Opiate Medication Overdose & Medical Malpractice
Posted by in Uncategorized on November 26, 2011
Opiates are a class of medications primarily used for pain management. More than any other class of drugs, opiates allow patients to manage their pain and live more normally. If they are administered under a doctor’s supervision, opiate medications are safe for long-term daily use. But these medications also pose dangers. The difference between an effective dose and a life-threatening overdose is small, meaning that drug interactions and prescription errors can be fatal.
Opiate medications are derived from opium, a substance produced by the poppy plant. The primary pain-killing chemical in opium is morphine, which is still among the most powerful medications known to science. Codeine, another component of opium, is used as a cough suppressant and for pain management. There are also a number of semi-synthetic opiate drugs, such as hydrocodone and oxycodone, which are derived in a laboratory from the various chemicals in opium.
The effects of opium been known for a very long time: the use of opium for medical and recreational purposes predates the invention of writing, the wheel, and the sword. Aside from reducing pain and inducing euphoria, opiate medications also suppress breathing. Opiate overdose kills people by slowing their breathing until it stops completely. It only takes 120 to 250 milligrams of pure morphine to cause death. Other opiate drugs are similarly powerful.
Doctors, pharmacists, and other medical professionals should be absolutely certain they are giving patients the correct dose of their medication. Receiving the incorrect dose can lead to overdose and death. They should also be absolutely certain their patients are aware of the dangers of their prescriptions and should make sure they are not at risk for a drug interaction.
Prescription errors cause tens of thousands of deaths yearly. If you or someone you love has been seriously harmed because of an opiate overdose caused by a prescription error or drug interaction, you may be entitled to compensation for your medical bills, losses, and suffering.
Supplement and Drug Interactions
Posted by in Uncategorized on November 26, 2011
A large percentage of the population in America take more than one prescription medication and over 30% also take dietary supplements regularly. Many people are not aware that drug interactions may occur between their medicine and nutraceuticals, and these could have a negative impact on their health.
Despite frequent reports in the newspaper on the latest health scares, we have benefited hugely from advances in both pharmaceutical and nutritional sciences. There is now a huge selection of medication and health supplements for our therapy and massive research is being undertaken into new cures and treatments.
Using Drugs and Supplements Together
Almost eight percent of Americans aged 18 to 44 take three or more prescription drugs daily. In seniors of retirement age this figure rises to nearly fifty percent. Other statistics show that over a third of adults in the USA use health supplements on a daily basis and almost a fifth have used a natural product over the past year.
It does not take a genius to work out that a large amount of people are taking drugs and dietary supplements at the same time and they may not be aware of drug interactions. This statistic is made more worrying by the fact that, according to one study, 70% of patients do not tell their physician that they are self medicating with an alternative treatment for their health concern. Conditions such as like allergies, obesity, arthritis, colds and flu and high blood pressure are now so common place that physicians may feel less inclined to investigate the persons own strategy for treatment. This is compounded by the fact that many people think that doctors will not understand their decision to use alternative treatment. For some of these people drug interactions can pose problems.
Lack of Knowledge about Drug Interactions with Supplement
Some famous cases in the media highlighting the side effects of drugs as well as the strict regulations concerning the marketing of drugs mean that most people are aware that drugs can have complications. To a lesser extent drug interactions are reasonably well known and your doctor as well as your pharmacist will generally make sure that you have not been prescribed a detrimental combination of medications. There are also regulatory and an ethical incentives for pharmaceutical companies to discover any possible drug-drug interactions. The situation is different when it comes to nutraceuticals and herbal supplements. Little research has been conducted into drug interactions with nutraceuticals. Physicians will usually play it safe if asked by telling patients not to take supplements to avoid drug interactions. This is partly due to the scant formal training for herbal products or nutraceuticals in medical school and the general distrust of the nutrition industry by the medical profession.
How do drugs and supplements interact?
After taking a drug and this then reaching the bloodstream, there are a number of ways that it can be cleared from the system. A major clearance pathway is through the liver. Certain enzymes in the liver will be responsible for the breakdown of certain drugs. These specific enzymes may also have the task of breaking down other substances that have been ingested including alcohol, nutrients and elements of herbal products. If the enzymes responsible for breaking down say paracetamol, are also responsible for breaking down a supplement you have taken previously, the enzymes will be busy with the supplement and the paracetamol will be left to float in the bloodstream.
Pharmacokinetics of Consumption
Problems with drug interactions can arise when the therapeutic window (the difference in concentration of a drug in your bloodstream between no effect, desired effect and harm) is short. A dose is a highly calculated amount so if this is thrown off because your enzymes are tied up dealing with supplements or something else then your drugs may not be working properly. Additionally, if you are taking multiple doses of the drug in a day and it has a long half life (the time it takes to decrease to half of the original concentration in your blood stream) then you will effectively be topping up the concentration of the drug which can lead to dangerously high levels and possible overdose.For example, calcium channel blockers such as felodipine (Plendil©) for high blood pressure or congestive heart failure are broken down by the same enzymes as quercetin, a flavonoid found in grapefruit juice but also available as a supplement. Regular use could easily increase the levels of the drug in the body and cause accidental overdose levels – despite taking the recommended dosage at the right times.
Supplements Can Enhance the Effects of Drugs
Drugs and dietary supplements can also have a synergistic interaction effect when taken at the same time. They can produce similar pharmacological effects in the body or enhance the effect of one another through some drug interaction. This can of course be dangerous to your health. The dietary supplement garlic is now very popular for atherosclerosis and cardiovascular problems. Garlic thins the blood and patients who are undergoing surgery or who are taking anti platelet agents (drugs used to stop the blood forming clots in the heart) can then have problems with blot clotting appropriately upon trauma to a blood vessel.
