-
Which of these three people
is doing something risky?
-
Is it the one who takes their cholesterol
medication with grapefruit juice?
-
The one who takes Acetaminophen pain
relievers
-
for a sore ankle before
going out for drinks?
-
Or the one who’s on a blood-thinning
medication
-
and takes an aspirin for a headache?
-
Actually, all of them are.
-
Each has inadvertently created a drug
interaction that could, in extreme cases,
-
lead to kidney failure; liver damage;
-
or internal bleeding.
-
Drug interactions happen
-
when the combination of a drug
with another substance
-
causes different effects than either
would individually.
-
Foods, herbal supplements, legal drugs,
and illicit substances
-
can all cause drug interactions.
-
Most drug interactions
fall into two categories.
-
Some take place when two substances’
effects influence each other directly.
-
In other cases, once substance effects
how the body processes another,
-
like how it is absorbed, metabolized,
or transported around the body.
-
Blood thinners and aspirin, for example,
-
have similar effects that become
dangerous when combined.
-
Both prevent blood clots from forming—
-
blood thinners by preventing the formation
of the clotting factors
-
that hold clots together,
-
and aspirin by preventing blood cells
from clumping into groups
-
that become clots.
-
Individually, these effects
are usually safe,
-
but taken together, they can prevent blood
clotting to a dangerous extent,
-
possibly causing internal bleeding.
-
While blood thinners and aspirin are
generally harmless
-
when taken individually,
-
Not Synced
interactions where one substance
exacerbates the effects of another
-
Not Synced
can also take place between drugs that
are independently harmful.
-
Not Synced
Cocaine and heroin are each dangerous,
-
Not Synced
and those dangers compound when the
two drugs are combined—
-
Not Synced
even though their behavioral effects may
feel like they cancel each other out.
-
Not Synced
Cocaine is a stimulant, and many of its
effects, like increased heart rate,
-
Not Synced
cause the body to need more oxygen.
-
Not Synced
But heroin, a depressant,
slows breathing—
-
Not Synced
reducing the body’s oxygen supply just
when it needs more.
-
Not Synced
This combination strains the organs and
can cause respiratory failure and death.
-
Not Synced
The interaction between grapefruit juice
and certain medications
-
Not Synced
in class of cholesterol-lowering drugs
called statins,
-
Not Synced
has to do with drug metabolism.
-
Not Synced
The liver produces enzymes, molecules
that facilitate the breakdown of substances
-
Not Synced
that enter the body.
-
Not Synced
Enzymes can both activate drugs,
-
Not Synced
by breaking them down into their
therapeutic ingredients
-
Not Synced
from more complex molecules,
and deactivate them,
-
Not Synced
by breaking harmful compounds down
into harmless metabolites.
-
Not Synced
There are many, many different enzymes,
-
Not Synced
each of which has a binding site that
fits a specific molecule.
-
Not Synced
Grapefruit binds to the same enzyme
as statins,
-
Not Synced
making less of that enzyme available
to break down statins.
-
Not Synced
So combining the two means that a
greater concentration of the drug
-
Not Synced
stays in the bloodstream for a longer
period of time,
-
Not Synced
potentially causing kidney failure.
-
Not Synced
Alcohol can also alter the function of the
enzyme that breaks down Acetaminophen,
-
Not Synced
the active ingredient in pain relievers
like Tylenol and paracetamol.
-
Not Synced
When someone takes Acetaminophen, some
of it is converted into a toxic substance.
-
Not Synced
At the recommended dose,
-
Not Synced
there isn’t usually enough of this toxic
byproduct to cause harm.
-
Not Synced
But heavy drinking can alter enzyme
activity
-
Not Synced
so more of that byproduct is produced,
-
Not Synced
potentially causing liver damage
-
Not Synced
even with what’s usually a safe dose of
acetominophen.
-
Not Synced
Meanwhile, the herbal remedy Saint John’s
Wort increases the liver’s production
-
Not Synced
of a particular enzyme.
-
Not Synced
That means the drugs this enzyme is
responsible for breaking down
-
Not Synced
get metabolized faster—
-
Not Synced
sometimes too fast, before they can
have their therapeutic effects.
-
Not Synced
In spite of the dizzying number of
possible interactions,
-
Not Synced
most of the dangerous interactions
with commonly used drugs are well known.
-
Not Synced
And new developments in science are
helping us keep better track
-
Not Synced
of drug interactions than ever.
-
Not Synced
Some researchers are developing AI
programs that can predict the side effects
-
Not Synced
of drug interactions before they occur,
-
Not Synced
using information about the landscape
of protein interactions within your body.
-
Not Synced
For the new drugs that are being developed
all the time,
-
Not Synced
supercomputers are being used to find
potential interactions
-
Not Synced
while those drugs
are still in development.