title: Harms from medicines: inevitable, in error or intentional.
abstract: Rational therapeutics requires a balance between benefits and harms. (i) Harm may be inevitable. Some adverse drug reactions cannot be predicted or prevented. (ii) Some harm occurs in error when a medicine is wrongly formulated, prescribed, dispensed or administered. Adverse drug reactions that might have been prevented, for example, by monitoring, fall into this category. (iii) Rarely, harm is inflicted deliberately, for example, in murder by poisoning. Here I consider adverse drug reactions, errors and deliberate drug-induced harm from the perspective of a clinical pharmacologist.
authors.affiliation: West Midlands Centre for Adverse Drug Reactions, City Hospital, Birmingham, B18 7QH; School of Clinical and Experimental Medicine, University of Birmingham, B15 2TT, UK.
authors.forename: Robin E
authors.initials: RE
authors.lastname: Ferner
mesh_terms: D003415:Crime; D004305:Dose-Response Relationship, Drug; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D006801:Humans; D033182:Intention; D008508:Medication Errors / Q000401:mortality / Q000517:prevention & control; D061214:Patient Safety; D011041:Poisoning / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: adverse drug reaction; dose-response; forensic pharmacology; medication error; susceptibility