Combined drug intoxication (CDI), or multiple drug intake (MDI), is a cause of death by

drug overdose A drug overdose (overdose or OD) is the ingestion or application of a drug or other substance in quantities much greater than are recommended. Retrieved on September 20, 2014.

from poly drug use, often implicated in polysubstance dependence.

Risk factors

People who engage in polypharmacy are at an elevated risk of death from CDI. Other dangers of combining drugs such as "brain damage, heart problems, seizures, stomach bleeding, liver damage/ liver failure, heatstroke, coma, suppressed breathing, and respiratory failure", along with many other complications. Disorders like depression and anxiety can also stem from polydrug use. Elderly people are at the highest risk of CDI, because of having many age-related and health problems requiring many medications combined with age-impaired judgment, leading to confusion in taking medications. Elderly patients are often prescribed more than one drug within the same drug class, and doctors may treat the side effects of prescribed drugs with even more drugs, which can overwhelm the patient.

Prevention

In general, the use of multiple drugs should be carefully monitored by a qualified individual such as board certified and licensed

medical doctor A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the study, diagnosis, prognosis ...

, either an MD or DO. Close association between prescribing physicians and pharmacies, along with the computerization of prescriptions and patients' medical histories, aim to avoid the occurrence of dangerous drug interactions. Lists of contraindications for a drug are usually provided with it, either in monographs, package inserts (accompanying prescribed medications), or in warning labels (for OTC drugs). CDI/MDI might also be avoided by physicians requiring their patients to return any unused prescriptions. Patients should ask their doctors and pharmacists if there are any interactions between the drugs they are taking.

Prevalence

In 2004, there were 3,800 deaths in the US resulting from a fatal medication error involving

alcohol Alcohol may refer to: Common uses * Alcohol (chemistry), a class of compounds * Ethanol, one of several alcohols, commonly known as alcohol in everyday life ** Alcohol (drug), intoxicant found in alcoholic beverages ** Alcoholic beverage, an alco ...

, while in 1983 there were fewer than 100 such deaths. It is more of a risk for older patients.

Common combinations

Alcohol

Alcohol Alcohol may refer to: Common uses * Alcohol (chemistry), a class of compounds * Ethanol, one of several alcohols, commonly known as alcohol in everyday life ** Alcohol (drug), intoxicant found in alcoholic beverages ** Alcoholic beverage, an alco ...

can exacerbate the symptoms and may directly contribute to increased severity of symptoms. The reasons for

toxicity Toxicity is the degree to which a chemical substance or a particular mixture of substances can damage an organism. Toxicity can refer to the effect on a whole organism, such as an animal, bacteria, bacterium, or plant, as well as the effect o ...

vary depending on the mixture of drugs. Usually, most victims die after using two or more drugs in combination that suppress breathing, and the low blood

oxygen Oxygen is a chemical element; it has chemical symbol, symbol O and atomic number 8. It is a member of the chalcogen group (periodic table), group in the periodic table, a highly reactivity (chemistry), reactive nonmetal (chemistry), non ...

level causes

brain death Brain death is the permanent, irreversible, and complete loss of Electroencephalography, brain function, which may include cessation of involuntary activity (e.g., Control of ventilation#Control of respiratory rhythm, breathing) necessary to su ...

."Combined Drug Intoxication"
American Outreach. (March 22, 2010).

References

External links

Drug Interactions Checker
at Drugs.com: Drug Information Online
Drug Interaction Checker
at Medscape (registration required) {{Authority control Clinical pharmacology Medical aspects of death Causes of death Substance intoxication