Things That Can Affect Medications

Some Things Don’t Mix Well

You may know that some medicines don’t work well together.  But what you eat and drink can have an effect on some drugs, too.  Before you take a medication for the first time, talk with your doctor or pharmacist to see if there’s anything you should stay away from.

Grapefruit

This citrus fruit changes the way certain cells in your gut take in and move medication through your body – it can affect more than 50 drugs.  It can make  some, like fexofenadine (Allegra) for allergies, less effective and make others too strong, including ones that lower your cholesterol like atorvastatin (Lipitor0.

Milk

This dairy product can make it harder for your body to process certain antibiotics.  Minerals in milk like calcium and magnesium are part of the reason, along with the protein casein.  If you’re taking antibiotics, make sure to find out about the foods or beverages you should stay away from.

Licorice

Some people use this a an herbal remedy to help with digestion, and others use it flavor foods.  But glycyrrhizin, a chemical in licorice, can weaken the effect of some drugs, including cyclosporine, used to keep people who’ve had transplants from rejecting their new organs.

Chocolate

Dark chocolate in particular can weaken the effects of drugs meant to calm you down or make you sleep, like zolpidem tartrate (Ambien).  It also can boost the power of some stimulant drugs, like methylphenidate (Ritalin).  And if you take an MAO inhibitor, used to treat depression, it can make your blood pressure dangerously high.

Iron Supplement

This can lower the effects of levothyroxine (Synthroid), a medicine that gives you thyroid hormone when your body doesn’t make enough (a condition called hypothyroidism).  If you take this medicine and a multivitamin, check to see if the vitamin has iron in it.  If you need an iron supplement, ask your doctor about taking it and your medication at different times.

Alcohol

This makes certain drugs less effective or even useless, including blood pressure and heart medicines.  It also can make others stronger than they should be or cause dangerous side effects.

Coffee

It can weaken antipsychotic drugs like lithium and clozapine, but boost the effects – and side effects – of others.  Those include aspirin, epinephrine (used to treat serious allergic reactions), and albuterol (taken by inhaler for breathing problems).  It can also make it harder for your body to take in and use iron.

Antihistamines

Those help with the sneezing and runny nose caused by allergies, but some of them can make medication for high blood pressure less effective and raise your heart rate.  Talk to your doctor about others ways to manage your allergies if you take blood pressure medicine.

Anti-Epileptic Drugs (AEDs)

These control seizures in people who have epilepsy.  But AEDs can make birth control pills less able to prevent pregnancy, and early research shows they may make other drugs stronger and cause potentially serious side effects.

Vitamin K

If you take the drug warfarin – used to treat and prevent blood clots – be aware of how much vitamin K you take in.  it can make the blood thinner less effective and put you at higher risk of a dangerous blood clot.  Broccoli, Brussels sprouts, kale, parsley, and spinach are some of the most common foods high in vitamin k.  Try to eat the same amount of these foods every day so the level of warfarin in your blood stays the same.

Ginseng

This can lower of the effects of warfarin, too.  And it can make you more likely to have internal bleeding if you take the blood thinners heparin or aspirin, as well as nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen.  If you take MAO inhibitors, ginseng can cause headaches, sleep problems, hyperactivity, and nervousness.

St. John’s Wort

Sometimes used to help people with depression, this herbal remedy isn’t a proven treatment for that or any other health condition.  It can make your liver release enzymes (things that boost certain chemical reactions in your body) that can weaken some medications.  Those include cholesterol drugs like lovastatin (Altoprev and Mevacor), the erectile dysfunction drug sildenafil (Viagra), and digoxin (Lanoxin), used to treat certain heart conditions.

Ginkgo Biloba

Some people use this herb to help with or prevent high blood pressure, dementia, ringing in the ears (tinnitus), and other conditions, but there’s no research that shows it does any of that.  It can weaken the effect of drugs used to control seizures, including carbamazepine (Carbatrol, Equetro, and Tegretol), and valproic acid (Depakene, Depakote, and Stavzor).

Take as Directed

Only about 50% of medication is taken as it’s prescribed.  People often take less than they need, take it at random times, or leave bug gaps between doses – all of which can weaken the effects.  Make sure you understand your treatment plan and follow your doctor’s instruction.

The Truth about Hormone Therapy

A Time of Change

 Menopause marks the end of a woman’s fertile years and her menstrual cycle.  But you don’t get there overnight.  Estrogen and other hormones start dropping off anywhere from 4 to 8 years before your last period.  As that happens, some women have hot flashes, night sweats, and pain during sex.  Others have sleep trouble, headaches, or mood changes.  Hormone replacement therapy (HRT) is designed to help with those.

What Is HRT?

Its hormones your doctor prescribes to replace or supplement the ones your body doesn’t make anymore.  Most women who use it take a combination of estrogen and progesterone.  Estrogen is what helps most with symptoms like hot flashes and vaginal dryness; progesterone is added to protect against uterine cancer and bone loss (osteoporosis).