Useless Drugs
Some dietary supplements can also induce the enzymes in the body to be more “active” than usual – they can have what is called an “inductive effect”. The enzymes are then much more efficient at clearing any prescribed drugs from the body. The drug dose is calculated so that enough of the drug is in the bloodstream for long enough for the active ingredient to be effective. If such drug interactions occur then the drug passes through the system too fast and may have a reduced effect or no effect at all.
Medical Drug Interactions
Posted by in Uncategorized on November 26, 2011
When two or more drugs are taken at the same time a drug interaction can occur. These interactions can also occur between pharmaceutical drugs and herbal medications or even between drugs and foods. The greater the number of drugs and/or herbs taken the greater the possibility of interactions.
What are drug interactions?
An interaction is a generally unwanted result of combining two or more chemicals within the body. Sometimes it involves the result of direct chemical interactions (such as when two chemicals combine to create a third and unplanned chemical) and sometimes it relates to the impact on the body caused by treatment with more than one drug at a time, such as two drugs affecting the same system, even though the drugs don’t themselves combine to create yet another drug. Drug interactions are very common and while many have only minor effects they can be quite dangerous, even lethal.
Drug interactions are usually characterised by one of two general effects. One involves the drugs enhancing their effects (that is potentiating or working together to have a stronger action). For example, drugs that are used to thin the blood and reduce the possibility that the blood will clot (anticoagulants) are commonly affected by this problem. Combined treatments will work together and the blood could become so thin that bleeding could occur and it would be difficult for the blood to form a clot to stop the bleeding. One example would be taking aspirin while being treated with heparin since both are known anticoagulants. There are also herbs that have an anticoagulant effect and these can interact with medical anticoagulants. These herbs include cayenne and ginger which are specific herbal anticoagulants. There are other herbs and vitamins that have an anticoagulant effect – these include ginkgo biloba, garlic and vitamin E. The other general effect of course is just the reverse. This involves the drugs working against each other causing them to be less effective.
How do the drug interactions occur?
There are many ways that the interactions can take place. The main ways are covered below.
Physical or chemical incompatibility – This usually occurs when drugs are mixed in the liquid form. If there is a physical incompatibility then there is often a precipitate – solid parts start forming in the mixture. An example is diazepam (Valium) – a common sedative. In the liquid form it will not mix well with water. This is a physical incompatibility. With a chemical incompatibility a chemical reaction can occur which alters the drug. For example, the liquid form of penicillin (an antibiotic) will be inactivated if it is mixed with aminoglycosides (another group of antibiotics) such as streptomycin.
However, this type of chemical incompatibility can be beneficial. For example, the drug action of the blood thinner heparin can be reversed by the drug protamine, a drug which binds to and inactivates the heparin. Protamine is therefore used as a specific antidote for a heparin overdose.
Interference with the absorption of nutrients in the digestive tract – The rate at which the stomach and intestines work can be affected by various drugs.
For example, when anti-nausea drugs such as metoclopramide (Maxolon, Pramin) are taken, they will speed up the rate at which the stomach empties. This is important to know if, for example, digitalis (a heart drug) is given as the time that it has to be absorbed in the stomach is reduced and the effective dose will therefore be lower. If the stomach emptying time is lowered, for example, with propantheline (an antispasmodic drug) the time spent in the stomach, and hence the absorption of digitalis, will be increased.
Changing of drug metabolism – Some drugs are able to stimulate the breaking down of other drugs in the liver.
For example, barbiturates (anti-anxiety sedatives) are known to do this. When barbiturates are given with oral anticoagulants (blood thinners) then the dose of the blood thinners needs to be increased because of the rate at which they will be broken down in the liver. There are many examples of where one drug will affect the rate at which another drug is broken down.
Drugs which affect the same body system – This is where two drugs have an effect, which may be intended or otherwise, on the same body system.
For example, drugs that dull the responses of the brain. These include: alcohol, antihistamines, sedatives and pain killers. The effects of one will tend to make the other stronger. This can also work by a drug reducing the effect of another drug. For example, drug doses of vitamin K works against the effects of oral blood thinners.
Drug and food interactions – The importance of these interactions should not be overlooked.
For example, Monoamine oxidase inhibitors (MAOIs) (such as Phenelzine, Iproniazid, Tranylcypromine) are antidepressant drugs that interact with foods rich in tyramine. The result can be a rapid and prolonged rise in the blood pressure. Foods that have to be avoided include: avocados, cheese, spirits and wine, pickled herring, beef extracts and broad beans. Some over-the-counter drugs such as cold remedies and nasal decongestants can have a similar interaction with the MAOIs.
The Unknown
There are many ways that drugs can interact with each other to either enhance or decrease their effect. This means that the way a medical drug will work in the body is somewhat unknown – especially if more than one or two medical drugs are used at the same time. Medical drugs are toxic chemicals and contrary to popular opinion encouraged by drug prescribers and pharmaceutical companies alike, we generally do not know or understand the real impact of these drugs upon the body.
When two or more drugs are taken, complex chemicals comprised of each drug plus the resulting effects of their combination are introduced to the body – this means that the body has a lot of toxicity to eliminate. The best advice is to only take medical drugs if they are absolutely essential and then only take them for as short a period of time as possible. In many/most cases alternatives to medical drugs are available. Alarmingly, many people are prescribed multiple drugs over time and end up taking many more than two drugs every day. The truth is, no one knows the real effects this situation will cause but we do know that avoidable illness and death are common outcomes.
Conclusion
It is best to work on improving your health and preventing the onset of disease. Ensure that your body is as free of toxins as you can. Having said these things though it is important that if you are currently taking medical drugs you need to discuss possible changes with your health professional. You may be wise to seek a second opinion but do not just stop your medication without specific professional advice.