Everyday Toxicology – The dose makes the poison & the cure

In this post, we'll cover the basics in ensuring you're taking the correct doses to get the maximum benefit.

Last week we covered dose and dose-rates. We know they are essential to ensuring medications, vaccines, and more work properly, but why? And how do researchers figure this out? In this post, we'll cover the basics in ensuring you're taking the correct doses to get the maximum benefit. 

What makes something a cure vs. a poison?

There is an adage in the toxicology community that says, "the dose makes the poison." Most ingredients we consume can cause harm when consumed in large enough quantities. For example, water can be toxic when Subscribe for weekly updates_ go.msu.edu/cris-connectconsumed in high enough quantities. 
A medication that can help us can also poison us if we consume too much of the potent compounds too quickly. While it's hard to over-consume water, one can very easily take too many medications unintentionally because medications are designed to interact with the body in small, yet potent quantities.
It's critical to follow the directions for all medications to prevent accidental harm. 

Why do doses matter?

The correct dose of a medication can cure you of a bacterial infection, the incorrect dosage or a dose taken incorrectly could cause the infection to get worse, or cause you to experience undesirable side-effects.
The dosage of medication you consume is necessary because drugs have different thresholds that produce different perceivable responses. Medications are designed to help you get the correct therapeutic dose with minimal adverse side-effects.

How do we know the therapeutic dose? 

Experts designing medications look at the optimal effect a particular drug can produce. These are broken down into primary effects and secondary effects. 

  • Primary effects are the reason you may take a specific medicine. For example, if you have a fever, you may take acetaminophen (e.g., Tylenol) to help reduce your temperature. 
  • Secondary effects are the other effects (e.g., side-effects) that a medication cause. These are not always adverse effects; sometimes, they are beneficial depending on your needs. 

Continuing with our acetaminophen example, a secondary effect of this medication is a reduction in pain. If you have a terrible cold that's causing a fever, you may be experiencing body aches too. In that case, you may welcome the secondary, pain-relieving effect of the acetaminophen. Other secondary effects of acetaminophen are undesirable, such as nausea.

If I take more than the recommended dose, will I get a greater benefit?

In most cases, no, you will not experience more significant benefits. The therapeutic dose or recommended doses are designed to give you the greatest primary effect. Increasing the dose doesn't necessarily increase the primary effect, but it can increase the adverse secondary effects that can be dangerous. 
Continuing with our acetaminophen example, if you consume more than the optimal dose, the medication may not reduce your fever quicker or decrease your pain more significantly. If you take more than recommended, you can experience a toxic effect, including severe liver damage that can lead to transplant or death. 

Why should I take one medication over another?

Medications may produce the same primary effects but have significantly different secondary effects, or they could be processed in different organs of the body (e.g., one drug may be primarily processed in the liver, another in the kidneys, etc.). 
Medical professionals will consider the different primary, secondary, and toxic effects of a drug as well as how the body processes the drug before prescribing or recommending them to patients. They will also recommend a specific dose and dose-rate to ensure patients receive the optimal therapeutic benefit without experiencing adverse secondary or toxic effects. 

How do I figure out what medication is best for me, and what dose to take?

Medical professionals, such as doctors and pharmacists, are trained and equipped to recommend or prescribe the correct drug, accurate dosage, and dose-rate of medicine to help treat an ailment. 
Even when considering taking over the counter medications, it's wise to talk with a pharmacist to ensure you're taking a medication that will treat your symptoms and will not contain ingredients that could interact with other drugs you're taking. 

What happens if I overdose myself or another?

Over-dosage can be fatal. If you suspect you or someone you know has potentially taken a life-threatening overdose of medication, contact emergency services immediately. 
If it's a less serious matter, you can contact your local pharmacist or your poison control center.


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