Different Types

HRT can be “systemic,” meaning the drug travels through your bloodstream, or “local,” meaning it only affects one area of your body.  Systemic HRT can help with hot flashes, night sweats, and vaginal symptoms like dryness and pain during sex.  It comes in pills, patches, gels, sprays, and shots.  If you main issue is vaginal discomfort, local HRT – creams, rings, or tablets you put in your vagina – might be a better option.

Side Effects

Some women who use HRT say they feel bloated or have breast soreness.  Nausea, dizziness, headaches, and blurry vision are also possible side effects, as is vaginal bleeding.  If you haven’t had a period for at least a year and have any bleeding or spotting, tell your doctor.

Things to Consider

While HRT works well to ease menopausal symptoms, a study by the Women’s Health Initiative found that it can make some women more likely to have certain health conditions.  Those include heart disease, stroke, and breast cancer.  HRT can also raise your chances of blood clots called deep vein thrombosis, or DVT.

Lower Your Chances of Issues

If you and your doctor decide HRT is right for you, you should use the lowest dose that works for you for the shortest amount of time.  Many of the serious problems linked with HRT have been tied to using it for a long time.  But using them at a low dose for 3 to 5 years may help protect you from some health issues like bone loss.

Who Shouldn’t Use HRT?

Generally, women who have had a type of breast cancer that’s fueled by hormones shouldn’t use HRT.  Your doctor also may advise against it if you have a history of blood clots, heart disease, or stroke.

What Are “Bioidenticals”?

“Bioidentical” means a drug has the same chemical and molecular structure as the hormones in your body.  Some people call these hormones “natural,” but they’re made in a lab not found in nature.

Custom Compounds

Some doctors will take a sample of your saliva to check your hormone levels, and then prescribe a custom blend made by a special kind of pharmacy called a compounding pharmacy.  While a personalized formula might sound like a good thing, these aren’t regulated by the FDA the way regular prescription drugs are.  That means they haven’t been tested for safety or to make sure they work well.

Other Options

If you’re looking for drug-free help for hot flashes and night sweats, try cutting back on caffeine and hot beverages, lowering the thermostat, and wearing lightweight, breathable clothes.  Deep breathing, tai chi, yoga, or meditation might help, too.  You also might ask your doctor about antidepressants.  Research has shown that venlafaxine (Effexor), for example, may help.  For vaginal discomfort, try lubricants and vaginal moisturizers.

Supplements

There’s not much proof that dietary supplements like soy, black cohosh, or DHEA ease menopausal symptoms.  There are also some risks:  Black cohosh, for example, carries a rare chance of liver damage.  Always talk with your doctor before trying any supplements to make sure it won’t affect anything else you take.

Men and HRT

Men don’t go through menopause, but their hormone levels do get lower with age.  While some people think supplemental testosterone can make men look and feel younger, most experts don’t recommend it for ‘anti-aging” purposes.  Studies haven’t shown that it works or is safe, and it may raise the chances of cardiovascular disease.

Questions for Your Doctor

Everyone is different, so you’ll need to work closely with your doctor to figure out if HRT is right for you.  Some things to talk about include:

·         Is it safe for me to try HRT?

·         Is local or systemic HRT a better option for me?

·         How long can I safely use it?

·         What side effects might I have, and what should I do about them?

·         If I choose not to choose HRT, what else can I do to help with my symptoms?

Pandemic Has Overburdened Parents Stressed Out

By Robert Preidt

If there’s such a thing as a “new normal” during the coronavirus pandemic, it’s a constant state of stress.

And it’s particularly intense for many parents who are keeping house, working from home, and trying to keep their kids’ online learning on track at the same time, according to a new online survey.

Nearly half (46%) of respondents who have kids younger than 18 said their average stress level is high these days.  Only 28% of adults without minor children said the same, according to the online poll of more than 3,000 adults.  It was conducted from April 24 to May 4.

The 2020 Stress in America poll is the first of at least three planned to gauge pandemic-related stress.

“The mental health ramifications of the coronavirus pandemic are immense and growing,” said Arthur Evans, Jr., chief executive officer of the American Psychological Association (APA), which sponsored the poll.

Other key findings;

·         With schools closed, nearly three-quarters (71%) of parents said managing distance/online learning for their kids is a significant source of stress.

·         Basic needs such as access to food and housing are more likely to be significant stress for parents than for non-parents (70%) versus 44%).

·         Two-thirds of parents said they are stressed out about access to health care services, compared to 44% on non-parents. They’re also more upset about missing major milestones, such as weddings and graduations (63% for parents versus 43% for others).

While parents may be overwhelmed by the competing demands of a job, homeschooling and possible financial setbacks from the pandemic, Evans emphasized that their kids are taking note.

“Children are keen observers and often notice and react to stress or anxiety in their parents, caregivers, peers and community,” he said.  “Parents should prioritize their self-care and try their best to model healthy ways of coping with stress and anxiety.”

