OVERDOSES

Many people think of an overdose purely in terms of attempted suicide, but accidents with drugs are every bit as common as deliberate misuse

Overdose has become a subject of major concern among doctors, and it is one which everyone should know about because almost always a tragedy can be avoided by following a few simple rules about when and how to take medicines.

Very occasionally, overdose happens because a doctor or a chemist makes a mistake in prescribing, making up or labelling a drug; but the majority of cases arise out of the user’s carelessness.

Care should be taken with all drugs, not just the ones that are obviously potent. Everyday medicines like aspirin are killers if taken in sufficient quantities, and so are many chemicals found around the house.

CHILDREN AND OVERDOSE

Children are the commonest victims of accidental overdose. They are much more gravely affected by drugs than adults, partly because of their small body size and partly because drugs intended for adults are exactly that: they can harm a child even if a tiny amount is given. Most medicines for children are specially prepared as such, made up so that they can be given in 5 ml(one teaspoonful) doses. Children should not be given medicines other than those specifically meant for them.

It is possible for medicines taken by a pregnant woman to pass to the foetus in sufficient woman to pass to the foetus it. So no medicines should be taken during a pregnancy without first consulting a doctor for advice. Drugs can also be passed from a mother to her baby while breast feeding. Again, the simple and necessary precaution is to consult a doctor.

Most overdoses among children occur, however, because children get hold of and swallow their parent’s medicines out of curiosity. It is common sense to store medicines where children cannot get at them. Remember that children can always climb or scramble or crawl further than you think is possible.

Many tablets look, to children, like sweets, so to stop them making such potentially fatal comparisons, do not let them see you taking pills. Another good reason for taking medicines discreetly is that young children love to copy grownups. If it is good for mummy and daddy, it must, they think, be good for them too.

ADULTS AND OVERDOSE

Forgetting whether or not you have had a particular tablet, or medicine, and taking another just to be sure, is the greatest risk. If this happens two or three times a day, or just once with a potent drug, overdose may occur.

Taking another dose ‘just to be sure’ is especially likely when the patient has to take several different drugs each day. To avoid mistakes, put the whole of the day’s tablets out in a small container - for example an egg cup-checking each time, with a careful reading of the label, that the drugs really are what you think they are. Also check the instructions, however familiar you think you may be with them. Doctors and nurses do this every time they give a patient medicine; so why should you be less careful?

Never take tablets or medicine from a bottle without a label, or where the label has become illegible, even if you are sure you can recognize what is inside. There are now many thousands of drugs available and not enough combinations of colour, size and shape for them all to look different so mistakes can be made.

Even doctors and nurses can sometimes be in doubt about the identity of a tablet or capsule, and have to refer to a complicated table; so again, why be less careful yourself?

DOUBTING THE MEDICINE

Sometimes a medicine does not have the expected or desired effect, and the patient starts to doubt it. This is potentially dangerous, too, because the temptation arises to increase the dose slightly, or take it at shorter intervals.

This may seem an obvious error, but it happens surprisingly often, sometimes with tragic results. Another temptation, especially strong for those who are already unwell and cannot spare the time to get to the doctor, is to take medicine which has been prescribed for someone else in the household on the assumption that it sounds as if it might help. This, too, can be fatal.

Similarly, it is unwise to take additional medicines, even ones bought over the counter at a chemist, while you are already on a course of drugs. They can combine with each other so there is a clash, or they can potentate each other -exaggerating each other’s effects. So consult your doctor before taking any drug while already on another.

SYMPTOMS OF OVERDOSE

These vary, of course, according to the drug involved and the amount taken. However, indications of mild overdose, (which should still be reported to a doctor) include dizziness, faintness, blurring of vision, drowsiness, difficulty in concentration and a mild degree of mental confusion. Perhaps there will be some disorientation - overdose victims may not know where they are or exactly how they came to be there.

More serious overdose is characterized by falling about, being difficult to arouse from a deep sleep and slipping into full unconsciousness.

OUTLOOK

Obviously it is worth knowing the relevant first aid procedures for overdose. Provided they are followed promptly, the outlook for the patient is good. Inevitably the hospital plays the major role in treatment, and here there are three things doctors can do: resuscitation in the intensive care unit, stomach washing and chemical antidotes.

Provided treatment is early enough, the patient almost always recovers, with no after-effects. But the most important point about overdoses is that prevention makes so much more sense than cure.

Safety with drugs

Keep all medicines in a lockable, dark cupboard out of the reach of children. Use child-proof containers. Don’t let children handle medicines, or see you taking them.

Do not keep medicines longer than a year. In any case don’t keep them longer than their expiry date. Destroy completely what is left of a medicine after you have finished it, but don’t throw in the dustbin, or onto a fire.

If a doctor has prescribed a medicine, complete the course. If in doubt, ask a doctor or a chemist.

Tell your doctor of any side effect experienced from a medicine.

If you are advised not to drink, drive or operate machinery while taking a medicine, don’t: it can be dangerous.

Always read the directions on the label; always take exactly the recommended dose.

Never treat any problem yourself for longer than a week without consulting your doctor

If a medicine you have used according to the instructions fails to have the right effect, consult your doctor.

Only give young children medicines which are described on the package as suitable for them.

Do not take any medicine during pregnancy, or while breast feeding, without the advice of a doctor.

If you are being treated by one doctor, do not, without consulting him, take any medicine prescribed for you by another doctor; indeed don’t take any other medicine without telling your doctor as the drugs could interact.