Side effect

In medicine, a side effect is an effect, whether therapeutic or adverse, that is secondary to the one intended; although the term is predominantly employed to describe adverse effects, it can also apply to beneficial, but unintended, consequences of the use of a drug.

Occasionally, drugs are prescribed or procedures performed specifically for their side effects; in that case, said side effect ceases to be a side effect, and is now an intended effect. For instance, X-rays were historically (and are currently) used as an imaging technique; the discovery of their oncolytic capability led to their employ in radiotherapy (ablation of malignant tumours).

Examples of therapeutic side effects

Possible side effects of nicotine.^[1]

• Bevacizumab (Avastin), used to slow the growth of blood vessels, has been used against dry age-related macular degeneration, as well as macular edema from diseases such as diabetic retinopathy and central retinal vein occlusion.^[2]
• Buprenorphine has been shown experimentally (1982–1995) to be effective against severe, refractory depression.^[3][4]
• Bupropion (Wellbutrin), an anti-depressant, is also used as a smoking cessation aid; this indication was later approved, and the name of the smoking cessation product is Zyban. In Ontario, Canada, smoking cessation drugs are not covered by provincial drug plans; elsewhere, Zyban is priced higher than Wellbutrin, despite being the same drug. Therefore, some physicians prescribe Wellbutrin for both indications.
• Sildenafil was originally intended for pulmonary hypertension; subsequently, it was discovered that it also produces erections, for which it was later marketed.
• Carbamazepine is an approved treatment for bipolar disorder and convulsions, but it has side effects useful in treating attention-deficit hyperactivity disorder (ADHD), schizophrenia, phantom limb syndrome, paroxysmal extreme pain disorder, neuromyotonia, and post-traumatic stress disorder.^[5]
• Dexamethasone and Betamethasone in premature labor, to enhance pulmonary maturation of the fetus.^[6]
• Doxepin has been used to treat angiodema and severe allergic reactions due to its strong antihistamine properties.^[7]
• Gabapentin, approved for treatment of seizures and postherpetic neuralgia in adults, has side-effects which are useful in treating bipolar disorder1, essential tremor, hot flashes, migraine prophylaxis, neuropathic pain syndromes, phantom limb syndrome, and restless leg syndrome.^[8]
• Hydroxyzine, an antihistamine, is also used as an anxiolytic.
• Magnesium sulfate in obstetrics for premature labor and preeclampsia.^[6]
• Methotrexate (MTX), approved for the treatment of choriocarcinoma, is frequently used for the medical treatment of an unruptured ectopic pregnancy.^[9]
• The SSRI medication sertraline is approved as an anti-depressant but delays conjugal climax in men, and thus may be supplied to those in which climax is premature.^[10]

Examples of undesirable/unwanted side effects

• Echinacea – more than 20 different types of reactions have been reported, including asthma attacks, loss of pregnancy, hives, swelling, aching muscles and gastrointestinal upsets.
• Feverfew – pregnant women should avoid using this herb, as it can trigger uterine contractions. In animal experiments, the use of feverfew was found to trigger spontaneous abortions (miscarriages).
• Asteraceae plants – which include feverfew, echinacea, dandelion and chamomile. Side effects include allergic dermatitis and hay fever.

References

1. Detailed reference list is located on a separate image page.
2. Boseley, Sarah (2006-06-17). "Drugs firm blocks cheap blindness cure". The Guardian (London). Retrieved 2010-05-20.
3. Gracer, Richard (February 2007). "The Buprenorphine Effect on Depression" (PDF). naabt.org. National Alliance of Advocates for Buprenorphine Treatment. Retrieved 19 September 2015.
4. Bodkin, JA; Zornberg, GL; Lukas, SE; Cole, JO (1995). "Buprenorphine Treatment of Refractory Depression". Journal of Clinical Psychopharmacology 15: 49–57. doi:10.1097/00004714-199502000-00008. PMID 7714228.
5. Mood Stabilizers for Bipolar Disorder (Manic Depressive). Leeheymd.com (2003-08-01). Retrieved on 2011-08-17.
6. Wing, DA; Powers, B; Hickok, D (2010). "U.S. Food and Drug Administration Drug Approval: Slow Advances in Obstetric Care in the United States". Obstetrics & Gynecology 115 (4): 825–33. doi:10.1097/AOG.0b013e3181d53843. PMID 20308845.
7. Shen, WW; Mahadevan, J; Hofstatter, L; Sata, LS (July 1983). "Doxepin as a potent H2 and H2 antihistamine for epigastric distress". Am J Psychiatry 140 (7): 957–8. doi:10.1176/ajp.140.7.957. PMID 6859336.
8. Off-label Use of Gabapentin, Idaho Drug Utilization Review, educational leaflet, 2004.
9. "Pregnancy". drugs.nmihi.com. (New Medical Information and Health Information). Archived from the original on 11 October 2008.
10. Deem, Samuel G. "Premature Ejaculation". Emedicine.com. Retrieved 2011-08-17.

External links

• MedEffect Canada (Health Canada)
• definitions.pdf