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class="vector-toc-numb">3.1</span> <span>Medical procedures</span> </div> </a> <ul id="toc-Medical_procedures-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Medications" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Medications"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2</span> <span>Medications</span> </div> </a> <ul id="toc-Medications-sublist" class="vector-toc-list"> <li id="toc-Examples_with_specific_medications" class="vector-toc-list-item vector-toc-level-3"> <a class="vector-toc-link" href="#Examples_with_specific_medications"> <div class="vector-toc-text"> <span class="vector-toc-numb">3.2.1</span> <span>Examples with specific medications</span> </div> </a> <ul id="toc-Examples_with_specific_medications-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> </ul> </li> <li id="toc-Controversies" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" 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Available in 20 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-20" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">20 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D8%A3%D8%AB%D8%B1_%D8%B6%D8%A7%D8%A6%D8%B1" title="أثر ضائر – Arabic" lang="ar" hreflang="ar" data-title="أثر ضائر" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-ca mw-list-item"><a href="https://ca.wikipedia.org/wiki/Efecte_advers" title="Efecte advers – Catalan" lang="ca" hreflang="ca" data-title="Efecte advers" data-language-autonym="Català" data-language-local-name="Catalan" class="interlanguage-link-target"><span>Català</span></a></li><li class="interlanguage-link interwiki-cs mw-list-item"><a href="https://cs.wikipedia.org/wiki/Ne%C5%BE%C3%A1douc%C3%AD_%C3%BA%C4%8Dinek" title="Nežádoucí účinek – Czech" lang="cs" hreflang="cs" data-title="Nežádoucí účinek" data-language-autonym="Čeština" data-language-local-name="Czech" class="interlanguage-link-target"><span>Čeština</span></a></li><li class="interlanguage-link interwiki-et mw-list-item"><a href="https://et.wikipedia.org/wiki/K%C3%B5rvaltoime" title="Kõrvaltoime – Estonian" lang="et" hreflang="et" data-title="Kõrvaltoime" data-language-autonym="Eesti" data-language-local-name="Estonian" class="interlanguage-link-target"><span>Eesti</span></a></li><li class="interlanguage-link interwiki-el mw-list-item"><a href="https://el.wikipedia.org/wiki/%CE%91%CE%BD%CE%B5%CF%80%CE%B9%CE%B8%CF%8D%CE%BC%CE%B7%CF%84%CE%B7_%CE%B5%CE%BD%CE%AD%CF%81%CE%B3%CE%B5%CE%B9%CE%B1" title="Ανεπιθύμητη ενέργεια – Greek" lang="el" hreflang="el" data-title="Ανεπιθύμητη ενέργεια" data-language-autonym="Ελληνικά" data-language-local-name="Greek" class="interlanguage-link-target"><span>Ελληνικά</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Efecto_adverso" title="Efecto adverso – Spanish" lang="es" hreflang="es" data-title="Efecto adverso" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-eu mw-list-item"><a href="https://eu.wikipedia.org/wiki/Kontrako_efektu" title="Kontrako efektu – Basque" lang="eu" hreflang="eu" data-title="Kontrako efektu" data-language-autonym="Euskara" data-language-local-name="Basque" class="interlanguage-link-target"><span>Euskara</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A7%D8%AB%D8%B1_%D9%86%D8%A7%D9%85%D8%B7%D9%84%D9%88%D8%A8" title="اثر نامطلوب – Persian" lang="fa" hreflang="fa" data-title="اثر نامطلوب" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-fr mw-list-item"><a href="https://fr.wikipedia.org/wiki/Effet_ind%C3%A9sirable" title="Effet indésirable – French" lang="fr" hreflang="fr" data-title="Effet indésirable" data-language-autonym="Français" data-language-local-name="French" class="interlanguage-link-target"><span>Français</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EC%9C%A0%ED%95%B4%ED%9A%A8%EA%B3%BC" title="유해효과 – Korean" lang="ko" hreflang="ko" data-title="유해효과" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-id mw-list-item"><a href="https://id.wikipedia.org/wiki/Efek_samping" title="Efek samping – Indonesian" lang="id" hreflang="id" data-title="Efek samping" data-language-autonym="Bahasa Indonesia" data-language-local-name="Indonesian" class="interlanguage-link-target"><span>Bahasa Indonesia</span></a></li><li class="interlanguage-link interwiki-la mw-list-item"><a href="https://la.wikipedia.org/wiki/Effectus_adversus" title="Effectus adversus – Latin" lang="la" hreflang="la" data-title="Effectus adversus" data-language-autonym="Latina" data-language-local-name="Latin" class="interlanguage-link-target"><span>Latina</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E6%9C%89%E5%AE%B3%E4%BD%9C%E7%94%A8" title="有害作用 – Japanese" lang="ja" hreflang="ja" data-title="有害作用" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-pt mw-list-item"><a href="https://pt.wikipedia.org/wiki/Efeito_adverso" title="Efeito adverso – Portuguese" lang="pt" hreflang="pt" data-title="Efeito adverso" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%9D%D0%B5%D0%B6%D0%B5%D0%BB%D0%B0%D1%82%D0%B5%D0%BB%D1%8C%D0%BD%D0%BE%D0%B5_%D1%8F%D0%B2%D0%BB%D0%B5%D0%BD%D0%B8%D0%B5" title="Нежелательное явление – Russian" lang="ru" hreflang="ru" data-title="Нежелательное явление" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-simple mw-list-item"><a href="https://simple.wikipedia.org/wiki/Adverse_effect_(medicine)" title="Adverse effect (medicine) – Simple English" lang="en-simple" hreflang="en-simple" data-title="Adverse effect (medicine)" data-language-autonym="Simple English" data-language-local-name="Simple English" class="interlanguage-link-target"><span>Simple English</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%9D%D0%B5%D0%BE%D1%87%D0%B5%D0%BA%D0%B8%D0%B2%D0%B0%D0%BD%D0%B8_%D0%BD%D0%B5%D0%B6%D0%B5%D1%99%D0%B5%D0%BD%D0%B8_%D0%B4%D0%BE%D0%B3%D0%B0%D1%92%D0%B0%D1%98_(%D0%BC%D0%B5%D0%B4%D0%B8%D1%86%D0%B8%D0%BD%D0%B0)" title="Неочекивани нежељени догађај (медицина) – Serbian" lang="sr" hreflang="sr" data-title="Неочекивани нежељени догађај (медицина)" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Advers_etki" title="Advers etki – Turkish" lang="tr" hreflang="tr" data-title="Advers etki" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-vi mw-list-item"><a href="https://vi.wikipedia.org/wiki/T%C3%A1c_d%E1%BB%A5ng_b%E1%BA%A5t_l%E1%BB%A3i" title="Tác dụng bất lợi – Vietnamese" lang="vi" hreflang="vi" data-title="Tác dụng bất lợi" data-language-autonym="Tiếng Việt" data-language-local-name="Vietnamese" class="interlanguage-link-target"><span>Tiếng Việt</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E4%B8%8D%E8%89%AF%E5%8F%8D%E5%BA%94_(%E5%8C%BB%E5%AD%A6)" title="不良反应 (医学) – Chinese" lang="zh" hreflang="zh" data-title="不良反应 (医学)" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div 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id="mw-content-subtitle"></div></div> <div id="mw-content-text" class="mw-body-content"><div class="mw-content-ltr mw-parser-output" lang="en" dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Harmful effect resulting from a medication or other medical intervention</div> <style data-mw-deduplicate="TemplateStyles:r1251242444">.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output 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article</a> by <a href="/wiki/Help:Referencing_for_beginners" title="Help:Referencing for beginners">adding citations to reliable sources</a>. Unsourced material may be challenged and removed.<br /><small><span class="plainlinks"><i>Find sources:</i> <a rel="nofollow" class="external text" href="https://www.google.com/search?as_eq=wikipedia&q=%22Adverse+effect%22">"Adverse effect"</a> – <a rel="nofollow" class="external text" href="https://www.google.com/search?tbm=nws&q=%22Adverse+effect%22+-wikipedia&tbs=ar:1">news</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?&q=%22Adverse+effect%22&tbs=bkt:s&tbm=bks">newspapers</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.google.com/search?tbs=bks:1&q=%22Adverse+effect%22+-wikipedia">books</a> <b>·</b> <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar?q=%22Adverse+effect%22">scholar</a> <b>·</b> <a rel="nofollow" class="external text" href="https://www.jstor.org/action/doBasicSearch?Query=%22Adverse+effect%22&acc=on&wc=on">JSTOR</a></span></small></span> <span class="date-container"><i>(<span class="date">February 2011</span>)</i></span><span class="hide-when-compact"><i> (<small><a href="/wiki/Help:Maintenance_template_removal" title="Help:Maintenance template removal">Learn how and when to remove this message</a></small>)</i></span></div></td></tr></tbody></table> <div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Medical condition</div><style data-mw-deduplicate="TemplateStyles:r1257001546">.