Wednesday, February 10, 2010

Prescription Drug Dangers: Drug Interactions

Prescription drug dangers are not generally recognized by patients and sometimes not even by physicians.  Everyone taking a prescription drug is at risk, but the risk rises with the number of prescribed and over-the-counter medications, supplements or herbal remedies taken. Often the adverse-effects of prescription drugs are far worse than the condition they were initially prescribed for.

Drug-Drug Interactions 
For those taking more than one drug, there is always the possibility of drug- drug interaction, when the combination of substances either increases or decreases the effect of one or both of them. For example, Aspirin thins the blood as well as decreasing pain, so those on blood thinners are at risk of a bleed if they also take aspirin. Antibiotics may make birth control pills less effective, so those using them should take extra precautions against pregnancy for the remainder of their cycle, These are just two examples of a myriad of drugs and supplements that can interact. Occasionally patients who see more than one doctor may be prescribed the same drug twice, but under a different trade name, so unwittingly receive double the dose.

To protect yourself against interaction you should always use the same pharmacist to dispense your drugs, or in times when this is not possible, give the new pharmacist a list of all the drugs overt-the-counter medications, and supplements that you are taking. Also, before buying over-the-counter medications or supplements check with the pharmacist that they are compatible with your prescribed and other over-the-counter medications.

Make a list of all your medications and supplements, keep it updated, and carry it with you at all times. Don't assume you will always remember what you are taking. In any case, you may sometime be admitted to emergency, and be semi-conscious or unconscious and unable to communicate.

Drug Condition Interactions 
Drugs can also interact with other health conditions you may have. For example, the drug pseudoephedrine found in nasal decongestants can raise blood pressure to dangerous levels, the beta-blocker class of drugs can worsen asthma, and several drugs can increase blood sugar in those with diabetes. So remember to also tell your pharmacist about all your health conditions and ask if they may be worsened by the substance you are about to buy. You can also check the package insert and ask the pharmacist for a patient handout on the drug.

Drug-Food Interactions 
Drugs and foods may also interact to produce unwanted and some times dangerous effects. One of the most commonly recognised foods that can increase the effects of certain drugs is grapefruit juice. Alcohol can also have serious unwanted effects either by increasing the effects of drugs that act on the brain such as antidepressants, sedatives, or stimulants, or by affecting the organs that metabolize the drug. For example, both alcohol and acetaminophen (Tylenol, Panadol, Paracetamol) are metabolized by the liver, and when taken on the same day can cause the liver to fail. Similarly other pain-relievers such as Ibuprofen (Advil) or Aspirin taken with alcohol are more likely to cause stomach bleed.

Prevent Drug Interactions 
Get to know your pharmacist and use them as a resource. After you have talked to them a few times(and shown them your list) they will start to remember you, and may be more likely to recognise that a prescribed medication does not fit with your current medications. The pharmacist is often easier to access than the doctor, so they can also be the first line of help if you experience new symptoms after you have started a new medication, supplement, or herbal remedy. They can quickly find out if this medication or combination of substances could cause these symptoms, and in some cases may even phone the doctor for you to suggest a medication change.                                                                                        Always ask the doctor about non-drug options to deal with any condition they wish to prescribe medication for, and find out what the prescribed drugs are supposed to achieve. Will they actually cure the condition, stop adverse effects such as raised blood sugar in Type-1 diabetes or grand mal seizures in epilepsy, or will they just mask the symptoms or prevent something that is preventable in other ways. The questions you will ask will differ if you are receiving the medication for a condition or symptom you already have versus a medication to prevent a condition from occurring. This latter situation will be covered in a later post.

Whenever possible opt for non-drug options. If the physician does not have many suggestions for these, research them yourself, or find a holistic doctor or alternative practitioner who may be familiar with treating the condition with non-drug treatments. Take action to protect yourself from the prescription drug dangers of drug interactions.
Photocredit  D Sharon Pruit

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