Medication-induced performance decrements: cardiovascular medications
Article Abstract:
The impact and incidence of the side effects of cardiovascular drugs on work performance are reviewed. Cardiovascular disease affects many adults in the US, and frequently the job performance of workers who are being treated with cardiovascular agents is compromised. Prior to approval by the Federal Food and Drug Administration, a drug is evaluated for adverse side effects. The complications that are primarily considered are those that would necessitate discontinuation of the drug. Not enough attention has been focused on the potential occupational and recreational impairments that may also be a result of the drug. Because cardiovascular disease affects so many individuals (about six million have coronary artery disease), a significant portion of the workforce takes medication for this condition. Other common cardiovascular disorders are high blood pressure and arrhythmias (irregular heart beat). Some of the major categories of cardiovascular agents that have been examined are beta blockers, calcium channel blockers, vasodilators, lipid-lowering agents, and diuretics. Beta blockers, calcium blockers, and vasodilators are known to cause dizziness and vertigo. Occupational conditions such as excessive heat may induce dizziness or cause fainting. This might have serious consequences for those in occupations such as fire fighters, policemen, and heavy-equipment operators. Diuretics can cause mental confusion; beta blockers frequently result in symptoms of weakness and fatigue. A number of cardiovascular medications have been associated with psychiatric side effects, such as psychosis, hallucinations, and anxiety or depression. Motor and sensory can also occur. The physician must perform a careful evaluation of the patient, taking into account the patient's occupation, lifestyle, and the potential side effects of any prescribed medication. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1990
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Laboratory study of drug-related performance changes
Article Abstract:
It has long been held that the use of both illicit and therapeutic drugs in the workplace has serious safety repercussions. However, most of the conclusions in this area have been reached on the basis of laboratory tests, rather than measurements of skill performance in the work environment. There are two major aspects to evaluating performance impairments: the actual measurement of the impairments resulting from drug use, and recognition of this impairment in the employee. An overview of this first aspect is presented and discussed. The stimulus-response model is frequently used to assess the effect of a drug. Other factors that must be specified include sample size, statistical significance, dose levels, and drug combinations. Instruments that measure the effects of a drug on sensory perception, response and function are useful. A number of experimental trials on some common drugs are described. One experiment examined the effects of diazepam, a tranquilizer, and alcohol separately and in combination; a placebo control was also used. Both diazepam and alcohol impaired performance, and when combined the extent of impairment was even greater. Another area that has been investigated is the effect of drugs on the cardiovascular system, measured in terms of heart rate, blood pressure, and peripheral vascular resistance. Cardiovascular irregularities may result in dizziness and irregular heat beat, which can directly or indirectly affect performance. Identification of medication-induced impairment in the workplace is often difficult. Along with efficacy and adverse effects of a drug, assessment of performance impairment is very important; continued experimentation will provide helpful data for better assessing all of the risks associated with therapeutic drugs. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1990
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Antihistamine- and decongestant-induced performance decrements
Article Abstract:
One of the most common health problems in the U.S. is allergies, which affect one in every six individuals. Fifty years ago, antihistamines were introduced and are now taken by about 30 million people each year. Antihistamines work by minimizing the effects of histamine, an inflammatory mediator that is released as a part of the body's immune response. Symptoms typically include itching, mucus secretion, and vascular leakage. Antihistamines are rapidly absorbed and usually produce relief of symptoms within about 15 to 30 minutes, and the effects last for about five to six hours. The pharmacological aspects of this class of drug are discussed. Most antihistamines are available without prescription, since the side effects are usually not dangerous. However, some serious adverse effects involving the central nervous system have been reported, such as depressive reactions (sedative effects) or other psychiatric complications (paranoid psychosis and schizophrenic-like symptoms). Drowsiness is the most frequently reported side effect and is usually dose-related. Other known side effects are stimulatory reactions such as muscle spasms, insomnia, nervousness and tremor; peripheral reactions may include paralysis, reflex impairment, and blurred vision. A number of laboratory experiments are discussed which have measured the effect of antihistamines on motor function and performance. Decongestants are another class of drugs that are widely available and are used to treat upper respiratory symptoms. Fewer side effects are associated with decongestants. Based on available data, decongestants do not seem to cause performance impairment, but they are associated with insomnia. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Journal of Occupational Medicine
Subject: Health care industry
ISSN: 0096-1736
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
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