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme) div:not(.notheme){background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table tr{display:table-row!important}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}</style><table class="infobox ib-medical-condition"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Adverse effect</th></tr><tr><th scope="row" class="infobox-label"><a href="/wiki/Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="/wiki/Pharmacology" title="Pharmacology">Pharmacology</a></td></tr></tbody></table> <p>An <b>adverse effect</b> is an undesired harmful effect resulting from a <a href="/wiki/Pharmaceutical_drug" class="mw-redirect" title="Pharmaceutical drug">medication</a> or other <a href="/wiki/Surgery#Definitions" title="Surgery">intervention</a>, such as <a href="/wiki/Surgery" title="Surgery">surgery</a>.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup> An adverse effect may be termed a "<a href="/wiki/Side_effect" title="Side effect">side effect</a>", when judged to be secondary to a main or <a href="/wiki/Therapeutic_effect" title="Therapeutic effect">therapeutic effect</a>. The term <a href="/wiki/Complication_(medicine)" title="Complication (medicine)">complication</a> is similar to adverse effect, but the latter is typically used in pharmacological contexts, or when the negative effect is expected or common. If the negative effect results from an unsuitable or incorrect <a href="/wiki/Dose_(biochemistry)" title="Dose (biochemistry)">dosage</a> or procedure, this is called a <a href="/wiki/Medical_error" title="Medical error">medical error</a> and not an adverse effect. Adverse effects are sometimes referred to as "<a href="/wiki/Iatrogenesis" title="Iatrogenesis">iatrogenic</a>" because they are generated by a <a href="/wiki/Physician" title="Physician">physician</a>/treatment. Some adverse effects occur only when starting, increasing or discontinuing a treatment. Using a drug or other medical intervention which is <a href="/wiki/Contraindication" title="Contraindication">contraindicated</a> may increase the <a href="/wiki/Risk" title="Risk">risk</a> of adverse effects. Adverse effects may cause complications of a <a href="/wiki/Disease" title="Disease">disease</a> or procedure and negatively affect its <a href="/wiki/Prognosis" title="Prognosis">prognosis</a>. They may also lead to <a href="/wiki/Compliance_(medicine)" class="mw-redirect" title="Compliance (medicine)">non-compliance</a> with a treatment regimen. Adverse effects of medical treatment resulted in 142,000 deaths in 2013 up from 94,000 deaths in 1990 globally.<sup id="cite_ref-GDB2013_2-0" class="reference"><a href="#cite_note-GDB2013-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup> </p><p>The harmful outcome is usually indicated by some result such as <a href="/wiki/Disease" title="Disease">morbidity</a>, <a href="/wiki/Death" title="Death">mortality</a>, alteration in <a href="/wiki/Body_weight" class="mw-redirect" title="Body weight">body weight</a>, levels of <a href="/wiki/Enzyme" title="Enzyme">enzymes</a>, loss of function, or as a <a href="/wiki/Pathology" title="Pathology">pathological</a> change detected at the microscopic, macroscopic or physiological level. It may also be indicated by <a href="/wiki/Symptom" class="mw-redirect" title="Symptom">symptoms</a> reported by a patient. Adverse effects may cause a reversible or irreversible change, including an increase or decrease in the susceptibility of the individual to other chemicals, <a href="/wiki/Food" title="Food">foods</a>, or procedures, such as <a href="/wiki/Drug_interaction" title="Drug interaction">drug interactions</a>. </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Classification">Classification</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=1" title="Edit section: Classification"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In terms of drugs, adverse events may be defined as: "Any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment."<sup id="cite_ref-Defs_3-0" class="reference"><a href="#cite_note-Defs-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p><p>In <a href="/wiki/Clinical_trial" title="Clinical trial">clinical trials</a>, a distinction is made between an <a href="/wiki/Adverse_event" title="Adverse event">adverse event</a> and a <a href="/wiki/Serious_adverse_event" title="Serious adverse event">serious adverse event</a>. Generally, any event which causes death, permanent damage, <a href="/wiki/Congenital_disorder" class="mw-redirect" title="Congenital disorder">birth defects</a>, or requires <a href="/wiki/Hospital" title="Hospital">hospitalization</a> is considered a serious adverse event.<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> The results of trials are often included in the labelling of the medication to provide information both for patients and the prescribing physicians. </p><p>The term "life-threatening" in the context of a serious adverse event refers to an event in which the patient was at risk of death at the time of the event; it does not refer to an event which hypothetically might have caused death if it were more severe.<sup id="cite_ref-Defs_3-1" class="reference"><a href="#cite_note-Defs-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Reporting_systems">Reporting systems</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=2" title="Edit section: Reporting systems"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In many countries, adverse effects are required by law to be reported, researched in <a href="/wiki/Clinical_trial" title="Clinical trial">clinical trials</a> and included into the patient information accompanying <a href="/wiki/Medical_device" title="Medical device">medical devices</a> and <a href="/wiki/Drug" title="Drug">drugs</a> for sale to the public. Investigators in human clinical trials are obligated to report these events in <a href="/wiki/Clinical_study_report" title="Clinical study report">clinical study reports</a>.<sup id="cite_ref-5" class="reference"><a href="#cite_note-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Research suggests that these events are often inadequately reported in publicly available reports.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup> Because of the lack of these data and uncertainty about methods for synthesising them, individuals conducting <a href="/wiki/Systematic_review" title="Systematic review">systematic reviews</a> and meta-analyses of therapeutic interventions often unknowingly overemphasise health benefit.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> To balance the overemphasis on benefit, scholars have called for more complete reporting of harm from clinical trials.<sup id="cite_ref-8" class="reference"><a href="#cite_note-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading3"><h3 id="United_Kingdom">United Kingdom</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=3" title="Edit section: United Kingdom"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>The <a href="/wiki/Yellow_Card_Scheme" title="Yellow Card Scheme">Yellow Card Scheme</a> is a <a href="/wiki/United_Kingdom" title="United Kingdom">United Kingdom</a> initiative run by the <a href="/wiki/Medicines_and_Healthcare_products_Regulatory_Agency" title="Medicines and Healthcare products Regulatory Agency">Medicines and Healthcare products Regulatory Agency (MHRA)</a> and the <a href="/wiki/Committee_on_Safety_of_Medicines" title="Committee on Safety of Medicines">Commission on Human Medicines (CHM)</a> to gather information on adverse effects to <a href="/wiki/Pharmaceutical_drug" class="mw-redirect" title="Pharmaceutical drug">medicines</a>. This includes all licensed medicines, from medicines issued on <a href="/wiki/Prescription_drug" title="Prescription drug">prescription</a> to medicines bought <a href="/wiki/Over-the-counter_drug" title="Over-the-counter drug">over the counter</a> from a supermarket. The scheme also includes all <a href="/wiki/Herbalism" class="mw-redirect" title="Herbalism">herbal supplements</a> and unlicensed medicines found in cosmetic treatments. Adverse drug reactions (ADRs) can