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Prescription Drug Side Effects
==============================
PRESCRIPTION DRUG SIDE EFFECTS
You might be surprised at what can raise or lower drug levels in your
body.
by Virginia Hopkins

When drugs are in the research and testing phase, they are most often
given to adult men between the ages of 25 and 50, but drugs may act
and interact very differently in children, teenagers, women, pregnant
and nursing women, menopausal women, and particularly in the elderly,
where nutrient absorption and liver function are issues. Your
physician's only way of gauging your tolerance to a drug is to begin
with a standard dose for an adult male and see what happens. If you
don't complain of side effects or no effect, chances are the dose will
never be changed.
There are dozens and dozens of factors that can influence what effect
a drug has on you, from how much sleep you got last night and what you
had for breakfast, to the condition of your liver and your blood
pressure. For example, alcohol abuse can greatly increase or decrease
tolerance to a drug, as can obesity, exercise, stress levels and
exposure to pollutants such as car exhaust, pesticides or industrial
chemicals.

Drugs and nutrients can affect each other in your digestive system, in
your bloodstream, in your liver and kidneys, or at the cell level
where the drug or nutrient receptor is.
Just as it takes a variety of vitamins, minerals, amino acids and
enzymes to process food so that your cells can use it, drugs also go
through changes as the body uses them. They are changed as they are
made useful, as they are being used, and as they are being excreted
from the body. Any interference in this process caused by nutritional
deficiencies or interference from other drugs, food or alcohol, can
raise or lower drug levels.

Your Body's Drug Disposal Systems
The four major routes for excreting a drug from the body are the
kidneys, liver, skin and lungs. Most drugs are processed out through
the liver and then the kidneys. If you have kidney or liver disease,
how your body handles drugs is profoundly affected. Food, drink or
lifestyle habits that stress and damage your kidneys or liver, such as
alcohol abuse or chronic exposure to toxins such as solvents and paint
fumes, can also affect how you process drugs. Kidney or liver stress
or damage usually raises drug levels higher than normal by slowing
down the excretion process.
The aminoglycoside antibiotics such as streptomycin, kanamycin,
gentamicin and garamicin cause kidney damage in as much as 15 percent
of patients treated with them, but thousands of other drugs cause less
obvious stress on your kidneys. When your drug information insert
indicates “renal” (kidney) problems, you should be aware that the drug
is probably going to be hard on your kidneys.

Keeping Your P-450 Pathways Clear
Many types of drugs are prepared for clearance out of the body through
the liver using the cytochrome P-450 enzymes, also known as the
cytochrome P-450 pathways.
In a drug-free body, or in the presence of only one drug, the P-450
pathways can handle the load. When you have more than one drug cleared
through the same pathway, the system quickly gets overloaded, stalling
the removal of the drugs from the system. The result is an overdose
that can be life-threatening.
Some examples of drugs that either use the P-450 pathways or block its
action are the SSRI antidepressants (e.g. Prozac, Zoloft), cimetidine
(Tagamet), cisapride (Propulsid), the cholesterol-lowering drugs in
the statin family, the macrolide antibiotics such as erythromycin and
clarithromycin, most antifungal drugs such as ketoconazole and
miconazole, antiarrhythmic drugs such as disopyramide (Norpace), the
seizure drug phenytoin (Dilantin), the anti-Parkinson's drug
bromocriptine (Parlodel), the benzodiazepine anti-anxiety drugs such
as diazepam (Valium) and nefazodone (Serzone), the calcium channel
blockers such as nifedipine (Procardia), the theophyllines used to
treat asthma, the tricyclic antidepressants such as Elavil, the blood
thinner warfarin (Coumadin), tacrine (Cognex) used to treat
Alzheimer's, the antihistamines terfenadine (Seldane) and astemizole
(Hismanal) and caffeine. And these are just the most commonly used
drugs. Grapefruit juice also uses this pathway, which is why drinking
it is contraindicated with some drugs.

