In the area of prescription and OTC (over the counter) medications, your
doctor is provided with a system of checks and balances which is in
place to insure that you are protected from adverse reactions to drugs.
This system has two main components:  1) the Physician's Desk Reference
(PDR) which you doctor can consult for interactions and side effects of
drugs, and which exists in both hardbound and computerized form; and
2) your pharmacist, who is trained and charged by law to review
prescriptions and notify your doctor of any reason why a prescription
should not be filled, and to advise customers on OTC medications
similarly.  He/she also relies on the PDR for this information.

It would seem that this system provides the public with significant
protection from inappropriate drug combinations or single prescriptions,
and offers the consumer the opportunity to obtain, for the asking,
similar levels of safety on OTC medications.  The information below,
taken directly from the PDR, indicates otherwise.

It seems that whether or not a product causes adverse side effects
and/or has adverse interactions with other products depends upon what
the manufacturer decides to say about the product.  As a sample, here is
some information directly from the PDR on ibuprofen.  Note that all
brand names listed below contain ibuprofen only.  This medication is
commonly used as an OTC pain killer; all versions listed are identical
in chemical content and quality, and all are within the same safety
range for dosage level.  The only differences are brand names and what
the manufacturer publishes as side effects.

If you buy Nuprin, you are told that the only side effect is "fetal
problems, unspecified", leading you to believe that if you are not a
pregnant female, the product is completely safe.  Motrin IB caplets and
Ibuprohm have the same information.  Midol adds the possibility of
delivery problems to the list, so again only pregnant females seem to be
at risk.  If you buy Haltran, you are told that ibuprofen causes fetal
problems plus heartburn, stomach ache, and gastrointestinal disorders;
if you buy Dristan, you are told that ibuprofen causes delivery
problems (the dizziness, insomnia, and nervousness listed comes from the
caffeine added to counteract the effects of the antihistimine content).
If you buy adult strength Advil, delivery problems and fetal harm are
listed.  BUT if you buy Pediaprofen, plain old Motrin, IBU, or children's
Advil, you are given a list of nearly one hundred side effects, ranging
from hemolytic anemia to liver failure to kidney damage to skin rash, most
of which affect less that 1% of those who take it but some of which have
been documented in scientific studies as affecting 9% of those who take
it, and some are listed simply as "common" reactions.  Figure this into
the number of people who use the drug daily and you have the possibility
of over nine million serious side effects per day in this country alone.

I have no desire to address the pharmaceutical industry hype about being
forced to list rare side effects.  The problem demonstrated above is
that the information contained in the PDR is not reliable, since it
depends upon the manufacturer.  The bottom line is that if ibuprofen
causes, for example, hemolytic anemia, this fact should be listed for
all ibuprofen, not just a few brands.  Since it is not, and since this
problem exists for virtually all medications listed in the PDR, your
doctor and your pharmacist cannot rely upon the PDR for information with
which to protect you from adverse drug side effects or interactions, and
with several thousand new drugs entering the market every year, not even
the most experienced physician can rely upon his knowledge to make up
for what the PDR does not contain.  Caveat Emptor.

How can YOU get around this problem?  Only partially...by using the PDR
yourself, cross-referencing all brand names of each chemical formulation,
and using all information combined to form your picture of chemical
effects and interactions.  Yes, to do this WELL you need to have
completed medical, chiropractic, or osteopathic school or be a
microbiologist, research chemist, or exceptionally well trained Ph.D. in
pharmacology, plus have enough working knowledge of true scientific
method (rare) to spot the bias, unsupportable conclusions, and other
bull$#!+ in research reports.  But anyone can learn enough from the PDR
to ask further questions, and to demand complete answers from
pharmaceutical companies (even though you won't get them) and from those
health care professionals you pay to assist you.

For those of you who are keyboard freaks, the complete PDR is available
on disk from Medical Economics Data of Montvale, NJ.  It makes the task
of drug information search a whole lot easier than flipping all over the
place in a strangely indexed book.

How else can you get around this problem?  Get to know the alternatives
to chemical "health care".  Learn what you can do yourself to reduce or
eliminate your dependence on pharmaceuticals, both prescription and OTC.
Learn about Chinese accupuncture, chiropractic, homeopathy, your immune
system, and nutrition.  Learn how your body is affected by environmental
exposures, and what you can do to counteract or avoid them.  Learn by
networking with others who are learning.  Find out how the guy or gal
or family down the street or on your local BBS has been able to enjoy
good health completely without pharmaceuticals for the last year or
decade.  Maybe you'll even become the pharmaceutical industry's worst
nightmare - a non-consumer!  Then you won't need that PDR any more.