be reported by a number of health care professionals including <a href="/wiki/Physician" title="Physician">physicians</a>, <a href="/wiki/Pharmacist" title="Pharmacist">pharmacists</a> and <a href="/wiki/Nurse" class="mw-redirect" title="Nurse">nurses</a>, as well as <a href="/wiki/Patient" title="Patient">patients</a>. </p> <div class="mw-heading mw-heading3"><h3 id="United_States">United States</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=4" title="Edit section: United States"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In the <a href="/wiki/United_States" title="United States">United States</a> several reporting systems have been built, such as the <a href="/wiki/Vaccine_Adverse_Event_Reporting_System" title="Vaccine Adverse Event Reporting System">Vaccine Adverse Event Reporting System</a> (VAERS), the Manufacturer and User Facility Device Experience Database (MAUDE) and the Special Nutritionals Adverse Event Monitoring System. <a href="/wiki/MedWatch" title="MedWatch">MedWatch</a> is the main reporting center, operated by the <a href="/wiki/Food_and_Drug_Administration_(United_States)" class="mw-redirect" title="Food and Drug Administration (United States)">Food and Drug Administration</a>. </p> <div class="mw-heading mw-heading3"><h3 id="Australia">Australia</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=5" title="Edit section: Australia"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In <a href="/wiki/Australia" title="Australia">Australia</a>,adverse effect reporting is administered by the <a href="/wiki/Adverse_Drug_Reactions_Advisory_Committee" title="Adverse Drug Reactions Advisory Committee">Adverse Drug Reactions Advisory Committee</a> (ADRAC), a subcommittee of the <a href="/wiki/Australian_Drug_Evaluation_Committee" title="Australian Drug Evaluation Committee">Australian Drug Evaluation Committee</a> (ADEC). Reporting is voluntary, and ADRAC requests healthcare professionals to report all adverse reactions to its current drugs of interest, and serious adverse reactions to any drug. ADRAC publishes the Australian Adverse Drug Reactions Bulletin every two months. The Government's <a href="/wiki/Quality_Use_of_Medicines" class="mw-redirect" title="Quality Use of Medicines">Quality Use of Medicines</a> program is tasked with acting on this reporting to reduce and minimize the number of preventable adverse effects each year. </p> <div class="mw-heading mw-heading3"><h3 id="New_Zealand">New Zealand</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=6" title="Edit section: New Zealand"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Adverse reaction reporting is an important component of New Zealand's <a href="/wiki/Pharmacovigilance" title="Pharmacovigilance">pharmacovigilance</a> activities. The <a rel="nofollow" class="external text" href="https://nzphvc.otago.ac.nz/carm/">Centre for Adverse Reactions Monitoring (CARM)</a> in Dunedin is New Zealand's national monitoring centre for adverse reactions. It collects and evaluates spontaneous reports of adverse reactions to medicines, vaccines, herbal products and dietary supplements from health professionals in New Zealand. Currently the CARM database holds over 80,000 reports and provides New Zealand-specific information on adverse reactions to these products, and serves to support clinical decision making when unusual symptoms are thought to be therapy related </p> <div class="mw-heading mw-heading3"><h3 id="Canada">Canada</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=7" title="Edit section: Canada"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In Canada, adverse reaction reporting is an important component of the surveillance of marketed health products conducted by the Health Products and Food Branch (HPFB) of Health Canada. Within HPFB, the Marketed Health Products Directorate leads the coordination and implementation of consistent monitoring practices with regards to assessment of signals and safety trends, and risk communications concerning regulated marketed health products. </p><p>MHPD also works closely with international organizations to facilitate the sharing of information. Adverse reaction reporting is mandatory for the industry and voluntary for consumers and health professionals. </p> <div class="mw-heading mw-heading3"><h3 id="Limitations">Limitations</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=8" title="Edit section: Limitations"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>In principle, medical professionals are required to report all adverse effects related to a specific form of therapy. In practice, it is at the discretion of the professional to determine whether a medical event is at all related to the therapy. As a result, routine adverse effects reporting often may not include long-term and subtle effects that may ultimately be attributed to a therapy.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> </p><p>Part of the difficulty is identifying the source of a complaint. A headache in a patient taking medication for <a href="/wiki/Influenza" title="Influenza">influenza</a> may be caused by the underlying disease or may be an adverse effect of the treatment. In patients with end-stage <a href="/wiki/Cancer" title="Cancer">cancer</a>, death is a very likely outcome and whether the drug is the cause or a bystander is often difficult to discern.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (February 2011)">citation needed</span></a></i>]</sup> </p> <div class="mw-heading mw-heading2"><h2 id="By_situation">By situation</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=9" title="Edit section: By situation"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="mw-heading mw-heading3"><h3 id="Medical_procedures">Medical procedures</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=10" title="Edit section: Medical procedures"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p><a href="/wiki/Surgery" title="Surgery">Surgery</a> may have a number of undesirable or harmful effects, such as <a href="/wiki/Infection" title="Infection">infection</a>, <a href="/wiki/Bleeding" title="Bleeding">hemorrhage</a>, <a href="/wiki/Inflammation" title="Inflammation">inflammation</a>, <a href="/wiki/Scar" title="Scar">scarring</a>, loss of function, or changes in local <a href="/wiki/Blood_flow" class="mw-redirect" title="Blood flow">blood flow</a>. They can be reversible or irreversible, and a compromise must be found by the physician and the patient between the beneficial or life-saving consequences of surgery versus its adverse effects. For example, a limb may be lost to <a href="/wiki/Amputation" title="Amputation">amputation</a> in case of untreatable <a href="/wiki/Gangrene" title="Gangrene">gangrene</a>, but the patient's life is saved. Presently, one of the greatest advantages of <a href="/wiki/Minimally_invasive_procedure" title="Minimally invasive procedure">minimally invasive</a> surgery, such as <a href="/wiki/Laparoscopic_surgery" class="mw-redirect" title="Laparoscopic surgery">laparoscopic surgery</a>, is the reduction of adverse effects. </p><p>Other nonsurgical physical procedures, such as high-intensity <a href="/wiki/Radiation_therapy" title="Radiation therapy">radiation therapy</a>, may cause <a href="/wiki/Burn" title="Burn">burns</a> and alterations in the <a href="/wiki/Skin" title="Skin">skin</a>. In general, these therapies try to avoid damage to healthy <a href="/wiki/Tissue_(biology)" title="Tissue (biology)">tissues</a> while maximizing the therapeutic effect. </p><p><a href="/wiki/Vaccination" title="Vaccination">Vaccination</a> may have adverse effects due to the nature of its biological preparation, sometimes using <a href="/wiki/Attenuated_vaccine" title="Attenuated vaccine">attenuated</a> <a href="/wiki/Pathogen" title="Pathogen">pathogens</a> and <a href="/wiki/Toxin" title="Toxin">toxins</a>. Common adverse effects may be <a href="/wiki/Fever" title="Fever">fever</a>, <a href="/wiki/Malaise" title="Malaise">malaise</a> and local reactions in the vaccination site. Very rarely, there is a serious adverse effect, such as <a href="/wiki/Eczema_vaccinatum" title="Eczema vaccinatum">eczema vaccinatum</a>, a severe, sometimes fatal complication which may result in persons who have <a href="/wiki/Eczema" class="mw-redirect" title="Eczema">eczema</a> or atopic <a href="/wiki/Dermatitis" title="Dermatitis">dermatitis</a>. </p><p><a