 1996年美國醫(yī)學(xué)會雜志報(bào)道了一項(xiàng)研究，喬治鎮(zhèn)大學(xué)醫(yī)學(xué)中心配藥學(xué)系的主任雷蒙德伍絲爾利和他的同事們向華盛頓市區(qū)的50位藥劑師展示了為同一病人開出的兩張藥方。一張是抗組胺藥塞爾岱，另一張是抗生素紅霉素。 從1992年起，美國食品及藥物管理局與藥品制造商就已經(jīng)發(fā)布警告說，將這兩種藥混用會產(chǎn)生致命的后果。但仍然有32%的藥劑師配發(fā)了這兩張藥方。在48家使用計(jì)算機(jī)指明副作用的藥店中，有29%的藥店的程序沒能給予警告。伍絲爾利說，在有些情況下，是藥劑師關(guān)閉了系統(tǒng)或者使它們失效。 那大多數(shù)藥店里釘在處方袋上的病人須知單又是怎樣的呢？這些單子同樣是為了進(jìn)一步防止藥物的相互作用或副作用而設(shè)計(jì)的。一般它們不是由藥劑師或醫(yī)生而是由商販們提供的。而且，往往要么是含糊不清要么就是已經(jīng)過時。 存在小的監(jiān)督疏漏。多數(shù)州政府委員會不要求藥店匯報(bào)配藥錯誤。而象美國藥典會（制定藥物生產(chǎn)質(zhì)量標(biāo)準(zhǔn)的非營利性組織）主持的國家錯誤匯報(bào)項(xiàng)目，也只是自愿執(zhí)行的。 不過，連鎖藥店通常要求藥劑師向管理者呈交錯誤報(bào)告。然而，即使內(nèi)部報(bào)告也不總是能避免將來的失誤。 59歲的來自亞拉巴馬州莫比爾的瑪爾維納霍羅威拿到的是一瓶泰布考（一種改變心臟節(jié)律的危險(xiǎn)藥物），而不是腫瘤醫(yī)生為她開出的治療乳腺癌的它莫西芬?；袅_威在五個月后，又配了兩次藥后才發(fā)現(xiàn)了這個錯誤。 幸運(yùn)的是，霍羅威沒有因這種心臟藥發(fā)生任何不良反應(yīng)，但她因耽擱了癌癥的治療而十分沮喪。她起訴了造成錯誤的地區(qū)性連鎖店哈克藥品公司。她的律師出示了曾上交給哈克管理部門的233次事故報(bào)告，其中大部分事故是有關(guān)前三年間這個藥店發(fā)生的配藥錯誤?；袅_威獲得了陪審團(tuán)判決的255,000美元賠款。 諸如此類的賠償推動了連鎖店改進(jìn)匯報(bào)錯誤的內(nèi)部管理程序。然而，國家配藥業(yè)委員會協(xié)會（全國各州許可委員會的代表）的負(fù)責(zé)人卡門凱狄左恩則要求進(jìn)行更嚴(yán)厲的監(jiān)督：“我們提議要求每一家藥店向州立委員會匯報(bào)嚴(yán)重的配藥錯誤。” 不過，保護(hù)自己的最終責(zé)任還在于消費(fèi)者。在大多數(shù)州，法律要求藥劑師必須向消費(fèi)者提供新處方的咨詢。不過，多數(shù)客戶謝絕這種“展示和介紹”的好意。 紐約米德爾潑特的一位藥劑師斯蒂芬吉洛克斯說：“倘若人們懂得配藥錯誤可能引起的危害，他們就不會認(rèn)為去藥店和去快餐店一樣方便了?！?如何保護(hù)自己 *做筆記：在診室里，記下所開藥的通用名及商標(biāo)名，并寫下用途與用量。這樣，你便可以對藥劑師交給你的藥品進(jìn)行復(fù)核。 *提供信息：提醒你的醫(yī)生和藥劑師有關(guān)你藥品過敏的情況，以及你正在服用的其它藥品。這包括止痛藥和感冒藥、維他命以及草本補(bǔ)給品等非處方藥。 *檢查再配藥：確保藥片與你通常所取藥片的顏色及大小一致。倘若不同，就認(rèn)定藥品是錯配，直到藥劑師對其進(jìn)行驗(yàn)證。 *在藥店非高峰期配藥：避免在周一配藥，周一通常是藥劑師最忙的一天。提前一、兩天電話預(yù)約再配藥，以減少在高峰期配藥的機(jī)率。倘若是通過郵遞配藥，你至少得在需要配藥前兩周預(yù)定。最重要的是，倘若在服用了剛剛配好的藥之后感到不舒服，必須立即聯(lián)系自己的醫(yī)生。Right Drug, Wrong Patientby Andrea RockAs a rule, the pharmacys proficiency and authority is little doubted. But the rate of pharmacy errors is much higher than people think. Imagine what would happen if the drug dispensed to you were not the proper one. The following article tells us more about pharmacy errors. At breakfast, seven-year-old Gabrielle Hundley took the first of two pills that would change her life. The new prescription that her mother, Peggie, had gotten filled at the Rite Aid in Rock Hill, S.C., was for Ritalin, a drug used to treat attention deficit-hyperactivity disorder. In an emergency room later that day, February 21, 1995, doctors discovered that the little girl hadnt taken Ritalin at all, but a high dose of Glynase, a diabetes medication. In court the next year, the Hundleys attorney argued that the pills were incorrectly dispensed, and contained 16 times the normal starting dose for adult diabetics, causing Gabrielles blood-sugar level to plummet so severely that she suffered permanent brain damage. The jury awarded the Hundley family $16 million. Rite Aid is . Pharmacy transactions seem so straightforward. How often could they go awry? While there are no definitive national statistics, there is evidence suggesting that drug-dispensing mistakes are more common than you think. In a 1997 nationwide survey conducted by the trade publication Drug Topics, 53 percent of pharmacists admitted having made errors in the preceding two months. A June 1996 survey of 3361 pharmacists in California and Oregon revealed that errors occurred at an annual rate of 324 per pharmacy nearly one a day. “Ten years ago, an acceptable error rate was considered one per year per pharmacy,” says Ralph Vogel, president of the Guild For Professional Pharmacists, a union representing 2000 pharmacists. “What were seeing today is the chaos