The People's Perspective on Medicine

Show 1064: How Can You Avoid Hazardous Drug Interactions?

Before taking any medication, patients should be clear about potential benefits, risks and drug interactions that are relevant.
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How Can You Avoid Hazardous Drug Interactions?

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Medications are often crucial for maintaining our health, but every drug you take has potential side effects and may interact with other medicines. What do you know about these hazards?

Understanding Benefits and Risks:

Our guest, Dr. Russ Altman, suggests that physicians should exercise more restraint in prescribing and patients should ask more questions about the drugs they are expected to take. That way, everyone will have a better understanding of the balance of benefits and risks that accompany every prescription. Both doctors and patients also need to pay attention to potential drug interactions.

Learning about Drug Interactions:

Dr. Altman describes the unusual computer analysis that he and his students employed to discover an unsuspected interaction between the cholesterol drug pravastatin (Pravachol) and the antidepressant paroxetine (Paxil). This combination can raise blood sugar significantly. What other drug interactions are yet to be discovered?

Over-the-Counter Drugs:

When it comes to over-the-counter drugs, too many people assume they are perfectly safe. OTC medicines also have potential side effects and may interact with other medicines in dangerous ways. How can you find out more about the drugs you take on your own?

This Week’s Guest:

Russ Altman, MD, PhD, is the Kenneth Fong Professor of Bioengineering, Genetics, Medicine, and Biomedical Data Science at Stanford University Medical School. He also holds a courtesy appointment in the Department of Computer Science. Here are some helpful links for his work:

Lab page: http://helix.stanford.edu/index.html

The PharmGKB resource for pharmacogenomics http://www.pharmgkb.org/

Paper on drug interaction discovery from FDA databases and electronic health records http://tatonettilab.org/resources/tatonetti-stm.html

 

Paper on interaction between Paxil and pravastatin https://www.nigms.nih.gov/news/meetings/documents/russ_altman_article.pdf

Ted Talk on Drug Interactions https://www.ted.com/talks/russ_altman_what_really_happens_when_you_mix_medications

Ted Talk on Pharmacogenomics https://www.youtube.com/watch?v=X1iKibDqtck

You may also be interested in our post about the Chicago Tribune study of pharmacies dispensing without warning of deadly drug interactions. You can learn more about the frightening interaction between ACE inhibitors and co-trimoxazole here and here.

Listen to the Podcast:

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for four weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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I have not been able to hear the playback either— looked forward to it and hope this is a computer glitch. Thanks for these wonderfully informative broadcasts

I also can’t find the playbacks either.. I would like to hear a program like I used to but can’t find how to get it any more. It’s still being advertised that we can hear a program for a month after it’s aired.

Usually I can listen to the show for a week or so after the broadcast. I notice that the playbacks are no longer available. Has there been a change?

I took Gabapentin 300 for 5 months for severe nerve damage. It caused me to have horrible nightmares and night sweats. I didn’t know until I went for a kidney check that Gabapentin had my GFR kidney factor down to a 32 rating from my normal 68. The doctor told me to get off Gabapentin immediately as I was “2 digits” from dialysis. (I went to Norco 325) My GFR took two months to get back out of the “danger zone”. May be a good idea to watch the kidney function while on this med as I was advised it can be a bad mix with kidney function. I had taken Tramadol prior to the Gabapentin and it worked super with all my other meds until my system resisted it after three years.

I highly recommend reading Drug Muggers by Suzy Cohen to research possible deficiencies brought on by medications. My mother also in her 80’s was given Tramadol. She would then fall out of bed and not be able to get up, or get up at midnight and get dressed. She also had constipation followed by bouts of diarrhea she slept through…

I enjoyed the conversation with Dr. Altman and am glad to hear that physician researchers and pharmacists are beginning to use big data to explore the problem of drug interactions. I was distressed, though, at the assumption that information about drug interactions is only of interest – or should only be shared with – clinicians. Patients are critical players in this – in fact the most important player. Any information about potential interactions should be shared with patients with a clear statement about the impact of the interaction and what types of symptoms patients’ should watch for which might indicate a problem. Dr. Altman suggested that this type of information would be “too scary” for patients – a very paternalistic attitude that I found condescending. If it is my body that is likely to be affected by some clinician’s decision then I should have as much information as that clinician.

I do a regular check with 4-5 different sites that cater to drug interactions. I find that the Childrens Aspirin (or any aspirin) seems to interfere with MANY medications. I have never seen this addressed. Every friend I have has been told to “take an aspirin a day” without regard to current meds for heart, cholesteral, nerve damage, etc… My Cardio tells me to take “the 81” even though I have never had a heart attack….I have had open heart (CABG-4) for 70-60-60-50 blockages as a “precaution” at age 60. Should there be an aspirin regime for ALL…What’s the medical consensus. Thank You.

Mother is in a NH. L-1 compressed the third time – nothing left. Norco 5-325 may be sedating with Gabapentin 300 twice a day. Tramadol has been ordered – what other drugs are dangerous with Tramadol in a 88 year old?

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