Drug interactions, antibiotic resistance and OTC painkillers, oh my! Don’t be frightened by the complexities of drugs; let New Albany resident and Ohio State University pharmacy professor Bella Mehta give you the courage to face your medicine cabinet with confidence.
Are there interactions between medications and herbs/dietary supplements that I should be aware of?
Many patients want to use natural products to treat conditions or prevent conditions from occurring. Some natural products show some very real benefits, but others either don’t show any benefits or have some very real concerns. Check with a doctor or pharmacist before starting a product to find out if it is the right one for you. Remember that herbs and dietary supplements can have effects similar to those of conventional medications and that “natural” doesn’t always mean “safe.” Some herbs and dietary supplements have side effects and may have drug interactions. For example, ginkgo can cause thinning of the blood, and if you are already on a blood thinner this can cause a severe problem with a risk of bleeding. Energy drinks have been in the news lately because of the severe side effects that have been linked to their use, including visits to the emergency room. Because herbs and dietary supplements are not regulated by the FDA, finding a good manufacturer is important to your health.
What are the dangers of drug interactions?
Drug interactions can come in a variety of forms – sometimes one drug can cause another drug to stay in the body for longer than it should or cause it to be in the body at too high of a concentration. Another type of drug interaction can cause a drug to leave the body too soon or have it work at too low of a dose because it lowers the concentration of that drug. Drug interactions can lead to severe reactions that may lead to hospitalizations, the need for urgent medical attention or even death. Your pharmacist is checking for potential drug interactions each time you get a medication filled in the pharmacy. But if you don’t always fill your medicines at the same pharmacy, then the pharmacist may only know about some of the medications you are on and cannot screen for all potential interactions. Choose a personal pharmacist like you would a doctor and carry a complete list of your medications with you, especially to visits with all your physicians, as they may not know what your other physicians are prescribing. It is important that every doctor has an accurate medication list.
What is the difference between brand name and generic medications?
When new medications come to the market, they are available as brand-only medications. Each brand name has 17 years to be exclusively available as that brand only, and part of this time is used in clinical trials. At the end of the 17 years, other companies are able to market their own versions of that medication as lower-cost generics. The active ingredients are the same in brand and generic medications. Generics have to show that they disperse in the body the same way and have the same action and effect, but don’t have to recreate all the same clinical studies. Generic medications are a good way to save money and still benefit from the medication. There are very few cases in which the medication is particularly sensitive and changing from one generic to another can have an impact on its effect. Warfarin (Coumadin) is one such drug. Other types of drugs might be thyroid or anti-seizure medications. If you aren’t sure about whether to choose a brand or generic for a specific medication, you can always check with your pharmacist.
What are the symptoms of a drug allergy, and what should I do if I notice these symptoms?
Allergies to medications usually occur when you first start taking a new medication, but can happen after you have been taking it for a few weeks. You can also have a reaction to a medication that you had no reaction to in the past. Drug allergies can appear as a rash, itching or hives. A more severe reaction might cause shortness of breath to the point you have trouble breathing. This can start with a cough and includes severe swelling of the airways or throat, a loss of consciousness and/or a sudden drop in blood pressure. If a severe reaction occurs, you need to get help right away. Remember that an allergy to a drug is different than experiencing a side effect. A side effect can also start when you are put on a new medication or if your medication dosage changes. If you aren’t sure what you are experiencing, check with a pharmacist or doctor.
When should or shouldn’t I take an antibiotic? Why is it so important for me to take every dose?
Infections can be caused by organisms such as bacteria, fungi, some parasites and viruses. Antibiotics can help your body fight the infections caused by all of them except viruses. Viruses cause the common cold and the flu, so an antibiotic is not something you would want to take for either of those. If you have another type of infection, an antibiotic can help your body get rid of the organism that is making you sick. Although you will start to feel better within a few days, it is important to take every dose and the full amount of antibiotics prescribed so that the bacteria or other organisms that caused the infection can be cleared completely.
Should I get a flu shot every year? What level of protection does a flu shot provide?
Yes, you should get a flu shot every year. The strains of influenza that the shot gives you protection from vary each year. The shot is based on which strains are causing flu in other parts of the world and predictions of which of those strains will travel to the U.S. during our peak flu season. Often the shot covers against two or three of the most prevalent strains. The flu shot cannot give you the flu. It does take a few weeks for the shot to start working, so you should try to get the shot in the fall before flu season hits. Each year, too many patients, including children and the elderly, die due to the flu.
Are over-the-counter medications safe to take? What precautions should I take when seeking out over-the-counter medications?
While over-the-counter (OTC) medications are safe to use, they are still medications, so they can cause side effects and they can have drug interactions. Many products that are now available over the counter used to be available by prescription only. They are intended to be used for short-term treatment for certain conditions and all are labeled to say how long a patient should use the product before seeking the attention of a physician. For example, if a patient has heartburn that lasts for longer than two weeks or constipation that lasts for longer than one week, he or she should see a physician.
Some over-the-counter medications can cause problems for certain conditions; for example, if you have high blood pressure, diabetes or a thyroid disorder, then you want to avoid certain products. Because there are so many OTC choices and not all are the right choice for every patient, I would recommend talking to your pharmacist to make sure you get the over-the-counter product that will be best for you.
What are the differences between types of OTC painkillers?
There are many choices in the OTC pain relief market. There are creams and ointments that can help with muscle pain and products to help with migraine headaches, sinus headaches and tension headaches, not to mention the aches and pains associated with a cold. The main categories of oral pain relievers are aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) and naproxen (Aleve), and acetaminophen (Tylenol). While all help with pain relief and reduce fevers, there are times when you would choose one over the other. All of the different categories of pain relievers can have interactions and side effects. Before choosing one, it is important to check with your pharmacist or physician to make sure you get the best one for your specific needs.
Bio
Bella H. Mehta, Pharm.D.,FAPhA, R.Ph., is an associate professor of Pharmacy and Family Medicine at The Ohio State University and director of the OSU College of Pharmacy Clinical Partners Program. Clinical Partners’ mission is to help patients make the best use of medications and to educate current and future pharmacists through innovative practice, teaching and scholarship. Mehta provides services at a pharmacist-consulting clinic near campus as well as within the Patient Centered Medical Home with OSU Family Medicine at CarePoint Gahanna. Her areas of focus include diabetes, heart disease, herbs/dietary supplements and establishing reimbursable models of pharmacist-managed direct patient care services.
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