How many people do you suppose have been killed in a scenario similar
to this one: Joe is taking a calcium channel blocker long-term, is
temporarily put on a macrolide antibiotic to treat chronic bronchitis,
then has a glass of grapefruit juice and a cup of coffee with
breakfast, raising his levels of the calcium channel blocker so high
that his blood pressure drops precipitously, causing heart failure.
It's not an unlikely scenario. Or let's say it's in the evening and he
takes some Tagamet (which is available over-the-counter) for heartburn
and a Valium to help him sleep.
Your best bet is to check with your pharmacist before mixing any
drugs, even over-the-counter drugs. Labels that warn of such things as
hepatic (liver) toxicity, injury, dysfunction or function impairment,
which is medical-ese for liver poison, should flash a red light in
your head.

Take Care of the Liver When On Drugs
Your liver is one of the busiest organs of the body, working
constantly to process food for transport through the bloodstream and
to metabolize waste matter for excretion through urine or feces. The
list of prescription drugs that stress or damage the liver is probably
longer than those that don't. If you drink alcohol in excess and take
liver-stressing drugs, you could be doing substantial damage to your
liver.
Some symptoms of liver toxicity are swelling and redness in the palms
of the hands, yellowish skin and whites of eyes, itching, small benign
fatty tumors and reddish spots on the skin or lumps under the skin of
damaged blood vessels.

Use Caution with Acetaminophen
One of the most commonly used drugs that damages the liver is
acetaminophen (Tylenol), which is loudly touted in advertising for
pain relief because it doesn't upset the stomach the way aspirin or
ibuprofen do. What those ads neglect to tell you is that acetaminophen
is very hard on the liver.
Recent research has shown that acetaminophen may inflict most of its
damage on the liver by blocking the production of the important
antioxidant glutathione. Without glutathione, the liver's ability to
break down toxins for elimination is impaired. According to a study
published in the journal, Free Radical Biology & Medicine, one hour
after an injection of acetaminophen, glutathione levels decrease as
much as 83 percent! That is a vulnerable liver. If some type of stress
is placed on the liver (i.e. alcohol, pesticides) at the same time the
acetaminophen hits it, the damage could be considerable.

If you’re in pain you may be in the position of having to pick your
poisons, so here’s a health-protecting strategy: if you’re going to
take acetaminophen, take the liver-protective herb milk thistle
beforehand (follow directions on the bottle) and add 500 mg of the
amino acid cysteine to your daily vitamins. Cysteine is the precursor
to glutathione. Also be sure to avoid alcohol when you're taking
acetaminophen.
Because drugs have potent and specific actions, they can easily become
toxic in excess. One of the biggest reasons that natural remedies are
preferable to use over prescription drugs whenever possible is that
the natural remedies tend to be much gentler and safer if you take too
much.

Factors that Can Increase or Decrease Drug Levels
Sex

Age
Race

Overweight or underweight
Pregnancy and Nursing

Illness
Alcohol abuse

Food
Other Drugs

Digestion
Kidney or liver damage

Nutritional deficiencies
Supplements

Exposure to toxins such as paint fumes, solvents, pesticides
Over- or under-exercise

Stress
Time of day

Drugs That Metabolize Differently in Women
There are probably many more drugs than these that are metabolized
differently in women, but these are the ones we currently know about.
If you're given a drug and experience negative side effects, ask your
physician to try changing the dosage.
alcohol

amitriptyline
benzodiazepines

beta blockers
chlordiazepoxide

diflunisal
imipramine

oxazepam
methylprednisolone

piroxicam
prednisolone

trazadone
Common Drugs that can Decrease the Effect of Oral Contraceptives
If you're taking oral contraceptives and are prescribed one of these
drugs, be sure to use an alternative form of birth control during the
time you're taking these drugs and for at least two weeks afterwards.

antibiotics
anticonvulsants

azole antifungals
griseofulvin

ritonavir
rifampin

For more information about how a specific drug may affect you, please
read Prescription Alternatives.
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Buyer Be Aware - Benadryl is a Serious Drug
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you drowsy, scramble your brain, and impair your driving more than
alcohol.
Buyer be Aware Report on Chantix
According to the FDA, people who use the drug Chantix to quit smoking
have an increased risk of agitation, depression and suicide. The
Federal Aviation Administration has banned the use of Chantix by
pilots.

The Drugs May be Worse than the Heart Attack
Carl had a heart attack and then the real nightmare started with
handfuls of prescription drugs and their side effects.
How to Report Drug Side Effects to the FDA
Reporting drug side effects to the FDA should be considered a public
service.

Made in China: Yet Another Reason to Avoid Prescription Drugs
When drug production is outsourced, we should have even less
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