href="/wiki/Medical_diagnosis" title="Medical diagnosis">Diagnostic</a> procedures may also have adverse effects, depending much on whether they are <a href="/wiki/Invasive_(medical)" class="mw-redirect" title="Invasive (medical)">invasive</a>, <a href="/wiki/Minimally_invasive_procedure" title="Minimally invasive procedure">minimally invasive</a> or <a href="/wiki/Non-invasive_(medical)" class="mw-redirect" title="Non-invasive (medical)">noninvasive</a>. For example, <a href="/wiki/Allergy" title="Allergy">allergic</a> reactions to <a href="/wiki/Radiocontrast" class="mw-redirect" title="Radiocontrast">radiocontrast</a> materials often occur, and a <a href="/wiki/Colonoscopy" title="Colonoscopy">colonoscopy</a> may cause the perforation of the <a href="/wiki/Intestine" class="mw-redirect" title="Intestine">intestinal</a> wall. </p> <div class="mw-heading mw-heading3"><h3 id="Medications">Medications</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=11" title="Edit section: Medications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Adverse_drug_reaction" title="Adverse drug reaction">Adverse drug reaction</a></div> <p>Adverse effects can occur as a collateral or side effect of many interventions, but they are particularly important in <a href="/wiki/Pharmacology" title="Pharmacology">pharmacology</a>, due to its wider, and sometimes uncontrollable, use by way of <a href="/wiki/Self-medication" title="Self-medication">self-medication</a>. Thus, <a href="/wiki/Responsible_drug_use" title="Responsible drug use">responsible drug use</a> becomes an important issue here. Adverse effects, like <a href="/wiki/Therapeutic_effect" title="Therapeutic effect">therapeutic effects</a> of drugs, are a function of <a href="/wiki/Dose_(biochemistry)" title="Dose (biochemistry)">dosage</a> or drug levels at the target <a href="/wiki/Organ_(anatomy)" class="mw-redirect" title="Organ (anatomy)">organs</a>, so they may be avoided or decreased by means of careful and precise <a href="/wiki/Pharmacokinetics" title="Pharmacokinetics">pharmacokinetics</a>, the change of drug levels in the organism in function of time after administration. </p><p>Adverse effects may also be caused by <a href="/wiki/Drug_interaction" title="Drug interaction">drug interaction</a>. This often occurs when patients fail to inform their physician and pharmacist of all the medications they are taking, including herbal and dietary supplements. The new medication may interact agonistically or antagonistically (potentiate or decrease the intended therapeutic effect), causing significant <a href="/wiki/Disease" title="Disease">morbidity</a> and mortality around the world. Drug-drug and food-drug interactions may occur, and so-called "natural drugs" used in <a href="/wiki/Alternative_medicine" title="Alternative medicine">alternative medicine</a> can have dangerous adverse effects. For example, extracts of <a href="/wiki/Hypericum_perforatum" title="Hypericum perforatum">St John's wort</a> (<i>Hypericum perforatum</i>), a <a href="/wiki/Phytotherapy" class="mw-redirect" title="Phytotherapy">phytotherapic</a> used for treating mild <a href="/wiki/Major_depressive_disorder" title="Major depressive disorder">depression</a> are known to cause an increase in the <a href="/wiki/Cytochrome_P450" title="Cytochrome P450">cytochrome P450</a> <a href="/wiki/Enzyme" title="Enzyme">enzymes</a> responsible for the <a href="/wiki/Metabolism" title="Metabolism">metabolism</a> and elimination of many drugs, so patients taking it are likely to experience a reduction in <a href="/wiki/Blood" title="Blood">blood</a> levels of drugs they are taking for other purposes, such as <a href="/wiki/Cancer" title="Cancer">cancer</a> <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapeutic</a> drugs, <a href="/wiki/Protease_inhibitor_(pharmacology)" title="Protease inhibitor (pharmacology)">protease inhibitors</a> for <a href="/wiki/HIV" title="HIV">HIV</a> and <a href="/wiki/Hormonal_contraception" title="Hormonal contraception">hormonal contraceptives</a>. </p><p>The scientific field of activity associated with drug safety is increasingly government-regulated, and is of major concern for the public, as well as to <a href="/wiki/Pharmaceutical_industry" title="Pharmaceutical industry">drug manufacturers</a>. The distinction between adverse and nonadverse effects is a major undertaking when a new drug is developed and tested before <a href="/wiki/Pharmaceutical_marketing" title="Pharmaceutical marketing">marketing</a> it. This is done in <a href="/wiki/Toxicity" title="Toxicity">toxicity</a> studies to determine the nonadverse effect level (NOAEL). These studies are used to define the dosage to be used in human testing (phase I), as well as to calculate the maximum admissible daily intake. Imperfections in clinical trials, such as insufficient number of patients or short duration, sometimes lead to <a href="/wiki/Public_health" title="Public health">public health</a> disasters, such as those of <a href="/wiki/Fenfluramine" title="Fenfluramine">fenfluramine</a> (the so-called <a href="/wiki/Fen-phen" class="mw-redirect" title="Fen-phen">fen-phen</a> episode), <a href="/wiki/Thalidomide" title="Thalidomide">thalidomide</a> and, more recently, of <a href="/wiki/Cerivastatin" title="Cerivastatin">cerivastatin</a> (Baycol, Lipobay) and <a href="/wiki/Rofecoxib" title="Rofecoxib">rofecoxib</a> (Vioxx), where drastic adverse effects were observed, such as <a href="/wiki/Teratology" title="Teratology">teratogenesis</a>, <a href="/wiki/Pulmonary_hypertension" title="Pulmonary hypertension">pulmonary hypertension</a>, <a href="/wiki/Stroke" title="Stroke">stroke</a>, <a href="/wiki/Heart_disease" class="mw-redirect" title="Heart disease">heart disease</a>, <a href="/wiki/Neuropathy" class="mw-redirect" title="Neuropathy">neuropathy</a>, and a significant number of deaths, causing the forced or voluntary <a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">withdrawal</a> of the drug from the market. </p><p>Most drugs have a large list of nonsevere or mild adverse effects which do not rule out continued usage. These effects, which have a widely variable incidence according to individual sensitivity, include <a href="/wiki/Nausea" title="Nausea">nausea</a>, <a href="/wiki/Dizziness" title="Dizziness">dizziness</a>, <a href="/wiki/Diarrhea" title="Diarrhea">diarrhea</a>, <a href="/wiki/Malaise" title="Malaise">malaise</a>, <a href="/wiki/Vomiting" title="Vomiting">vomiting</a>, <a href="/wiki/Headache" title="Headache">headache</a>, <a href="/wiki/Dermatitis" title="Dermatitis">dermatitis</a>, dry mouth, etc. These can be considered a form of pseudo-allergic reaction, as not all users experience these effects; many users experience none at all. </p><p>The Medication Appropriateness Tool for Comorbid Health Conditions in Dementia<sup id="cite_ref-10" class="reference"><a href="#cite_note-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> (<a href="/wiki/MATCH-D" class="mw-redirect" title="MATCH-D">MATCH-D</a>) warns that people with dementia are more likely to experience adverse effects, and that they are less likely to be able to reliably report symptoms.<sup id="cite_ref-11" class="reference"><a href="#cite_note-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading4"><h4 id="Examples_with_specific_medications">Examples with specific medications</h4><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=12" title="Edit section: Examples with specific medications"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Abortion" title="Abortion">Abortion</a>, <a href="/wiki/Miscarriage" title="Miscarriage">miscarriage</a> or <a href="/wiki/Uterus" title="Uterus">uterine</a> <a href="/wiki/Bleeding" title="Bleeding">hemorrhage</a> associated with <a href="/wiki/Misoprostol" title="Misoprostol">misoprostol</a> (Cytotec), a labor-inducing drug (this is a case where the adverse effect has been used legally and illegally for performing abortions)<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Substance_dependence" title="Substance dependence">Addiction</a> to many <a href="/wiki/Sedative" title="Sedative">sedatives</a> and <a href="/wiki/Analgesic" title="Analgesic">analgesics</a>, such as <a href="/wiki/Diazepam" title="Diazepam">diazepam</a>, <a href="/wiki/Morphine" title="Morphine">morphine</a>, etc.