Seven out of 10 respondents called the current economy a significant source of stress – compared to 46% in last year’s poll.  Seventy percent also pointed to work as a significant stressor, compared with 64% in 2019.

APA said current stress levels are similar to those during the Great Recession of 2008.

And people of color seem to be especially hard hit by pandemic-related worries, the poll showed.

That includes fear of getting the coronavirus (71% versus 59% of whites); being able to meet basic needs (61% versus 47%); and access to health care services (59% versus 46%).

About 2 in 5 Hispanic adult said their average level of pandemic-related stress during the past month was between 8 and 10 on a 10-point scale.

Hispanic adults were most likely to say they constantly or often feel stress due to the pandemic (37%).  That compares to 32% of whites, 32% of blacks, 31% of Native Americans and 28% Asians.

Evans described the findings as a call to action.

“We need to prepare for the long-term implications of the collective trauma facing the population,” he said in an APA news release.  “On an individual level, this means looking out for one another, staying connected, keeping active and seeking help when necessary.”

Source:  http://www.webmd.com/pandemic-has-overburdened-parents-stressed-out/

Medications Seniors Should Use With Caution

Why Age Makes a Difference

It’s no secret that when you get older, your body doesn’t work the way it used to.  And that’s true for how you react to medicine.  Your digestive system might not absorb medications as quickly.  Liver problems might mean the drug builds up in the bloodstream or doesn’t get into it as fast as it should.  And kidney trouble could affect how well medicine moves out of your body as waste.  Ask your doctor about the impact of your meds as you age.

Over-the-Counter Painkillers

Non-steroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, aspirin, and naproxen, can keep some prescription medications you take from working the way they should.  They’re often not a good combo with blood thinners, diabetes drugs, diuretics, or blood pressure drugs.  NSAIDs are also rough on major organs when your body gets older, such as your kidneys, liver, heart, and the digestive system.

Muscle Relaxants

Your doctor may suggest these drugs to ease muscle spasms.  Muscle relaxants like cyclobenzaprine (Flexaril), methocarbamol (Robaxin), and carisoprodol (Soma) can have side effects like feeling woozy and confused.  That could raise your chances of falling and hurting yourself.

Certain Diabetes Drugs

Long-acting sulfonylurea drugs for diabetes, such as chlorpropamide (Diabinese) and glyburide (DiaBeta, Glynase), can cause low blood sugar, a condition called “hypoglycemia.”  You might get confused, shaky, sweaty, hungry, and tired.  If the condition is severe or long-lasting, it can cause seizures and, in rare cases, could be life-threatening.

Antihistamines

If you have hay fever, your doctor may suggest over-the-counter drugs called antihistamines.  They can keep you from sneezing, but some come with more side effects than others.  Some antihistamines may leave older adults extra drowsy and confused, which raises your chances of a taking a tumble.

Certain Sleep Aids

Drugs that help you go to sleep can cause problems when you wake up.  You might feel groggy and have trouble with balance when you get out of bed in the morning.  Your ability to think clearly might be affected.  Diphenhydramine, the main ingredient in many sleeping pills, can also lead to dry mouth, blurred vision, and bladder problems.

Anxiety Medication

Benzodiazepines are drugs that treat anxiety.  They include diazepam (Valium), alprazolam (Xanax), and chlordiazepoxide (Librium).  Some of these medications stick around in your system a lot longer than others.  Their side effects, like confusion, can last past the day you take them and raise your chances of falling.

Anticholinergics

Your doctor may prescribe these drugs to help treat conditions like Parkinson’s disease, irritable bowel syndrome, and depression.  But anticholinergics can cause confusion, dry mouth, and blurry vision, especially in older adults.  In older men, they are more likely to cause problems with peeing.

Tricyclic Antidepressants

 They’re an older class of drugs that doctors don’t prescribe often.  But if you take tricyclics, such as amitriptyline and imipramine, keep in mind they have side effects that can be worse in older adults.  These include problems like constipation, irregular heartbeat, blurry vision, confusion, memory trouble, and dry mouth.  Men could have problems with peeing.

Antipsychotics

These drugs treat mental disorders, such as schizophrenia and bipolar disorder, and are risky for some older adults.  Taking antipsychotics raises your chances of a life-threatening heart problem or a brain bleed if you have dementia.

Cimetidine (Tagamet)

It’s an over-the-counter treatment for heartburn, indigestion, and ulcers.  If you’re an older adult and take this medicine, it can have side effects like confusion, even at regular doses.

Combination Drugs

Look carefully at the labels of over-the-counter medicines to see if they have more than one active ingredient.  Some cold and sinus medications, for example, have decongestants along with antihistamines.  The combination can make you confused, drowsy, and groggy.  It can also raise your blood pressure and cause problems going to the bathroom.

Laxatives

A lot of older folks take medications to help ease constipation.  But it isn’t wise to take some medicine, like bisacodyl (Dulcolax), as long-term, regular treatment.  Over time, laxatives can cause permanent problems with your bowels.