Prescription medications interactions

Garlic s proven mechanisms of action include (a) inhibition of platelet function, (b) increased levels of two antioxidant enzymes, catalase and glutathione peroxidase, and (c) inhibition of thiol enzymes such as coenzyme A and HMG coenzyme A reductase. Garlic s anti-hyperlipidemic effects are believed to be in part due to the HMG coenzyme A reductase inhibition since prescription medications for hyperlipidemia have that mechanism of action (statins). It is unknown whether garlic would have the same drug interactions, side effects, and need for precautions as the statins. 

Patients, health care professionals, and pharmacists all have roles in preventing the abuse1 of and addiction to prescription medications. For example, patients should follow the directions for use carefully learn what effects and side effects the medication could have and inform their doc-tor/pharmacist whether they are taking other medications [including over-the-counter (OTC) medications or health supplements], since these could potentially interact with the prescribed medication. The patient should read... 

Because nearly 70% of patients who use alternative therapies do not inform their health-care providers about these products, pharmacists and other health-care professionals should question all patients about their use of alternative therapies. Health-care professionals should remain vigilant for potential interactions between alternative therapies and prescription medications, especially medications with a narrow therapeutic index, and should report suspected interactions to the FDA... 

MedWatch program. The FDA recently established the Special Nutritionals Adverse Event Monitoring System, a searchable database including information about suspected adverse events associated with dietary supplements or nutritional products. This database includes reports that have been submitted to MedWatch and can be accessed via the Internet (http //vm.cfsan.fda.gov/ dms/ aems.html). Continued efforts by health-care professionals to recognize and report suspected interactions between prescription medications and herbal and other alternative therapies should ultimately increase knowledge and awareness of interactions and improve the quality of patient care (see Heck et al., 2000 Izzo, 2004 Butterweck, 2004 Chan, 2005). 

Discusses the potential interactions of alternative medicine products with prescription medications... 

Pharmacists and technicians play a major role in medication safety in modern pharmacy practice. After summarizing several studies performed in hospitals and long-term care facilities, Allan and Barker (1990) estimated that medication errors occur at a rate of about 1 per patient per day. In a more recent study performed in ambulatory pharmacies, they found an overall dispensing accuracy rate for prescription medications of 98.3 percent (Allan, Barker, and Carnahan, 2003). While most of these errors probably have minimal clinical relevance and do not affect patients adversely, many experts believe that medication error rates may be higher in the ambulatory care setting because errors may not always be evident to the health professionals who work there. For example, medication errors can occur when a patient purchases nonprescription medications without speaking with the pharmacist about any potential interactions with his or her prescription medications or if patients fail to verify the appropriate dose of the over-the-counter (OTC) medication. 

There are hundreds of drugs available as OTC preparations that are used for self-medication. Obviously, these drugs also lend themselves to interacting with not only prescription medications but also herbal preparations. Table 4.7 lists the generic name of some of the most popular OTC medications, followed by the prescription drug they are most likely to interact with, followed by the effect(s). 

The observations made with respect to potential interactions involving non-prescription products also apply to the use of herbal products, dietary supplements, and other related products that are available without a prescription. Although much is still to be learned about the properties of these products, many appear to have a potential to interact with prescription medications. Therefore, patients should be asked whether they are using such products. 

Pharmacist can help a patient know if there are any drug-drug or drug-food interactions with their OTC medications. A thorough medication history of both prescription and non-prescription medication including herbal supplements is a vital component to pharmaceutical care. By evaluating the medication history, the pharmacist can help the consumer make... 

Unwanted side effects and undesirable interactions can occur when herbals are taken with prescription medication. For example, Coumadin, which is an anticoagulant, interacts with ginkgo, an herb that inhibits platelets, resulting in increased bleeding and stroke. 

It is particularly important, while taking these drugs, that you do not mix this medical use with the recreational use of alcohol or other drugs. The effects of prescriptive medication (tranquilizers, for example) can be amplified by additional substance use (taking another depressant like alcohol, for example), and the interaction can be dangerous in unpredictable ways."... 

A second type of medicine practiced in this country is referred to as complementary medicine. In this q)proach to medical care, clients generally receive traditional adjuncts to therapy such as prescription medications, which are often complemented by noninvasive approaches that use the mind-body interaction (Cheng, 1995). Strategies like those described in chapter 6 for anxiety that involve deep breathing, meditation exercises, yoga, and other means of relaxing are frequently used. 

Be sure that the list of medications a client is taking is updated. If it cannot be easily tracked in the client s record, other ways of providing this information should be instituted. For example, the social worker can help the client to create an index card that lists current and past medications. The client should have the card available for review at every appointment with a health care provider. Be sure that all medications are listed including the name, dose, number, and date of last refill. By ensuring that all providers are aware of what a client is taking, problems with duplicate prescriptions, drug interactions and side effects, contraindicated medications, and errors in dosages can be avoided. 

Alternative medicine therapies have become increasingly popular, and it has been estimated that one-third of all Americans use herbal products. In 1997, herbal medicine sales increased nearly 59%, reaching an estimated total of 3.24 billion. One particular safety concern is potential interactions of alternative medicine products with prescription medications. This issue is especially important with respect to drugs with narrow therapeutic indexes, such as warfarin. More food and drug interactions have been... 

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