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Congenital_disorder" class="mw-redirect" title="Congenital disorder">Birth defects</a> associated with <a href="/wiki/Thalidomide" title="Thalidomide">thalidomide</a></li> <li><a href="/wiki/Bleeding" title="Bleeding">Bleeding</a> of the <a href="/wiki/Intestine" class="mw-redirect" title="Intestine">intestine</a> associated with <a href="/wiki/Aspirin" title="Aspirin">aspirin</a> therapy<sup id="cite_ref-14" class="reference"><a href="#cite_note-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Circulatory_system" title="Circulatory system">Cardiovascular</a> disease associated with <a href="/wiki/COX-2_inhibitor" class="mw-redirect" title="COX-2 inhibitor">COX-2 inhibitors</a> (i.e. Vioxx)<sup id="cite_ref-15" class="reference"><a href="#cite_note-15"><span class="cite-bracket">[</span>15<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hearing_impairment" class="mw-redirect" title="Hearing impairment">Deafness</a> and <a href="/wiki/Renal_failure" class="mw-redirect" title="Renal failure">kidney failure</a> associated with <a href="/wiki/Gentamicin" title="Gentamicin">gentamicin</a> (an <a href="/wiki/Antibiotic" title="Antibiotic">antibiotic</a>)<sup id="cite_ref-16" class="reference"><a href="#cite_note-16"><span class="cite-bracket">[</span>16<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Death" title="Death">Death</a>, following <a href="/wiki/Sedation" title="Sedation">sedation</a>, in children using <a href="/wiki/Propofol" title="Propofol">propofol</a> (Diprivan)<sup id="cite_ref-17" class="reference"><a href="#cite_note-17"><span class="cite-bracket">[</span>17<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Depression_(mood)" title="Depression (mood)">Depression</a> or <a href="/wiki/Cirrhosis" title="Cirrhosis">hepatic injury</a> caused by <a href="/wiki/Interferon" title="Interferon">interferon</a><sup id="cite_ref-18" class="reference"><a href="#cite_note-18"><span class="cite-bracket">[</span>18<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Diabetes_mellitus" class="mw-redirect" title="Diabetes mellitus">Diabetes</a> caused by <a href="/wiki/Atypical_antipsychotic" title="Atypical antipsychotic">atypical antipsychotic</a> medications (neuroleptic <a href="/wiki/Psychiatry" title="Psychiatry">psychiatric</a> drugs)<sup id="cite_ref-19" class="reference"><a href="#cite_note-19"><span class="cite-bracket">[</span>19<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Diarrhea" title="Diarrhea">Diarrhea</a> caused by the use of <a href="/wiki/Orlistat" title="Orlistat">orlistat</a> (Xenical)<sup id="cite_ref-20" class="reference"><a href="#cite_note-20"><span class="cite-bracket">[</span>20<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Erectile_dysfunction" title="Erectile dysfunction">Erectile dysfunction</a> associated with many drugs, such as <a href="/wiki/Antidepressant" title="Antidepressant">antidepressants</a><sup id="cite_ref-21" class="reference"><a href="#cite_note-21"><span class="cite-bracket">[</span>21<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Fever" title="Fever">Fever</a> associated with <a href="/wiki/Vaccination" title="Vaccination">vaccination</a><sup id="cite_ref-22" class="reference"><a href="#cite_note-22"><span class="cite-bracket">[</span>22<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-23" class="reference"><a href="#cite_note-23"><span class="cite-bracket">[</span>23<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Glaucoma" title="Glaucoma">Glaucoma</a> associated with <a href="/wiki/Corticosteroid" title="Corticosteroid">corticosteroid</a>-based <a href="/wiki/Eye_drop" title="Eye drop">eye drops</a><sup id="cite_ref-24" class="reference"><a href="#cite_note-24"><span class="cite-bracket">[</span>24<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Alopecia" class="mw-redirect" title="Alopecia">Hair loss</a> and <a href="/wiki/Anemia" title="Anemia">anemia</a> may be caused by <a href="/wiki/Chemotherapy" title="Chemotherapy">chemotherapy</a> against <a href="/wiki/Cancer" title="Cancer">cancer</a>, <a href="/wiki/Leukemia" title="Leukemia">leukemia</a>, etc.<sup id="cite_ref-25" class="reference"><a href="#cite_note-25"><span class="cite-bracket">[</span>25<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Headache" title="Headache">Headache</a> following <a href="/wiki/Spinal_anaesthesia" title="Spinal anaesthesia">spinal anaesthesia</a><sup id="cite_ref-26" class="reference"><a href="#cite_note-26"><span class="cite-bracket">[</span>26<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Hypertension" title="Hypertension">Hypertension</a> in <a href="/wiki/Ephedrine" title="Ephedrine">ephedrine</a> users, which prompted FDA to remove the <a href="/wiki/Dietary_supplement" title="Dietary supplement">dietary supplement</a> status of <a href="/wiki/Ephedra_(medicine)" title="Ephedra (medicine)">ephedra</a> extracts<sup id="cite_ref-27" class="reference"><a href="#cite_note-27"><span class="cite-bracket">[</span>27<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Insomnia" title="Insomnia">Insomnia</a> caused by stimulants, <a href="/wiki/Methylphenidate" title="Methylphenidate">methylphenidate</a> (Ritalin), <a href="/wiki/Adderall" title="Adderall">Adderall</a>, etc.<sup id="cite_ref-28" class="reference"><a href="#cite_note-28"><span class="cite-bracket">[</span>28<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Lactic_acidosis" title="Lactic acidosis">Lactic acidosis</a> associated with the use of <a href="/wiki/Stavudine" title="Stavudine">stavudine</a> (Zerit, for <a href="/wiki/HIV" title="HIV">HIV</a> therapy)<sup id="cite_ref-29" class="reference"><a href="#cite_note-29"><span class="cite-bracket">[</span>29<span class="cite-bracket">]</span></a></sup> or <a href="/wiki/Metformin" title="Metformin">metformin</a> (for diabetes)<sup id="cite_ref-30" class="reference"><a href="#cite_note-30"><span class="cite-bracket">[</span>30<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Mania" title="Mania">Mania</a> caused by <a href="/wiki/Corticosteroid" title="Corticosteroid">corticosteroids</a><sup id="cite_ref-31" class="reference"><a href="#cite_note-31"><span class="cite-bracket">[</span>31<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Liver" title="Liver">Liver</a> damage from <a href="/wiki/Paracetamol" title="Paracetamol">paracetamol</a><sup id="cite_ref-32" class="reference"><a href="#cite_note-32"><span class="cite-bracket">[</span>32<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Melasma" title="Melasma">Melasma</a> and <a href="/wiki/Thrombosis" title="Thrombosis">thrombosis</a> associated with use of estrogen-containing <a href="/wiki/Hormonal_contraception" title="Hormonal contraception">hormonal contraception</a>, such as the <a href="/wiki/Combined_oral_contraceptive_pill" title="Combined oral contraceptive pill">combined oral contraceptive pill</a><sup id="cite_ref-33" class="reference"><a href="#cite_note-33"><span class="cite-bracket">[</span>33<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-34" class="reference"><a href="#cite_note-34"><span class="cite-bracket">[</span>34<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Priapism" title="Priapism">Priapism</a> associated with the use of <a href="/wiki/Sildenafil" title="Sildenafil">sildenafil</a><sup id="cite_ref-35" class="reference"><a href="#cite_note-35"><span class="cite-bracket">[</span>35<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Rhabdomyolysis" title="Rhabdomyolysis">Rhabdomyolysis</a> associated with <a href="/wiki/Statin" title="Statin">statins</a> (anti<a href="/wiki/Cholesterol" title="Cholesterol">cholesterol</a> drugs)<sup id="cite_ref-36" class="reference"><a href="#cite_note-36"><span class="cite-bracket">[</span>36<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Seizure" title="Seizure">Seizures</a> caused by withdrawal from <a href="/wiki/Benzodiazepine" title="Benzodiazepine">benzodiazepines</a><sup id="cite_ref-37" class="reference"><a href="#cite_note-37"><span class="cite-bracket">[</span>37<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Somnolence" title="Somnolence">Drowsiness</a> or increase in <a href="/wiki/Appetite" title="Appetite">appetite</a> due to <a href="/wiki/Histamine_antagonist" class="mw-redirect" title="Histamine antagonist">antihistamine</a> use. Some antihistamines are used in sleep aids explicitly because they cause drowsiness.