Effect of blind treatment on stone disease.
Most of the drugs administered to stone patients appear to be inappropriate and doing more harm than good to the patients. The objective of this paper is to identify the prevalence of blind chemotherapy among the stone patients and find out the real indication for the drugs administered. Patients who attended the stone clinic for the first time were interviewed to find out what drugs they had been taking before the attendance at the stone clinic. 350 patients consuming specific drugs relevant to stone formation at least for a period of 15 days were selected for a detailed assessment. The type of drug consumed, the dose, the duration, the side effects, compliance rate and effect on stone disease were assessed. The biochemical profile of the patients was assessed to identify the role of the therapeutic modalities utilised. Conclusions regarding the utility of drugs in the process of stone formation were made. The values were compared with those of patients not on medication and considering laboratory standards. Of the 350 patients studied, 96 patients were consuming potassium citrate in different doses, 50 were consuming allopurinol, 44 cystone, 27 potassium citrate + magnesium, 25 calcury, 24 rowatinex, 21 ayurvedic drugs, 17 dystone, 17 homeopathic medicines and 17 other drugs. The longest duration of compliance was for cystone-2.5 years. All other drugs were stopped by the patients themselves due to recurrence of symptoms. As much as 93% of the patients did not feel that there was any significant relief of symptoms. The side effects which prompted the patients to stop medicine were gastro intestinal upset, particularly with potassium citrate, rowatinex and potassium citrate + magnesium combination. The relevant biochemical changes noted were increased urinary citrate levels in patients consuming potassium citrate alone or in combination with magnesium. Serum uric acid was within normal limits in patients consuming allopurinol. Urine uric acid levels were also lower in patients on allopurinol. It is concluded that most of the drugs administered blindly were neither indicated nor beneficial for the patients. Metabolic correction has to be based on proper metabolic assessment.
Fazil Marickar
Y M
YM
Department of Surgery, Zensa Hospital, Trivandrum, 695009, India. fazilmarickar@hotmail.com
Salim
Abiya
A
Vijay
Adarsh
A
D000963:Antimetabolites / Q000627:therapeutic use*; D004232:Diuretics / Q000627:therapeutic use*; D006801:Humans; D007669:Kidney Calculi / Q000188:drug therapy*; D019357:Potassium Citrate / Q000627:therapeutic use; D016037:Single-Blind Method; D052878:Urolithiasis / Q000188:drug therapy* / Q000517:prevention & control
D000963:Antimetabolites; D004232:Diuretics; D019357:Potassium Citrate