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Guarding Against Drug Interactions

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Giving medication can be one of the scariest responsibilities for caregivers. Being diligent and staying informed is perhaps one of the best remedies. Ensure you communicate openly with the doctor and the pharmacy to provide better care for your loved one.

Understanding potential interactions between prescription drugs, over-the-counter medications, herbal remedies, food, and alcohol is crucial for maintaining health and safety. This article offers essential details to assist you and your family in avoiding harmful drug interactions and ensuring proper medication management.


Drug-drug Interactions

As people age, the risk of drug interactions increases when they take multiple medications for treating different diseases. What most people don’t realize is that common OTC medications can cause serious drug interactions as well. For this reason, it is critical to take a complete list of drugs to your doctor and pharmacist, even simple cough and cold medicines or painkillers.

Why It Matter

  • Pharmacists’ Expertise: Pharmacists are trained to recognize drug interactions; checking with them is vital to avoid adverse effects.
  • Consistent Pharmacy Use: Using the same pharmacy for all prescriptions ensures that records are kept and potential interactions are flagged.
  • OTC Medications: Include any OTC medications in the list provided to your pharmacist to ensure comprehensive safety checks.

Practical Tips

  • Read Leaflets: Always read the leaflets provided with prescriptions to understand side effects and interactions.
  • Ask Questions: If you have any questions about safe medication use, bring the leaflet to your doctor or call your pharmacist.

The Ohio Department on Aging provides helpful information about drug interactions and reactions. For example,

  • One medication can increase or decrease the effectiveness of another.
  • Taking two medications can produce one interaction that can be dangerous for the patient.
  • Taking two similar medications can produce one reaction that is greater than one would normally expect.

Depending on the condition being treated, your physician may suggest you avoid certain over-the-counter (OTC) medications. For example, individuals with heart disease need to be cautious when taking cold medicines containing decongestants such as phenylephrine or pseudoephedrine, as these medications can increase heart rate and blood pressure. It is important to consult the physician treating you to understand all health conditions that may affect the medications you need and to avoid duplications.


Herbal-Drug Interactions

While some individuals have found significant health benefits from herbal remedies, caregivers should still exercise caution. The label “natural” does not guarantee safety, as some herbal products can dangerously interact with medications.

Why it Matters:

  • Duplicate effects therapeutically: The herbal remedy has the same effect as the prescribed medication for the condition.
  • Unwanted contaminants: Due to processing methods, some herbal preparations can contain high levels of metals such as lead and mercury, and contaminants like pesticides may also be present in these remedies.

Practical Tips:

  • Be sure to list any herbal remedies and other medications to provide a complete picture to your healthcare provider.
  • If you need an herbal remedy, consult your loved one’s physician first.

There have been instances where herbal remedies contained illicit prescription medicines without proper labeling. Herbal remedies often make claims that are not evaluated by the Food and Drug Administration (FDA). These claims lack scientific backing without standardized testing, and the remedies can pose risks. Since many herbal products are marketed as food supplements, they are not as stringently regulated by the FDA, and manufacturers are not held to the same accountability standards as pharmaceutical companies.


Food-Drug Interactions

Certain foods can affect how medications are absorbed and utilized in the body. For example:

  • Caffeine and Vitamin K: These can interfere with medications like anticoagulants.
  • Grapefruit Juice: Known to reduce or eliminate the effectiveness of some medications.
  • Food can slow the absorption of some medicines throughout the body.
  • Meals high in carbohydrates can adversely affect the absorption rate of some medications.
  • Some medications need food to help them absorb for their use.


Alcohol-Drug Interactions

Although not technically a food, alcohol is often grouped with foods when considering interactions with medications. The National Institute of Alcohol Abuse and Alcoholism estimates that 25 percent of emergency room admissions may have alcohol-drug interactions as a component of the underlying problem. The elderly are especially at risk for this type of interaction since they consume more than 30 percent of all prescription medications, and the risk for alcohol abuse is also significant in the elderly population.

Why it Matters:

  • Increases effect: Alcohol intensifies the effect of some medications, such as sedatives or pain medicines. Some medications increase the effects of alcohol, causing dizziness, drowsiness, and inability to control balance or walk properly, as well as many others.
  • Reduces effectiveness: Alcohol can exhaust enzymes needed to metabolize the medication, thereby prolonging its absorption and risking more side effects in the body. It can also have the opposite effect by prolonging the metabolizing of medication in the bloodstream, rendering the drug less effective.

Practical Tips:

  • Keep track of any adverse reactions and check with your doctor immediately if there is cause for alarm.


 How to Manage Multiple Medications

How about drug reactions?

While there are concerns about foods or medicines interfering with one another, there is also the question of how a person will react to a medication. Side effects are possible with any medication on the market since many different types of people and diseases exist. It is important to minimize side effects while treating the underlying condition.

Keep a diary at home of any reaction that seems unusual. Include the following:

Name of medicine:
Time is given at:
A reaction happens at:
Nature of reaction(s):
Got better around:
Got worse around:
List the side effects. Are they expected ones?
Discomfort level (1= least, 5= worst):
Other observations:


By keeping a comprehensive diary of reactions, you can determine whether or not this is a true drug reaction, a symptom of the underlying disease, or even a new one that may be developing. Your doctor will want to see the diary, at least partly, when determining how best to treat the reaction.

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