<sup id="cite_ref-38" class="reference"><a href="#cite_note-38"><span class="cite-bracket">[</span>38<span class="cite-bracket">]</span></a></sup></li> <li><a href="/wiki/Stroke" title="Stroke">Stroke</a> or <a href="/wiki/Myocardial_infarction" title="Myocardial infarction">heart attack</a> associated with <a href="/wiki/Sildenafil" title="Sildenafil">sildenafil</a> (Viagra), when used with <a href="/wiki/Nitroglycerin" title="Nitroglycerin">nitroglycerin</a></li> <li><a href="/wiki/Suicide" title="Suicide">Suicide</a>, increased tendency associated to the use of <a href="/wiki/Fluoxetine" title="Fluoxetine">fluoxetine</a> and other <a href="/wiki/Selective_serotonin_reuptake_inhibitor" title="Selective serotonin reuptake inhibitor">selective serotonin reuptake inhibitor</a> (SSRI) antidepressants</li> <li><a href="/wiki/Tardive_dyskinesia" title="Tardive dyskinesia">Tardive dyskinesia</a> associated with use of <a href="/wiki/Metoclopramide" title="Metoclopramide">metoclopramide</a> and many <a href="/wiki/Antipsychotic" title="Antipsychotic">antipsychotic</a> medications<sup id="cite_ref-39" class="reference"><a href="#cite_note-39"><span class="cite-bracket">[</span>39<span class="cite-bracket">]</span></a></sup></li></ul> <div class="mw-heading mw-heading2"><h2 id="Controversies">Controversies</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=13" title="Edit section: Controversies"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>Sometimes, putative medical adverse effects are regarded as controversial and generate heated discussions in society and <a href="/wiki/Lawsuit" title="Lawsuit">lawsuits</a> against drug manufacturers. One example is the recent controversy as to whether <a href="/wiki/Controversies_in_autism" title="Controversies in autism">autism</a> was linked to the <a href="/wiki/MMR_vaccine" title="MMR vaccine">MMR vaccine</a> (or to <a href="/wiki/Thiomersal" title="Thiomersal">thiomersal</a>, a <a href="/wiki/Mercury_(element)" title="Mercury (element)">mercury</a>-based preservative used in some <a href="/wiki/Vaccine" title="Vaccine">vaccines</a>). No link has been found in several large studies, and despite removal of thimerosal from most early childhood vaccines beginning with those manufactured in 2003, the rate of autism has not decreased as would be expected if it had been the causative agent.<sup id="cite_ref-40" class="reference"><a href="#cite_note-40"><span class="cite-bracket">[</span>40<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-41" class="reference"><a href="#cite_note-41"><span class="cite-bracket">[</span>41<span class="cite-bracket">]</span></a></sup> </p><p>Another instance is the potential adverse effects of <a href="/wiki/Silicone" title="Silicone">silicone</a> <a href="/wiki/Breast_implant" title="Breast implant">breast implants</a>, which led to class actions brought by tens of thousands of plaintiffs against manufacturers of gel-based implants, due to allegations of damage to the <a href="/wiki/Immune_system" title="Immune system">immune system</a> which have not yet been conclusively proven.<sup id="cite_ref-42" class="reference"><a href="#cite_note-42"><span class="cite-bracket">[</span>42<span class="cite-bracket">]</span></a></sup> In 1998, Dow Corning settled its remaining suits for $3.2 Billion and went into bankruptcy.<sup id="cite_ref-43" class="reference"><a href="#cite_note-43"><span class="cite-bracket">[</span>43<span class="cite-bracket">]</span></a></sup> </p><p>Due to the exceedingly high impact on public health of widely used medications, such as <a href="/wiki/Hormonal_contraception" title="Hormonal contraception">hormonal contraception</a> and <a href="/wiki/Hormone_replacement_therapy_(menopause)" class="mw-redirect" title="Hormone replacement therapy (menopause)">hormone replacement therapy</a>, which may affect millions of users, even marginal probabilities of adverse effects of a severe nature, such as <a href="/wiki/Breast_cancer" title="Breast cancer">breast cancer</a>, have led to public outcry and changes in medical therapy, although its benefits largely surpassed the statistical risks. </p> <div class="mw-heading mw-heading2"><h2 id="See_also">See also</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=14" title="Edit section: See also"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1184024115">.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}</style><div class="div-col" style="column-width: 18em;"> <ul><li><a href="/wiki/Adverse_drug_reaction" title="Adverse drug reaction">Adverse drug reaction</a></li> <li><a href="/wiki/Biosafety" title="Biosafety">Biosafety</a></li> <li><i><a href="/wiki/Classification_of_Pharmaco-Therapeutic_Referrals" title="Classification of Pharmaco-Therapeutic Referrals">Classification of Pharmaco-Therapeutic Referrals</a></i></li> <li><a href="/wiki/Consultant_pharmacist" title="Consultant pharmacist">Consultant pharmacist</a></li> <li><a href="/wiki/Drug_interaction" title="Drug interaction">Drug interaction</a></li> <li><a href="/wiki/EudraVigilance" title="EudraVigilance">EudraVigilance</a></li> <li><a href="/wiki/Evidence-based_medicine" title="Evidence-based medicine">Evidence-based medicine</a></li> <li><a href="/wiki/List_of_pharmaceutical_companies" title="List of pharmaceutical companies">List of pharmaceutical companies</a></li> <li><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">List of withdrawn drugs</a></li> <li><a href="/wiki/Medical_algorithm" title="Medical algorithm">Medical algorithm</a></li> <li><a href="/wiki/Medical_prescription" title="Medical prescription">Medical prescription</a></li> <li><a href="/wiki/Nocebo" title="Nocebo">Nocebo</a></li> <li><a href="/wiki/Patient_safety" title="Patient safety">Patient safety</a></li> <li><a href="/wiki/Perioperative_mortality" title="Perioperative mortality">Perioperative mortality</a></li> <li><a href="/wiki/Pharmacotoxicology" title="Pharmacotoxicology">Pharmacotoxicology</a></li> <li><a href="/wiki/Placebo" title="Placebo">Placebo</a></li> <li><a href="/wiki/Pleiotropy_(drugs)" title="Pleiotropy (drugs)">Pleiotropy (drugs)</a></li> <li><a href="/wiki/Polypharmacy" title="Polypharmacy">Polypharmacy</a></li> <li><a href="/wiki/Toxicology" title="Toxicology">Toxicology</a></li></ul> </div> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=15" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output 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Retrieved <span class="nowrap">2023-05-20</span></span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=Frontline&rft.atitle=Breast+Implant+Litigation+Timeline&rft_id=https%3A%2F%2Fwww.pbs.org%2Fwgbh%2Fpages%2Ffrontline%2Fimplants%2Fcron.html&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAdverse+effect" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Adverse_effect&action=edit&section=16" title="Edit section: External links"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <div class="navbox-styles"><style data-mw-deduplicate="TemplateStyles:r1236075235">.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 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ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}</style></div><div role="navigation" class="navbox" aria-label="Navbox" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q2047938" class="extiw" title="d:Q2047938">D</a></div><div class="hlist" style="text-align:left;"><ul><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/ICD-10" title="ICD-10">10</a></b>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/T78">T78</a></li><li><b><a href="/wiki/International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="/wiki/List_of_ICD-9_codes" title="List of ICD-9 codes">9-CM</a></b>: <a rel="nofollow" class="external text" href="http://www.icd9data.com/getICD9Code.ashx?icd9=995.89">995.89</a></li><li><b><a href="/wiki/Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a></b>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D000069451">D000069451</a></li></ul></div></div></td></tr></tbody></table></div> <ul><li><a rel="nofollow" class="external text" href="https://psnet.ahrq.gov/">Patient Safety Network</a> – includes a glossary and articles on adverse effects, drug reactions, medical error, iatrogenesis, among others.