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At the show “RTS Surgery” Dr. Samardzic clears up the truths and misconceptions about drug use.
Hydroxychloroquine is the most effective drug in the fight against coronavirus (misconception)
“It is wrong to say that when it comes to viral infections, something is more effective because we have an antiviral drug targeting a small number of viral infections. Hydroxychloroquine cannot be said to be the most effective, but it is a very good drug for certain patient groups, “says Dr. Janko. Samardzic.
According to him, these are patients who have an acute and turbulent clinical picture in the initial phase of a viral infection. If administered for a long time in patients with autoimmune diseases, it expresses an immunomodular effect and has a very beneficial effect in those patients.
In recent months, Dr. Samardzic says, this situation has reminded us that hydroxychloroquine is a very good medicine if we have a well-selected patient.
It emphasizes that the drug has potential cardiotoxicity, that is, that it can affect the cardiovascular system, and that care must be taken that patients with heart problems use this drug with much more caution or opt for another drug.
When asked if hydroxychloroquine can cause hallucinations, Dr. Samardzic replied that if the drug penetrates the blood-brain barrier, it can have certain effects on the central nervous system. These effects can be expected in a relatively small number of patients.
There are almost no such side effects for hydroxychloroquine because penetration into the central nervous system is less.
When asked which drug was effective in the treatment of coronavirus infection, the doctor said that for him, the drug in prevention that could have the greatest efficacy in preventing the appearance of moderate and severe clinical pictures was vitamin De, for patients who have a deficiency. Vitamin Ce and zinc are important.
“They are substances that have the right place in prevention,” explains a clinical pharmacologist at the Belgrade Faculty of Medicine.
Paracetamol cannot have any harmful effect because it is also given to babies (misconception)
“Paracetamol is an example of a drug that has a favorable safety profile. It is a very safe drug with very few side effects, but it is not a drug without side effects,” emphasizes Dr. Janko Samardzic.
He adds that it can be used in children and adults, in the elderly, but if we overdose, it can cause liver damage.
There is an antidote for acetaminophen poisoning and cases of acetaminophen poisoning have been reported in the literature.
Paracetamol should be used according to the recommended doses. It is recommended to drink for six hours, exceptionally for four hours.
“It is an analgesic, it will reduce mild to moderate pain, fever, and for a more turbulent clinical picture we went to the second line as ibuprofen, which is stronger. It reduces inflammatory processes, lowers the temperature, but also has side effects. It negatively affects the gastric mucosa. when we talk about prolonged use of the drug, ”says Samardzic.
When asked if painkillers can be combined, the doctor says that frequent use of painkillers can lead to a headache that does not react to any painkiller.
“The basic principle, which is simple, but let’s forget it as soon as the signs and symptoms of a headache begin, it is convenient to take the painkiller at an early stage that suits us best,” explains the doctor.
According to him, if two pain relievers are combined, care should be taken to combine those pain relievers that do not add to side effects.
“If you take paracetamol, in certain cases it will affect the liver, if you take ibuprofen, it acts on the stomach by combining those two drugs that have similar effects but diametrically opposite side effects,” Dr. Samardzic specified.
All medications should be taken before meals (misconception)
A clinical pharmacologist points out that no universal rule can be given. We strive to formulate medications so that food has the least effect on it. More and more medications are being taken regardless of meals.
“However, there are always drugs that can be drastically affected by food. Food does not affect the safety aspect but the efficacy of the drug, how much of the dose of the drug we take will actually enter the systemic circulation and have an effect,” he explains the doctor.
He points out that some antibiotics bind calcium, so you shouldn’t carry milk and dairy products with them, or you need to take a two to three hour break.
Most pain relievers are taken with or without food. The general advice, he says, is that whenever you get a chance and when food does not affect the reabsorption of the drug, you should take it with a meal because tolerability is better.
Most drugs that have intensive liver metabolism should not be taken with grapefruit and ginger because they affect metabolism in the liver and alter metabolism.
In some viral infections, antibiotics may be used as part of therapy (true)
“Every viral infection leads to an alteration of the immune system and all other infections begin to flourish in the body, mainly bacteria. A strong viral infection can produce a bacterial infection. We must remember the choice of antibiotics, we must not forget about penicillin preparations “advises Dr. Samarddzic.
Some antibiotics can permanently damage hearing and kidneys (true)
“There are groups of antibiotics, gentamicin and the like, that have side effects on hearing and kidneys, especially in sensitive people. This does not only refer to the elderly but also at a young age. These are effects that will not occur with use short-term, but long-term use can cause side effects, “says Dr. Janko Samardzic.
Depression is not treated with sedatives (true)
The doctor explains that when antidepressants are administered, the effect is expected in two, three or four weeks.
He points out that in those first weeks, until the effect of antidepressants is observed, it is necessary to administer a sedative. As the antidepressant becomes effective, the sedative is discontinued.
“The period that we consider addictive to sedatives is four to six weeks, and in the elderly there is a coordination disorder,” believes the clinical pharmacologist.
Sedatives should not be used with alcoholic beverages (true)
Cases of fatal outcome have been described in the literature when larger amounts of sedatives were taken together with alcohol because both act as central nervous system depressants leading to respiratory depression.
“These drugs will not solve the problem, they can only help you see the problem better in the short term,” says the doctor.
He adds that sedatives should not be stopped suddenly, because those are the symptoms that make us start taking the drug, perhaps even more drastically.
