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← The dangers of mixing drugs - Céline Valéry

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Showing Revision 8 created 12/21/2019 by lauren mcalpine .

  1. Which of these three people
    is doing something risky?
  2. Is it the one who takes their cholesterol
    medication with grapefruit juice?

  3. The one who takes Acetaminophen pain

  4. for a sore ankle before
    going out for drinks?
  5. Or the one who’s on a blood-thinning

  6. and takes an aspirin for a headache?
  7. Actually, all of them are.

  8. Each has inadvertently created a drug
    interaction that could, in extreme cases,
  9. lead to kidney failure; liver damage;
  10. or internal bleeding.
  11. Drug interactions happen
  12. when the combination of a drug
    with another substance
  13. causes different effects than either
    would individually.
  14. Foods, herbal supplements, legal drugs,
    and illicit substances
  15. can all cause drug interactions.
  16. Most drug interactions
    fall into two categories.

  17. Some take place when two substances’
    effects influence each other directly.
  18. In other cases, one substance effects
    how the body processes another,
  19. like how it is absorbed, metabolized,
    or transported around the body.
  20. Blood thinners and aspirin, for example,

  21. have similar effects that become
    dangerous when combined.
  22. Both prevent blood clots from forming—
  23. blood thinners by preventing the formation
    of the clotting factors
  24. that hold clots together,
  25. and aspirin by preventing blood cells
    from clumping into groups
  26. that become clots.
  27. Individually, these effects
    are usually safe,
  28. but taken together, they can prevent blood
    clotting to a dangerous extent,
  29. possibly causing internal bleeding.
  30. While blood thinners and aspirin are
    generally harmless

  31. when taken individually,
  32. interactions where one substance
    exacerbates the effects of another
  33. can also take place between drugs that
    are independently harmful.
  34. Cocaine and heroin are each dangerous,
  35. and those dangers compound when the
    two drugs are combined—
  36. even though their behavioral effects may
    feel like they cancel each other out.
  37. Cocaine is a stimulant, and many of its
    effects, like increased heart rate,
  38. cause the body to need more oxygen.
  39. But heroin, a depressant,
    slows breathing—
  40. reducing the body’s oxygen supply just
    when it needs more.
  41. This combination strains the organs and
    can cause respiratory failure and death.
  42. The interaction between grapefruit juice
    and certain medications

  43. in class of cholesterol-lowering drugs
    called statins,
  44. has to do with drug metabolism.
  45. The liver produces enzymes, molecules that
    facilitate the breakdown of substances
  46. that enter the body.
  47. Enzymes can both activate drugs,
  48. by breaking them down into their
    therapeutic ingredients
  49. from more complex molecules,
    and deactivate them,
  50. by breaking harmful compounds down
    into harmless metabolites.
  51. There are many, many different enzymes,
  52. each of which has a binding site that
    fits a specific molecule.
  53. Grapefruit binds to the same enzyme
    as statins,

  54. making less of that enzyme available
    to break down statins.
  55. So combining the two means that a
    greater concentration of the drug
  56. stays in the bloodstream for a longer
    period of time,
  57. potentially causing kidney failure.
  58. Alcohol can also alter the function of the
    enzyme that breaks down Acetaminophen,

  59. the active ingredient in pain relievers
    like Tylenol and paracetamol.
  60. When someone takes Acetaminophen, some
    of it is converted into a toxic substance.
  61. At the recommended dose,
  62. there isn’t usually enough of this toxic
    byproduct to cause harm.
  63. But heavy drinking can alter enzyme
  64. so more of that byproduct is produced,
  65. potentially causing liver damage
  66. even with what’s usually a safe dose of
  67. Meanwhile, the herbal remedy Saint John’s
    Wort increases the liver’s production

  68. of a particular enzyme.
  69. That means the drugs this enzyme is
    responsible for breaking down
  70. get metabolized faster—
  71. sometimes too fast, before they can
    have their therapeutic effects.
  72. In spite of the dizzying number of
    possible interactions,

  73. most of the dangerous interactions
    with commonly used drugs are well known.
  74. And new developments in science are
    helping us keep better track
  75. of drug interactions than ever.
  76. Some researchers are developing AI
    programs that can predict the side effects
  77. of drug interactions before they occur,
  78. using information about the landscape
    of protein interactions within your body.
  79. For the new drugs that are being developed
    all the time,
  80. supercomputers are being used to find
    potential interactions
  81. while those drugs
    are still in development.