</li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20050728153509/http://www.tga.gov.au/adr/aadrb.htm">Australian Adverse Drug Reactions Bulletin</a> – published bimonthly</li> <li><a rel="nofollow" class="external text" href="http://medeffectcanada.ca/">MedEffect Canada (Health Canada)</a></li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20050206235805/https://www.fda.gov/cder/drug/MedErrors/default.htm">Medication Errors</a>—from the <a href="/wiki/Food_and_Drug_Administration_(United_States)" class="mw-redirect" title="Food and Drug Administration (United States)">U.S. Food and Drug Administration</a>.</li> <li><a rel="nofollow" class="external text" href="https://www.fda.gov/medwatch/safety.htm">Medical Product Safety Information</a> – MedWatch lists safety alerts for drugs, biologics, devices and dietary supplements, recalls, market withdrawals, public health advisories and links</li> <li><a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/drugandmedicaldevicesafety.html">Medical Devices Safety</a> National Library of Medicine (Medline Plus, useful lists of conventional drug and medical device articles and websites)</li> <li><a rel="nofollow" class="external text" href="https://web.archive.org/web/20080509012408/http://www.agingresearch.org/content/article/detail/706">When Medicine Hurts Instead of Helps</a> – June 1998 report by the <a href="/wiki/Alliance_for_Aging_Research" title="Alliance for Aging Research">Alliance for Aging Research</a>.</li></ul> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Medical_harm" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2" style="text-align:center;"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><style data-mw-deduplicate="TemplateStyles:r1239400231">.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Medical_harm" title="Template:Medical harm"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Medical_harm" title="Template talk:Medical harm"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Medical_harm" title="Special:EditPage/Template:Medical harm"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Medical_harm" style="font-size:114%;margin:0 4em">Medical harm</div></th></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Concepts</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Iatrogenesis" title="Iatrogenesis">Iatrogenesis</a></li> <li><a href="/wiki/Medical_malpractice" title="Medical malpractice">Medical malpractice</a></li> <li><a href="/wiki/Medical_error" title="Medical error">Medical error</a></li> <li><a href="/wiki/Patient_safety" title="Patient safety">Patient safety</a></li> <li><a href="/wiki/Unnecessary_health_care" title="Unnecessary health care">Unnecessary health care</a></li> <li><a class="mw-selflink selflink">Adverse effect</a></li> <li><a href="/wiki/Patient_abuse" title="Patient abuse">Patient abuse</a></li> <li><a href="/wiki/Never_event" title="Never event">Never event</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Economic and financial concerns</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Medical_debt" title="Medical debt">Medical debt</a></li> <li><a href="/wiki/Balance_billing" title="Balance billing">Balance billing</a></li> <li><a href="/wiki/Financial_toxicity" title="Financial toxicity">Financial toxicity</a></li> <li><a href="/wiki/Prescription_drug_prices_in_the_United_States" title="Prescription drug prices in the United States">Prescription drug prices in the United States</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Political abuse</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Drapetomania" title="Drapetomania">Drapetomania</a></li> <li><a href="/wiki/Sluggish_schizophrenia" title="Sluggish schizophrenia">Sluggish schizophrenia</a></li> <li><a href="/wiki/Compulsory_sterilization" title="Compulsory sterilization">Compulsory sterilization</a></li> <li><a href="/wiki/Physician_gag_law" title="Physician gag law">Physician gag law</a></li> <li><i><a href="/wiki/The_Protest_Psychosis" title="The Protest Psychosis">The Protest Psychosis</a></i></li> <li><a href="/wiki/Political_abuse_of_psychiatry" title="Political abuse of psychiatry">Political abuse of psychiatry</a></li> <li><a href="/wiki/Political_abuse_of_psychiatry_in_the_United_States" class="mw-redirect" title="Political abuse of psychiatry in the United States">Political abuse of psychiatry in the United States</a></li> <li><a href="/wiki/Political_abuse_of_psychiatry_in_Russia" title="Political abuse of psychiatry in Russia">Political abuse of psychiatry in Russia</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Related concerns</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Adverse_drug_reaction" title="Adverse drug reaction">Adverse drug reaction</a></li> <li><a href="/wiki/Hospital-acquired_pneumonia" title="Hospital-acquired pneumonia">Hospital-acquired pneumonia</a></li> <li><a href="/wiki/Hospital-acquired_infection" title="Hospital-acquired infection">Hospital-acquired infection</a></li> <li><a href="/wiki/Iatrogenic_anemia" title="Iatrogenic anemia">Iatrogenic anemia</a></li> <li><a href="/wiki/Hand_washing" title="Hand washing">Hand washing</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="text-align:center;;width:1%">Records and histories</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Drug_pollution" title="Drug pollution">Drug pollution</a> (<a href="/wiki/List_of_medicine_contamination_incidents" title="List of medicine contamination incidents">List</a>)</li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Consequences_of_external_causes" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Consequences_of_external_causes" title="Template:Consequences of external causes"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Consequences_of_external_causes" title="Template talk:Consequences of external causes"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Consequences_of_external_causes" title="Special:EditPage/Template:Consequences of external causes"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Consequences_of_external_causes" style="font-size:114%;margin:0 4em">Consequences of <a href="/wiki/External_cause" title="External cause">external causes</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Temperature</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%">Elevated</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Burn" title="Burn">Burn</a></li> <li><a href="/wiki/Hyperthermia" title="Hyperthermia">Hyperthermia</a></li> <li><a href="/wiki/Heat_syncope" title="Heat syncope">Heat syncope</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Reduced</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypothermia" title="Hypothermia">Hypothermia</a></li> <li><a href="/wiki/Immersion_foot_syndromes" title="Immersion foot syndromes">Immersion foot syndromes</a> <ul><li><a href="/wiki/Trench_foot" title="Trench foot">Trench foot</a></li> <li><a href="/wiki/Tropical_immersion_foot" class="mw-redirect" title="Tropical immersion foot">Tropical immersion foot</a></li> <li><a href="/wiki/Warm_water_immersion_foot" class="mw-redirect" title="Warm water immersion foot">Warm water immersion foot</a></li></ul></li> <li><a href="/wiki/Non-freezing_cold_injury" title="Non-freezing cold injury">Non-freezing cold injury</a></li> <li><a href="/wiki/Chilblains" title="Chilblains">Chilblains</a></li> <li><a href="/wiki/Frostbite" title="Frostbite">Frostbite</a></li> <li><a href="/wiki/Aerosol_burn" title="Aerosol burn">Aerosol burn</a></li> <li><a href="/wiki/Cold_intolerance" class="mw-redirect" title="Cold intolerance">Cold intolerance</a></li> <li><a href="/wiki/Acrocyanosis" title="Acrocyanosis">Acrocyanosis</a></li> <li><a href="/wiki/Erythrocyanosis_crurum" title="Erythrocyanosis crurum">Erythrocyanosis crurum</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Radiation</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chronic_radiation_keratosis" class="mw-redirect" title="Chronic radiation keratosis">Chronic radiation keratosis</a></li> <li><a href="/wiki/Eosinophilic,_polymorphic,_and_pruritic_eruption_associated_with_radiotherapy" class="mw-redirect" title="Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy">Eosinophilic, polymorphic, and pruritic eruption associated with radiotherapy</a></li> <li><a href="/wiki/Radiation_acne" class="mw-redirect" title="Radiation acne">Radiation acne</a></li> <li><a href="/wiki/Radiation_burn" title="Radiation burn">Radiation burn</a></li> <li><a href="/wiki/Radiation-induced_cancer" title="Radiation-induced cancer">Radiation-induced cancer</a></li> <li><a href="/wiki/Radiation-induced_erythema_multiforme" class="mw-redirect" title="Radiation-induced