that comes from and other new stresses in the pharmacy. “ The pharmacy industry insists that worries over error rates are overblown. Nevertheless, many state regulators, consumer advocates and pharmacists contend that a revolution in the retail drug business is causing problems by increasing workloads. They point to two factors: First, overall prescription volume keeps rising up 30 percent between 1992 and 1997, according to IMS Health, a health care information company. Second, the percentage of prescriptions paid for by insurance or has risen from 28 percent in 1991 to 60 percent in 1997. These third-party payers are imposing ever-lower reimbursement rates on pharmacies, which must churn out a high volume of prescriptions to keep profit margins up. Even the Big Four chains Rite Aid, CVS, Eckerd and Walgreens are affected. Against this backdrop, too many people are taking the prescription transaction for granted. Indeed, for the past nine years, Americans responding to Gallup Polls have ranked pharmacists as the countrys most honest and ethical professionals ahead of clergy members. No wonder so many people assume nothing can go wrong. “I had blind faith,” says Peggie Hundley. Heres what you need to know to protect your family: You cant rely solely on your doctor. Most physicians get only one year of formal training in medical school on the use of prescription drugs. And, generally, continuing education on medications is not required. In contrast, many states require pharmacists to complete an average 15 hours of continuing education each year. And theres no dearth of homework: new drugs are pouring into the market, stimulated by a 1992 program shortening the FDAs drug-approval times. In the past two years, 92 new drugs hit the market compared with 125 approved for the previous five years. So dont assume you would never leave your doctors office with a problem prescription. Ruth Paxton, 44, of Dayton, Nev., trusted her doctor implicitly when she sought treatment for a sinus infection in July 1992. Years earlier, Paxton had experienced severe allergic reactions to the antibiotics penicillin and Keflex. Unaware of the severity of her past reactions, her doctor prescribed the antibiotic Ceftin, which can cause life-threatening allergic responses in people with extreme sensitivities to either of the other two drugs. Within 20 minutes of taking Ceftin, Paxtons throat began to swell, making it difficult to breathe. Swift self-treatment with an anti-histamine stopped the reaction. Nevadas board of pharmacy reprimanded Paxtons pharmacist, saying he should have warned her of the potential for allergic reaction. A white coat does not a pharmacist make. The burden of knowing about potentially dangerous drug reactions is one reason pharmacists must complete five or six years of academic training. Yet increasingly, the white-coated person who dispenses medicine isnt a pharmacist at all but a pharmacy technician. Depending on the state, such techs may have nothing more than a high school degree and on-the-job training. As pharmacy chains face squeezes on profit margins, the use of techs is growing. Why? Techs typically earn $5 to $12 an hour compared with the average of $30 to $39 an hour for registered pharmacists. Of course, pharmacists are supposed to check technicians work. Failure to do so was cited as a major cause of dispensing errors by nearly a third of pharmacists in the Drug Topics survey. You could get the right drug, but the wrong dose. Hazel Van Hattem of Crete, Ill., says