Prescription medicine is strong enough to treat serious conditions, but this strength also makes it dangerous in the wrong dose or combination. It only takes a small change to turn a helpful medicine into a harmful one, and what happens next depends on who notices the warning signs.
Prescription Medicine Risks
Elderly people, people with kidney or liver disease, and people taking three or more medicines at once carry the highest risk of a serious problem with a prescription medicine. Risks include:
Two or medicines taken together
Alcohol
Stopping your medication suddenly
Grapefruit juice for certain calcium channel blockers used to lower blood pressure.
Opioid Painkillers
Opioid painkillers are among the most tightly controlled prescription medicines in Australia. Drugs in this class include oxycodone, codeine, tramadol, morphine, and fentanyl. Slowed breathing is the biggest danger, and an opioid combined with alcohol, a benzodiazepine, or a sedating sleeping tablet multiplies this effect.
Your body’s tolerance to opioids quickly falls after you stop taking the medicine, meaning someone who returns to their old dose faces a higher overdose risk. Constipation, drowsiness, and pinpoint pupils are familiar effects of an opioid at therapeutic dose. Slow shallow breathing, blue lips, snoring or gurgling sounds, and no response to voice or touch are signs that the dose has crossed into overdose.
Benzodiazepines and Sleeping Tablets
Benzodiazepines and sleeping tablets (also known as Z-drugs) work by calming the brain. Common benzodiazepines include diazepam, temazepam, alprazolam, and oxazepam, while Z-drugs include zolpidem and zopiclone.
A benzodiazepine plus alcohol, an opioid, or another sedative can sedate a person deep enough to stop their breathing. Stopping the drug suddenly can then trigger withdrawal which can cause seizures in some people.
Antidepressants
Antidepressants treat depression, anxiety, obsessive-compulsive disorder, and several other mental health conditions. The most prescribed types are SSRIs (sertraline, fluoxetine, escitalopram) and SNRIs (venlafaxine, duloxetine).
The first risk is serotonin syndrome, which often happens because someone has taken two serotonin-boosting drugs together (an SSRI plus tramadol, or an SSRI plus a migraine triptan, for example). Symptoms start with agitation, sweating, fast heart rate, and muscle twitching, and untreated cases progress to a body temperature high enough to cause organ failure.
The second risk is discontinuation syndrome, which happens when doses are stopped or skipped and puts a person out of action for days or weeks while the body readjusts. Withdrawal symptoms include dizziness, electric-shock sensations, and nausea, alongside a return of the depression or anxiety that the medicine was treating.
Blood Thinners
Blood thinners reduce the body’s ability to form clots, and are commonly prescribed after a heart attack, stroke, or deep vein thrombosis, and for people with atrial fibrillation. Their main risk is that if the body does bleed it won’t be able to stop. A small cut, a knock to the head, a stomach ulcer, or internal bleeding from a fall can become life-threatening when clotting is suppressed.
Signs that bleeding has gone too far include unexplained bruising, blood in urine or stool, black tarry stools, vomiting blood, severe headache after a bump, or sudden weakness on one side of the body.
Respond to an Overdose with First Aid
Prescription medicines aren’t without their risks. All it takes is a missed dose or a mistaken combination to send someone to the hospital. It’s an accident that can happen to anyone. By enrolling in a first aid course you can help keep someone alive until paramedics arrive.
FAQs
What is the Pharmaceutical Benefits Scheme (PBS)?
The PBS is an Australian government program that subsidises approved prescription medicines for people enrolled in Medicare, with patients paying a capped amount and the government covering the rest.
Do I Need to Be a Health Professional or Pharmacist to Provide First Aid?
No. Australia’s good Samaritan laws protect anyone who acts in good faith to help someone in an emergency in every state and territory, as long as the help is not given for payment and the helper is not impaired by alcohol or drugs.
What is the Active Ingredient in Panadol?
The active ingredient in Panadol is paracetamol. Although paracetamol is available over-the-counter without a prescription, taking more than the recommended daily limit can cause severe liver damage that may not show symptoms for two or three days.
