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Treating chronic diseases: Medications and side effects

According to the Centers for Disease Control and Prevention (CDC), chronic diseases (i.e. heart disease, cancer, diabetes, etc.) are the leading causes of death and disability in the United States.  

The CDC further states that 7 out of ten deaths each year are from chronic diseases, with heart disease, cancer and stroke accounting for more than 50 percent of all deaths each year.  A majority of these diseases have numerous causes, most preventable; lack of physical activity, poor nutrition, tobacco use and excessive alcohol consumption are the most common culprits.

For those chronic conditions which cannot be treated with lifestyle remedies, medications are often prescribed.  With 133 million Americans having at least one chronic disease, it should not come as a surprise that many of these people are on multiple medications for these conditions.  

Furthermore, each medication has its own side effects; so in combination, some medications may interact with another, thus rendering one ineffective or even hyper-effective.  Here we will discuss the most common chronic diseases, the most common medications and their associated side effects.

Heart disease

Heart disease is the leading cause of death in both men and women.  Hypertension, high cholesterol, obesity, and diabetes, in addition to the four culprits mentioned above, are the most common risk factors for heart disease.  

Aspirin is the most commonly used medication for primary and secondary prevention of heart disease.  The most common side effect associated with aspirin is an increased risk of gastrointestinal bleeding.  

Statins are used to aid in high cholesterol patients and carry side effects including: hepatic (liver) dysfunction, muscle injury/toxicity, renal (kidney) dysfunction and glucose metabolism issues (leading to diabetes).

Hypertension can be treated by a few medications including angiotensin converting enzyme (ACE) inhibitors, diuretics, calcium channel blockers and beta-blockers, all of which have their respective side effects.  

ACE inhibitors may be associated with hypotension (weakness, dizziness); hyperkalemia (high plasma potassium concentration); a dry, hacking cough; and are not recommended for use during pregnancy.  

Side effects of diuretics include: low blood sodium (hyponatremia); dizziness; headaches; increased thirst; muscle cramps; increased cholesterol; gout; and impotence.  

Calcium channel blockers can be associated with constipation; headache; rapid heartbeat (tachycardia); and dizziness.  

Beta-blockers carry the possible side effects of fatigue; cold hands; headache; upset stomach; constipation; diarrhea; and dizziness.

Cancer

According to the National Cancer Institute, over 1.5 million new cases of cancer will be diagnosed in the U.S. this year.  It is the second most common cause of death after heart disease; every day, more than 1,500 people will succumb to it.  

Lung cancer is the leading cause of cancer death among both men and women, while prostate cancer in men and breast cancer in women are the most commonly diagnosed cancers.

Chemotherapy is one of the most common treatments for cancer.  During chemotherapy treatment, the following side effects can occur: nausea; vomiting; diarrhea; hair loss; loss of appetite; fatigue; and easy bruising.  

Sometimes, the side effects of chemotherapy are not evident until long after treatment.  These include: damage to lung tissue; heart problems; infertility; kidney problems; nerve damage (peripheral neuropathy) and risk of a second cancer.

Diabetes

According to the CDC, an estimated 25.8 million (8.3 percent) Americans have diabetes.  Of these, 7 million people are undiagnosed.  Among those diagnosed, type 2 diabetes accounts for approximately 90 percent of all cases.  

Diabetes is a leading cause of heart disease and stroke and is the seventh leading cause of death in the U.S.  The exact causes of both type 1 and type 2 diabetes remain unknown; however, in the case of type 2, most risk factors are modifiable including: increased weight; physical inactivity; having high blood pressure; having abnormal cholesterol levels; and having high levels of triglycerides.

Depending on the type of diabetes, the treatment plan will differ; however, all will begin with lifestyle changes such as weight loss, physical activity, healthy diet and monitoring blood sugar levels.  

If these are not effective, sulfonylureas are often the first line of medication.  Side effects often include hypoglycemia; nausea; skin reactions (photosensitivity); and abnormal liver function.  
Metformin is often used as the next medication and side effects include: diarrhea; nausea/vomiting; flatulence; and muscular weakness.  

Insulin is often the last line of medication and can be injected when needed or can be injected via a pump automatically.  Side effects may include: low blood sugar; reaction at the injection site; seizures; and confusion.

Always make sure your physician is aware of all medications you are taking and their dosages.  If you are on one or more medications, be sure to check with your doctor and/or pharmacist to ensure there are no drug interactions.  

Speak with your doctor to find out if you can make any lifestyle changes to avoid taking medication.  If this is not an option, make sure to strictly adhere to the instructions on your medication.

Dr. David B. Samadi is the Chairman of the Department of Urology and Chief of Robotic Surgery at Lenox Hill Hospital in New York City. He is a board-certified urologist, specializing in the diagnosis and treatment of urological disease, with a focus on robotic prostate cancer treatments. Dr. Samadi joined Fox News Channel in 2009 as a medical contributor. To learn more please visit his websites RoboticOncology.com and SMART-surgery.com. Find Dr. Samadi on Facebook.