erythema multiforme">Radiation-induced erythema multiforme</a></li> <li><a href="/wiki/Radiation-induced_hypertrophic_scar" class="mw-redirect" title="Radiation-induced hypertrophic scar">Radiation-induced hypertrophic scar</a></li> <li><a href="/wiki/Radiation-induced_keloid" class="mw-redirect" title="Radiation-induced keloid">Radiation-induced keloid</a></li> <li><a href="/wiki/Radiation-induced_morphea" class="mw-redirect" title="Radiation-induced morphea">Radiation-induced morphea</a></li> <li><a href="/wiki/Radiation_poisoning" class="mw-redirect" title="Radiation poisoning">Radiation poisoning</a></li> <li><a href="/wiki/Radiation_recall_reaction" class="mw-redirect" title="Radiation recall reaction">Radiation recall reaction</a></li> <li><a href="/wiki/Sunburn" title="Sunburn">Sunburn</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Oxygen</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypoxia_(medical)" class="mw-redirect" title="Hypoxia (medical)">Hypoxia</a>/<a href="/wiki/Asphyxia" title="Asphyxia">Asphyxia</a></li> <li><a href="/wiki/Oxygen_toxicity" title="Oxygen toxicity">Oxygen toxicity</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Pressure</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Barotrauma" title="Barotrauma">Barotrauma</a> <ul><li><a href="/wiki/Arterial_gas_embolism" class="mw-redirect" title="Arterial gas embolism">Arterial gas embolism</a></li> <li><a href="/wiki/Aerosinusitis" title="Aerosinusitis">Aerosinusitis</a></li> <li><a href="/wiki/Middle_ear_barotrauma" title="Middle ear barotrauma">Middle ear barotrauma</a></li> <li><a href="/wiki/Pneumothorax" title="Pneumothorax">Pneumothorax</a></li></ul></li> <li><a href="/wiki/Decompression_sickness" title="Decompression sickness">Decompression sickness</a> <ul><li><a href="/wiki/Inner_ear_decompression_sickness" title="Inner ear decompression sickness">Inner ear decompression sickness</a></li></ul></li> <li><a href="/wiki/Effects_of_high_altitude_on_humans" title="Effects of high altitude on humans">High altitude</a> <ul><li><a href="/wiki/Altitude_sickness" title="Altitude sickness">Altitude sickness</a></li> <li><a href="/wiki/Chronic_mountain_sickness" title="Chronic mountain sickness">Chronic mountain sickness</a></li> <li><a href="/wiki/Death_zone" title="Death zone">Death zone</a></li> <li><a href="/wiki/High-altitude_pulmonary_edema" title="High-altitude pulmonary edema">High-altitude pulmonary edema</a> (HAPE)</li> <li><a href="/wiki/High-altitude_cerebral_edema" title="High-altitude cerebral edema">High-altitude cerebral edema</a> (HACE)</li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Food</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Starvation" title="Starvation">Starvation</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Maltreatment</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Physical_abuse" title="Physical abuse">Physical abuse</a></li> <li><a href="/wiki/Sexual_abuse" title="Sexual abuse">Sexual abuse</a></li> <li><a href="/wiki/Psychological_abuse" title="Psychological abuse">Psychological abuse</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Travel</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Motion_sickness" title="Motion sickness">Motion sickness</a></li> <li><a href="/wiki/Seasickness" class="mw-redirect" title="Seasickness">Seasickness</a></li> <li><a href="/wiki/Airsickness" title="Airsickness">Airsickness</a></li> <li><a href="/wiki/Space_adaptation_syndrome" title="Space adaptation syndrome">Space adaptation syndrome</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Adverse effect</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypersensitivity" title="Hypersensitivity">Hypersensitivity</a> <ul><li><a href="/wiki/Anaphylaxis" title="Anaphylaxis">Anaphylaxis</a></li> <li><a href="/wiki/Angioedema" title="Angioedema">Angioedema</a></li> <li><a href="/wiki/Allergy" title="Allergy">Allergy</a></li> <li><a href="/wiki/Arthus_reaction" title="Arthus reaction">Arthus reaction</a></li></ul></li></ul> <ul><li><a href="/wiki/Adverse_drug_reaction" title="Adverse drug reaction">Adverse drug reaction</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Electrical_injury" title="Electrical injury">Electrical injury</a> <ul><li><a href="/wiki/Lightning_injuries" class="mw-redirect" title="Lightning injuries">Lightning injuries</a></li></ul></li> <li><a href="/wiki/Drowning" title="Drowning">Drowning</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Ungrouped <br /> skin conditions <br /> resulting from <br /> physical factors</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Dermatosis_neglecta" title="Dermatosis neglecta">Dermatosis neglecta</a></li> <li><a href="/wiki/Pinch_mark" title="Pinch mark">Pinch mark</a></li> <li><a href="/wiki/Pseudoverrucous_papules_and_nodules" title="Pseudoverrucous papules and nodules">Pseudoverrucous papules and nodules</a></li> <li><a href="/wiki/Sclerosing_lymphangitis" title="Sclerosing lymphangitis">Sclerosing lymphangitis</a></li> <li><a href="/wiki/Tropical_anhidrotic_asthenia" class="mw-redirect" title="Tropical anhidrotic asthenia">Tropical anhidrotic asthenia</a></li> <li><a href="/wiki/UV-sensitive_syndrome" title="UV-sensitive syndrome">UV-sensitive syndrome</a></li> <li><i>environmental skin conditions</i> <ul><li><a href="/wiki/Electrical_burn" title="Electrical burn">Electrical burn</a></li></ul></li> <li><i>frictional/traumatic/sports</i> <ul><li><a href="/wiki/Black_heel_and_palm" title="Black heel and palm">Black heel and palm</a></li> <li><a href="/wiki/Equestrian_perniosis" title="Equestrian perniosis">Equestrian perniosis</a></li> <li><a href="/wiki/Fissure_of_the_nipple" title="Fissure of the nipple">Fissure of the nipple</a></li> <li><a href="/wiki/Pulling_boat_hands" title="Pulling boat hands">Pulling boat hands</a></li> <li><a href="/wiki/Runner%27s_rump" title="Runner's rump">Runner's rump</a></li> <li><a href="/wiki/Surfer%27s_knots" title="Surfer's knots">Surfer's knots</a></li> <li><a href="/wiki/Tennis_toe" class="mw-redirect" title="Tennis toe">Tennis toe</a></li> <li><a href="/wiki/Vibration_white_finger" class="mw-redirect" title="Vibration white finger">Vibration white finger</a></li> <li><a href="/wiki/Weathering_nodule_of_ear" title="Weathering nodule of ear">Weathering nodule of ear</a></li> <li><a href="/wiki/Wrestler%27s_ear" class="mw-redirect" title="Wrestler's ear">Wrestler's ear</a></li> <li><a href="/wiki/Coral_cut" title="Coral cut">Coral cut</a></li> <li><a href="/wiki/Painful_fat_herniation" class="mw-redirect" title="Painful fat herniation">Painful fat herniation</a></li></ul></li> <li><a href="/wiki/Uranium_dermatosis" title="Uranium dermatosis">Uranium dermatosis</a></li> <li><i>iv use</i> <ul><li><a href="/wiki/Skin_pop_scar" title="Skin pop scar">Skin pop scar</a></li> <li><a href="/wiki/Skin_track" title="Skin track">Skin track</a></li> <li><a href="/wiki/Slap_mark" class="mw-redirect" title="Slap mark">Slap mark</a></li> <li><a href="/wiki/Pseudoacanthosis_nigricans" class="mw-redirect" title="Pseudoacanthosis nigricans">Pseudoacanthosis nigricans</a></li> <li><a href="/wiki/Narcotic_dermopathy" title="Narcotic dermopathy">Narcotic dermopathy</a></li></ul></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="font-weight: bold;"><div> <ul><li><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 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law</a></li> <li><a href="/wiki/Cobra_effect" class="mw-redirect" title="Cobra effect">Cobra effect</a></li> <li><a href="/wiki/CSI_effect" title="CSI effect">CSI effect</a></li> <li><a href="/wiki/Externality" title="Externality">Externality</a></li> <li><a href="/wiki/Excess_burden_of_taxation" title="Excess burden of taxation">Excess burden of taxation</a></li> <li><a href="/wiki/Four_Pests_campaign" title="Four Pests campaign">Four Pests campaign</a></li> <li><a href="/wiki/Goodhart%27s_law" title="Goodhart's law">Goodhart's law</a></li> <li><a href="/wiki/Hawthorne_effect" title="Hawthorne effect">Hawthorne effect</a></li> <li><a href="/wiki/Hutber%27s_law" title="Hutber's law">Hutber's law</a></li> <li><a href="/wiki/Hydra_effect" title="Hydra effect">Hydra effect</a></li> <li><a href="/wiki/Inverse_consequences" title="Inverse consequences">Inverse consequences</a></li> <li><a href="/wiki/Jevons_paradox" title="Jevons paradox">Jevons paradox</a></li> <li><a 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