there were two pharmacists and three technicians on duty on May 30,1995, when she picked up a refill of Coumadin, a powerful blood-thinning medication, for her husband, Ernest. “At the trial, they said they couldnt be sure who filled the prescription,” says Hazel, referring to her lawsuit against Kmart. Her attorney argued that whoever filled the prescription did so with pills containing 5 mg. of Counmadin rather than Ernests usual 2 mg. an overdose that caused massive bleeding and led to his death. A jury levied an $810 000 judgment against the pharmacy. A Kmart spokesperson says the company is appealing. Some dispensing errors can be attributed to unreasonable workloads. Three medical studies conducted over an 11-year period found a correlation between pharmacists workloads and error rates :”There does appear to be a greater risk of errors when a pharmacist is expected to fill more than 24 prescriptions per hour,” says Elizabeth Allan Flynn of Auburn Universitys School of Pharmacy. Increasingly, pharmacists say, pushing beyond that rate is not unusual. The safety net has holes. Most pharmacies rely on computer setups that are supposed to be updated regularly with information about new drugs or new risks for existing drugs. But these systems dont always work. In a study reported in the Journal of the American Medical Association in 1996, Raymond Woosley, chairman of the department of pharmacology at Georgetown University Medical Center, and his colleagues presented two prescriptions for the same patient to 50 pharmacists in the Washington, D.C., area. One was for the antihistamine Seldane; the other was for the antibiotic erythromycin. Since 1992 the FDA and the drug manufacturers have issued warnings that mixing the two drugs could be fatal. Still, 32 percent of the pharmacies filled the prescriptions. Of the 48 pharmacies using computers to flag adverse interactions, 29 percent had programs that failed to issue an alert. In some cases, Woosley says, pharmacists had shut down the systems or overridden them. And what about the patient information leaflets stapled to prescription bags at most pharmacies? These are also designed to give added protection against drug interactions or side effects. They usually arent prepared by pharmacists or physicians but by commercial vendors. And theyre often vague or out-of-date. Little watchdog oversight exists. Most state boards dont require pharmacies to report dispensing errors. And national error-reporting programs such as one run by U.S. Pharmacopeia (a nonprofit group that sets drug-manufacturing quality standards) are voluntary.Drug chains, however, usually require pharmacists to submit error reports to management. But even those internal reports dont always prevent future errors. Malvina Holloway, 59, of Mobile, Ala., received a bottle filled with Tambocor, a dangerous heart-rhythm-altering medication, rather than the breast-cancer drug Tamoxifen that her oncologist had prescribed. Holloway didnt discover the mistake until five months and two refills later. Luckily, she did not experience any adverse reactions to the heart drug, but Holloway was distressed that her cancer treatment was delayed. She Harco Drugs, Inc., the regional chain where the mistake was made. Her attorney presented 233 incident reports that had been submitted to Harco management, the majority involving dispensing errors at their stores over the preceding three years. Holloway won a $255 000 jury award. Such awards have motivated chains to improve