Tag Archives: Pharmacy

Straight, No Chaser: Do Medications Work Differently in Older People?

February 26, 2017General Health and WellnessDrug, SterlingMedicalAdvice.com, Sterling Medical Advice, Pharmacy, Pharmaceutical drug, Old age, mental-health, health, Drugs and Medications, Drug interaction, Behind the CurtainJeffrey Sterling, MD

Have you ever seen the individual with a small ‘army’ of medications? Think about it. The more medications one takes, the more likely drug interactions will ensue and changes in effectiveness in any single medication may occur. This effect incrementally increases with each additional drug one takes. Similarly, the more medications one is taking, the most likely one is to make a mistake in taking the correct medication at the right time. Now consider your independently living parents or grandparents. The elderly often are more prone to make these types of errors.
What can you do about this? Get organized, and get help! Those daily medication containers are good solutions to incorrectly dosing medications. If you’re especially organized, a log is great—not necessarily for you, but for the physician that will be trying to figure out why you’re dizzy or have an altered mental status if and when that occurs.
Talk with each doctor you see or a pharmacist about what to expect from the combination of medications you take; it can make your lives a lot less complicated.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Do Medications Work Differently in Older People?

February 28, 2016General Health and Wellnesshealth, Drugs and Medications, Drug interaction, Drug, Behind the Curtain, mental-health, Straight No Chaser, SterlingMedicalAdvice.com, Sterling Medical Advice, Pharmacy, Pharmaceutical drug, Old ageJeffrey Sterling, MD

Have you ever seen the individual with a small ‘army’ of medications? Think about it. The more medications one takes, the more likely drug interactions will ensue and changes in effectiveness in any single medication may occur. This effect incrementally increases with each additional drug one takes. Similarly, the more medications one is taking, the most likely one is to make a mistake in taking the correct medication at the right time. Now consider your independently living parents or grandparents. The elderly often are more prone to make these types of errors.
What can you do about this? Get organized, and get help! Those daily medication containers are good solutions to incorrectly dosing medications. If you’re especially organized, a log is great—not necessarily for you, but for the physician that will be trying to figure out why you’re dizzy or have an altered mental status if and when that occurs.
Talk with each doctor you see or a pharmacist about what to expect from the combination of medications you take; it can make your lives a lot less complicated.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: When Good Drugs Do Bad—Drug Interactions

December 30, 2013Toxicology/DrugsPrescription medication, WordPress, Substance abuse, Straight No Chaser, SterlingMedicalAdvice.com, Sterling Medical Advice, Pharmacy, Pharmaceutical drug, health, Facebook, Drug interaction, Drug, Benadryl, Adverse effectJeffrey Sterling, MD

“Be sure to let your doctor know if you grow a third foot.”
Ok, well maybe that is about the only side effect you haven’t heard at the end of one of those commercials that seem to spend half of its time describing the side effects. If you pay attention to a pharmaceutical commercial, though, you’ll appreciate that even though medicines do a world of good, sometimes they cause significant problems. Those problems can become sped up or magnified by the effects of taking several drugs at a time. Alternatively, combinations of medications may make one or more of the drugs less effective. Regarding the medicines you’re taking, you should be clear if drug interactions can be minor and insignificant or serious and life-threatening. Let’s review the various types of drug interactions.

Drug/drug interactions: Two or more different drugs taken together may interact and cause an unwanted effect or change how the drug acts in the body. Here are some common examples:

An individual who already takes a sedative (e.g., sleeping pill) to help combat insomnia develops an exacerbation of their seasonal allergies. To treat the allergies, they decide to take an over-the-counter (OTC) antihistamine (like diphenhydramine, branded as Benadryl). Diphenhydramine also may cause drowsiness, so the combination of the medications may pose a danger to the person, especially if s/he is operating heavy machinery, such as driving a car.
Caffeine (which is a drug) in everyday foods—such as coffee and chocolate—also can interact with certain other drugs. In fact, caffeine is known to interact with over 80 different drugs, including about a dozen with which it produces serious effects. These include commonly used medications like aspirin, ciprofloxacin (branded as Cipro), guafenesin (the generic name for your favorite cough medicines) and diazepam (branded as Valium).
Nicotine (another drug) in tobacco products can interact with other medications, especially nicotine-replacement products. So if you’re taking medicine to help with your smoking cessation efforts, and you’re still smoking, you’re making the problem worse!

Drug/food interactions: If you’re a fan of grapefruit or chocolate, then it’s likely that your physician has cautioned you on drug/food interactions. These occur when certain foods or beverages interfere with the metabolism of certain medications. In the example of grapefruit, it’s known to interfere with metabolism of medications used to lower cholesterol levels (called statins). This can lead to adverse drug effects and actual liver damage. Other examples are to be found in the many foods (e.g., red wine, aged cheese) that affect the antidepressant class of drugs known as MAO inhibitors.
Drug/condition interactions: You see these all the time. Many different medication instructions warn you not to take them if you have certain medical conditions, as the medications may make the medical condition worse. Prominent examples include over-the-counter cold, cough and flu remedies that advise you not to take if you have heart disease or high blood pressure. Also if you have kidney or liver disease, any medicine that gets metabolized via one of those routes may have difficulty and delays in getting metabolized and excreted, leading to longer than desired activity of the given drug.
Drug/alcohol interactions: This is actually a subcategory of the drug/drug interaction because alcohol is a drug. It deserves special mention because drinking alcohol while taking certain medications can cause adverse effects related to the additive effects of alcohol and various drugs. Any medication involving the central nervous system or one’s mental state would likely be worsened by alcohol.
The best way to guard against these concerns is to discuss any new medications with your physician or pharmacist prior to taking them. Be smart about medicines you’re putting in your body and don’t be cavalier about them; the wrong combinations can turn a medicine into a toxin.
One final note: don’t be lulled into complacency by herbal preparations as some form of replacement. Herbals are still medicines and work via the same active ingredient as the pharmaceutical drug they’re replacing. As such, they are subject to cause the same types of problems listed above. Even more concerning is that as a class, comparatively less research has been done on herbals. Therefore, the full extent of side effects and drug interactions is not defined. Not knowing the full extend of an herbal medicine’s side effect profile isn’t the same as saying the herbal doesn’t have side effects, and you shouldn’t interpret things that way.
Feel free to contact your SMA expert consultant for any questions you may have on this topic.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

