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Worried about prescription drugs? How to weigh your risk? When the pain reliever Vioxx was withdrawn from the worldwide mark

admin2010-10-14  24
问题              Worried about prescription drugs? How to weigh your risk?
    When the pain reliever Vioxx was withdrawn from the worldwide market last September after the announcement that it increased patients’ risk of heart attacks and strokes, millions panicked. Suddenly, ads for the drug were replaced with ads looking for Vioxx "victims". Not only did patients stop taking Vioxx but, doctors say, many people stopped taking their other medicines, too—sometimes putting their health at serious risk. The sometimes-sensationalized headlines didn’t help. People wondered. Should I trust my doctors? Could what I thought would help me actually kill me? Is the drug safety system broken?
    Americans have somehow come to believe they should get the best medical care with the latest remedies with no side effects. But there is no drug that doesn’t have side effects. Peter Corr, head of worldwide research and development for drug manufacturer Pfizer says, "As a society we expect medicine to be perfect. There is no such thing. There is always a risk."
                        How You Can Make Informed Decisions
    Since there is no such thing as a pill that is completely safe, including aspirin, consumers have to accept the dichotomy(一分为二)that the same medicines that extend and enhance our lives may hurt us; some of them may merely have minor side effects, while others are able to cause death. So how should you and your doctor proceed?
    1. Weigh the risks and benefits of any drug. As a smart consumer you must decide whether a drug is "safe enough" for you. The greater the benefit, the more risk you may be willing to take. If your illness is mild and not very bothersome, you may decide that any risk is too big and opt against taking any medications at all. On the contrary, if your illness is serious or potentially life threatening, you may even be willing to try an experimental drug with greater risk for serious side effects.
    Zena McAdams, 59, a regional clergyman in Macon, Georgia, has lived with a condition that causes chronic pain for many years. For a long time she took OTC ibuprofen(布洛芬,一种镇痛非处方药), "I mean lots of it," she says. In the spring of 2001, her doctor prescribed Vioxx. Taken only once a day, it was "remarkable," she says. "I took it every day till it was taken off the market."
    After speaking to her doctor, she switched to Celebrex last October. It was also effective in controlling the aches and pains associated with her condition—until she heard concerns that it, too, had serious potential side effects. She talked to her doctor, weighed the risks versus the benefits and decided that her quality of life was most important. "There is always that nasty feeling about safety," she says, "but there is no reason to think that I have any heart problems. The benefits at this point in my life certainly outweigh the risks. The drug works. It eases the pain."
    2. Be especially cautious about new drugs. New drugs are inherently risky. So if you’re taking one, monitor yourself carefully. Have your eating and digestive habits changed? Are you feeling unusually tired or agitated? Have your breathing patterns or skin color changed? If so, call your doctor immediately, who may tell you to stop taking the drug. How does a consumer know that a drug is new? Ask your doctor or pharmacist(药剂师)?
    If you have a choice between two or more equally effective drugs, choose the one with a longer track record of safety. If you are taking a drug in the same class as one that has been recalled, it is careful to ask your doctor if that drug places you at greater risks.
    3. Know if you’re in a high-risk group. Although scientists still don’t know precisely why, certain individuals have bad reactions to a drug or to a particular dose of a drug, while others don’t. Men metabolize(新陈代谢)drugs differently than women do, for example. Be especially watchful if you are very young, very old or pregnant. Drugs usually aren’t tested on these groups. "I worry the most about the elderly," says Avorn. "They are vastly under-represented in trials of drugs, yet they are the most likely to be taking the drugs when they are approved."
    4. Ask the right questions. When you get a new prescription, never leave the doctor’s surgery without a clear understanding of why you’re taking the drug, how to take it, and how you’ll know if it’s working. Even if it makes you a bit uncomfortable, ask. You are responsible for your own health and safety. "If the doctor doesn’t want to answer questions, you should probably find an other doctor," says Avorn.
    After your visit, if you still have questions, call or e-mail the doctor. Use your pharmacist as an expert consultant for any additional concerns you have about the drug or its side effects.
    You can ask the pharmacist for the professional package insert(插页)for the drug, says Corr. Although it’s written for health care providers, it includes information on clinical trials and side effects. Also, if there’s been a label change, with new information about the drug or any warnings, it will be part of the PPI(保险证明). Or request more consumer-friendly information, which should tell you how to use the drug properly and warn of any precautions. You can also call the drug company’s toll-free number for more information, or go to its web-site.
    5. Be informed, and follow directions carefully. Check that the pills you receive are the correct ones. Errors crop up in the dispensing of medications: It’s easy to confuse products with similar names(for example, Zantac and Xanax).
    Read the instructions and take your pills exactly as prescribed. Be alert for expiration dates, and stay attentive to recalls and warnings. Tell your doctor about any other medications you take, either prescribed or OTC(over the counter). Drug interactions can cause serious problems. For ex ample, Posicor, an anti-hypertensive drug(治疗高血压的药), was taken off the market because it could cause blood pressure to drop sharply when used with other heart medications. If you fill all your prescriptions at the same store, the pharmacist may be able to warn you of known interactions.
    It is vitally important that patients and their doctors provide feedback to manufacturers and regulators if they have any suspicion of a problem. Then these signals will be known and can be analyzed to see if they are more widespread, which could save lives.
The reason is still ______ why certain individuals have bad reactions to a drug or to a particular dose of a drug, while others don’t.
选项
答案not precisely known
解析 空白处可能是形容词、名词或动词的被动语态。对比分析二者，可以看出答案应该是not precisely known，或者也可改写为precisely unknown。
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