internal procedures on error reports. But Carmen Catizone, executive director of the National Association of Boards of Pharmacy, which represents state licensing boards across the country, argues for greater oversight: “We are proposing that each individual pharmacy be required to report serious dispensing errors to the state board.” The ultimate responsibility of protecting himself, though, rests with the consumer. In most states, pharmacists are required by law to counsel customers about new prescriptions. Nevertheless, most customers turn down offers for a “show and tell.” Says Stephen Giroux, a pharmacist in Middleport, N.Y. “If people understood the harm that could be done to them by a dispensing error, they wouldnt treat going to a pharmacy like going to a fast-food store.”How to Protect Yourself* Take notes: At your doctors office, write down the generic and brand names of your prescribed medicine, along with its purpose and the dosage. That way you can double-check the medication the pharmacist hands you.* Inform Everyone: Remind both your doctor and your pharmacist of any drug allergies you have, as well as any other medications youre taking. Include over-the-counter pain or cold remedies, vitamins and herbal supplements.* Check Refills: Make sure the pills are the same color and size you usually get. If theyre different, assume theyre wrong until a pharmacist examines them.* Shop Off-Peak: Avoid getting prescriptions filled on a Monday, traditionally a pharmacys busiest day. Call in refills a day or two ahead to lessen chances that your prescription will be filled during busy hours. If you get your prescriptions by mail, order them at least two weeks before you need a refill. Most importantly, if you feel sick after taking a newly prescribed drug, call your physician immediately. A.R. (1 645 words)(From Readers Digest,Sept., 1999 )課文二非處方藥的潛在危險(xiǎn)威廉艾斯恩巴捷 18歲的她跌跌撞撞地走進(jìn)急癥室，兩眼圓睜，大口大口地喘著粗氣。她的氣管極度腫脹。那家中西部醫(yī)院的快速反應(yīng)醫(yī)生們，成功地用緊急氣管切開術(shù)及靜脈注射藥物治療來控制她的呼吸。她又被呼吸科特護(hù)處接納進(jìn)行隨后的治療，并最終得到了康復(fù)。 這位年輕女士近乎致命的經(jīng)歷，是阿司匹林的過敏反應(yīng)造成的。她知道自己對阿司匹林過敏，但是卻粗心大意地服下了藥。怎么會發(fā)生這樣的事情呢？ 在剛剛出現(xiàn)頭疼癥狀時，她去取一種普通的非處方（OTC）藥，以為這種藥里含有醋氨酚。藥里確實(shí)含有醋氨酚-但倘若她費(fèi)心認(rèn)真地閱讀一下標(biāo)簽，她就會看見上面有小字說明它也含有阿司匹林。 幸虧，由OTC藥引起的走近死神的經(jīng)歷并不常見。但是這位年輕女士的錯誤-不讀標(biāo)簽-是太常見了。美國藥學(xué)會在去年進(jìn)行的一場調(diào)查發(fā)現(xiàn)：47%的成人有時不閱讀非處方止痛藥的標(biāo)簽，不到40%的人在服用這些藥品之前咨詢藥劑師，43%的人不了解與配方藥同時服用這些藥品的潛在危險(xiǎn)。這些危險(xiǎn)會相當(dāng)嚴(yán)重。我們買來用于治療過敏、頭疼、胃不舒服以及其他一些常見病的東西是藥品。必須負(fù)責(zé)任地使用它們。你在服用處方藥，一定要向醫(yī)生或藥劑師咨詢。消費(fèi)者不看標(biāo)簽上以及夾在包裝里的警告而吞咽、噴灑、吮吸、塞入或涂抹目前市場上10萬種藥品中的某一種藥，就是冒險(xiǎn)。以下列出的是一些誤區(qū)：劑量過大 “人們常有這樣的想法，一片不行，我就吃兩片，”藥物學(xué)家，人民配藥業(yè)系列叢書的作者喬格雷登說。那不是個好主意。 今年初，一位45歲的卡車駕駛員出現(xiàn)在豪斯頓頭痛診所，抱怨自己頭疼欲裂。這疼能疼得鉆心，讓他從熟睡中疼醒，嘔吐。 沒費(fèi)多少時間就找到了癥結(jié)所在。這個人近一年來每周大約吞服了200片Excedrin止頭痛藥。標(biāo)簽上警告使用者每天用量不要超過八片，而且使用期不要超過兩天。每片藥含有250克醋氨酚，250克阿司匹林，以及65克咖啡因。 “這是典型的復(fù)發(fā)性頭疼，”診所主任尼南T馬休醫(yī)生說?！半S著疼痛的加劇，他服用了更多的止痛片，還以為那是安全的藥品呢。我們讓他中止服用所有的日常止痛藥，而進(jìn)行了一種休息與 控制緊張的治療程序，讓他使用防止偏頭痛的藥品。現(xiàn)在他恢復(fù)得不錯。” 雖然尚未有確定的研究，但馬休估計(jì)2%到3%之間的人口-相當(dāng)于8百萬美國人-可能在過量使用OTC頭疼藥。 許多OTC藥品僅僅是那些只有憑處方才能取到的藥品的小劑量版本。比如說，止痛藥奧諾迪斯KT是處方藥酮絡(luò)芬的一種翻版，倘若長期高劑量地服用這種處方藥 ，可以引起潰瘍和嚴(yán)重的胃出血。 “習(xí)慣性以及長期性的使用具有一種以上活性成分的止痛藥可能是在冒險(xiǎn)，”國家腎病基金會的公共政策委員會主席威廉亨瑞奇醫(yī)生警告說?！斑@會導(dǎo)致腎損傷并引起腎功能衰退?！辈贿^，有些專家說腎病與使用化合止痛劑的關(guān)系尚未得到證實(shí)。在任何情況下，只有當(dāng)按照指示的方法服用時，這些藥品才能被當(dāng)作是安全的。相互作用 醫(yī)學(xué)權(quán)威人士敦促使用處方藥者，尤其是慢性病患者，在使用任何OTC藥之前都要向醫(yī)生或藥劑師進(jìn)行咨詢。比如說，數(shù)以百萬的美國人服用治療心痛，胃酸過多以及胃部其它小毛病的常用藥泰格米特HB。但是，倘若他們同時服用經(jīng)常開出的處方藥香豆定(防止血塊