What's the difference between phenylephrine and pseudoephedrine?

December 8, 2013Toxicology/DrugsSterling Medical Advice, Sudafed, Straight No Chaser, SterlingMedicalAdvice.com, Pseudoephedrine, Phenylephrine, Pharmacy, Nasal congestion, Hypertension, health, DecongestantJeffrey Sterling, MD

Unlike many things, this is a distinction with a difference, and one you should know. Both pseudoephedrine and phenylephrine are decongestants used to treat nasal congestion due to colds and allergies and other upper respiratory tract nuisances. The issue is pseudoephedrine can be made into methamphetamine. As a result, the U.S. Senate passed a bill restricting its sale. Pseudoephedrine products can still be purchased in limited quantities, but certain restrictions and other requirements are in place. In some states this includes requiring a prescription.
Regarding the difference between the two drugs, no studies have been done to confirm whether these two decongestants are equally effective, so we’re left to look at the chemical effects to judge.
There are some differences in the way the drugs are absorbed by the body:

The intestines will absorb only about 1/3 of the amount of phenylephrine in one tablet, while pseudoephedrine is 100% absorbed.
Phenylephrine’s effects do not last as long as those of pseudoephedrine. As a result, phenylephrine needs to be taken every four hours, while pseudoephedrine can be taken every four to six hours.

If you are considering trying either medication, discuss it with your physician or SMA consultant first. People with certain medical conditions such as diabetes, heart disease, high blood pressure, and overactive thyroid should not take products containing either of these ingredients. Also, people taking propranolol or certain antidepressants should avoid using these products.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Do medications work differently in older people?

December 7, 2013Geriatrics/Elderly CareStraight No Chaser, Drug interaction, SterlingMedicalAdvice.com, Sterling Medical Advice, Pharmacy, Pharmaceutical drug, Old age, mental-health, health, Drugs and Medications, DrugJeffrey Sterling, MD

The elderly are living longer and more productively. Part of being able to do so is by maintaining an understanding of how your actions affect you. One common action of many of the elderly is taking medications. You should be aware that medications have changing effects with aging, and there are many different reasons for that fact.
First of all, changes in our physiology due to aging make the effects of drugs less predictable and consistent than in younger people. A slower metabolism, increases in body fat and alterations in the function of the kidney and liver (major mechanisms for drug elimination) have important ramifications for what ingested substances will do. Thus, the elderly require more stringent monitoring of drug levels and effects, and you may find that your physician needs to adjust medication doses. This same consideration explains why side effects are more common among the elderly.
Be reminded the presence of other diseases brings additional effects and challenges. Just as with one’s own relatively diminished function, disease imposes the same type of changes onto the body. This can speed the presence of side effects and toxicity as well as adjust the effective dose of a medication.
Have you ever seen the individual with a small ‘army’ of medications? Think about it. The more medications one takes, the more likely drug interactions will ensue and changes in effectiveness in any single medication may occur. This effect incrementally increases with each additional drug one takes. Similarly, the more medications one is taking, the most likely one is to make a mistake in taking the correct medication at the right time. Now consider your independently living parents or grandparents. The elderly often are more prone to make these types of errors.
What can you do about this? Get organized, and get help! Those daily medication containers are good solutions to incorrectly dosing medications. If you’re especially organized, a log is great—not necessarily for you, but for the physician that will be trying to figure out why you’re dizzy or have an altered mental status if and when that occurs.
Talk with each doctor you see or a pharmacist about what to expect from the combination of medications you take; it can make your lives a lot less complicated.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

From the Health Library of SterlingMedicalAdvice.com: "Is It OK to Take Leftover Antibiotics to Treat a Current Infection?"

October 21, 2013Health Prevention, General Health and WellnessAntibiotic resistance, Antibacterial, Facebook, WordPress, Twitter, Sterling Medical Advice, Pharmacy, Infection, healthJeffrey Sterling, MD

You should never use any leftover antibiotics to treat a current infection. The various antibiotics that are available are effective only against specific bacteria, so do not assume that the old medication will take care of your current infection. Your physician should determine the cause of your infection and prescribe appropriate treatment.
It also is important to note that any time your doctor prescribes an antibiotic, you should take all the medicine you are given on the schedule your doctor provides—even when you start to feel better. Unless your doctor tells you to discontinue the antibiotic, you should not have any left over. Not finishing the prescription means some bacteria could survive and possibly come back even stronger. The surviving bacteria can then become resistant to the antibiotic, make the infection worse, and make it harder to treat.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
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