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Iatrogenic Disease - Medically-Induced Disease Iatrogenesis Disease that is caused by medical intervention is termed 'iatrogenic'. This means that anything ranging from damage caused by an ill-fitting plaster cast to drug side-effects or long-term results of drug overuse will fall under this banner. Side-effects of drugs, misuse of drugs, harmful drug combinations, medical negligence, medical error or misjudgement, contravention of contra-indications and nosocomial disease (one acquired in hospital) can all constitute iatrogenic disease. Of course, when a guiding motto of medicine is: "first do no harm" (primum non nocere), it can be difficult to accept the notion of medically-induced harm. However, powerful interventions cannot be without risk. Nonetheless, this phenomenon represents a serious and widespread welfare problem. Should there ever be an adverse reaction to a drug or treatment or a 'suspect' or 'possible' adverse reaction, this should be reported to the Veterinary Medicines Directorate forthwith, on a yellow form (MLA252a), by visiting www.vmd.gov.uk. http://www.vmd.gov.uk/Publications/SARSS/sarss.pdf (Guidance) http://www.vmd.gov.uk/General/Adverse/animal2.pdf (Guidance) http://www.defra.gov.uk/corporate/regulat/forms/vetmed/mla252a.pdf (Form MLA252A) http://www.vmd.gov.uk/General/Adverse/mal252.pdf (Form MLA252A) Notable examples in the veterinary field are: Disturbed bowel flora - when caused by antibiotic usage (this effect can be so severe as to be lethal in some species - e.g. penicillin-type antibiotics in guinea pigs and some oral antibiotics in horses and cattle). Dry eye in dogs - when caused by using sulphasalazine for colitis. Laminitis in horses and ponies - when caused by steroid treatment (corticosteroid, cortisone). Cushing's Syndrome in dogs - when caused by overlong usage of steroids. Arthus reaction in dogs - when caused by sudden violent reaction to an injection (seen several times with a heat prevention hormone injection). Vaccination reactions in all species - reactions at the site of injection are not uncommon; horses can react over their whole neck area, when injected in the neck. Vaccinosis in all species - the long term ill-effects of vaccination (not usually recognised or accepted by the conventional world). Myelosuppression (aplastic anaemia - reduction in red blood cell production) - when caused by chloramphenicol antibiotic. Vestibular nerve (8th cranial nerve) damage - when caused by some antibiotics. Neurological disorders - when caused by organophosphate-containing medications. Immune hypersensitivity - when induced by use of trimethoprim-sulphadiazine antibiotics. Cartilage changes and joint destruction in foals and young horses - when caused by enrofloxacin or other fluoroquinolone antibiotics given to young horses or pregnant mares. Birth defects - when caused by drug administration during pregnancy. Liver toxicity - when caused by long-term phenobarbitone administration. Gastro-intestinal ulceration - when caused by non-steroidal anti-inflammatory drugs (NSAIDs). Fatality (or neurological damage) in Collies - when caused by ivermectin-type drugs (link). Any drug side-effect or Adverse Drug Event (ADE) can be termed iatrogenic. Of course, there is such a thing as iatrogenic death, too, when the reaction is fatal (e.g. penicillin-type antibiotics in guinea pigs and some other rodents). Happily, this type of risk has not been shown to accompany the use of homeopathy. See also: Side-Effects : Animal Experiments : Vivisection Copyright © AVMC - December 2007 |
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