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Millions of consumers are using the Internet to get health information. And thousands of web sites are offering health information. Some of those sites are reliable and up-to-date; some are not. How can you tell the good from the bad? Some websites that sell medicine can be not state-licensed pharmacies or aren't pharmacies at all; or may give a diagnosis that is not correct and sell medicine that is not right for you or your condition; or won't protect your personal information. Make sure the site requires a prescription and has a pharmacist available for questions.
There are more opportunities today than ever before to learn about your health and to take better care of yourself. It is also more important than ever to know about the medicines you take. If you take several different medicines, see more than one doctor, or have certain health conditions, you and your doctors need to be aware of all the medicines you take. Doing so will help you to avoid potential problems such as drug interactions. Mixing two drugs together could make one of the drugs ineffective. The combination also could increase a drug's effect, and be harmful. The result might be mild symptoms such as nausea, stomach upset, or headache, or more serious symptoms such as a dramatic drop in blood pressure, irregular heart beat, or damage to the liver-the primary way that drugs pass through the human body. When a drug is taken orally, it usually travels from the stomach to the liver, where it can be metabolized-the process of breaking down and removing chemicals from the body. Enzymes are complex proteins that act as catalysts in starting or speeding up chemical reactions. They cause a specific chemical change in other substances without being changed themselves. A drug may affect these enzymes by inhibiting them, which causes reduced activity of the enzyme and a buildup of the drug in the body. Or drugs may "induce" the enzymes, which causes increased activity of the enzyme and a reduction of the drug in the body. In addition to having a good grasp of drugs and their effects, doctors take medication histories, and they consult with other members of their team to guide them in making decisions about drug interactions. They also use concise drug summaries and resources on pharmacological principles. Health professionals also use computer systems with drug-interaction screening software, electronic prescribing, and other technology. Mark Langdorf, M.D., chair of the department of emergency medicine at the University of California, Irvine, says, "In a busy emergency room, you have to quickly find out what a patient is taking and how those drugs could interact with other treatments." The large number of drugs on the market, combined with the common use of multiple medications, makes the risk for drug interactions significant. Consumers need to tell doctors what they're taking and ask questions, and health professionals could do a better job at trying to get the information they want. So rather than asking patients what medications they take, doctors should make the questions specific: "Are you taking any over-the-counter medication? Are you taking any herbal treatments or vitamins?" Drug interactions with other drugs includes both prescription and over-the-counter medicines. Tricyclic antidepressants such as Elavil (amitriptyline) and Pamelor (nortriptyline) can interfere with blood pressure-lowering Catapres (clonidine). Taking the antibiotic Cipro (ciprofloxacin) with antacids lowers Cipro's effectiveness. Drug interactions with dietary supplements includes herbs and vitamins, which can interact with drug-metabolizing enzymes. St. John's wort is an herb commonly used by people with cancer to improve mood, but research has shown it interferes with the metabolism of irinotecan, a standard chemotherapy treatment. Vitamin K (in dietary supplements or food) produces blood-clotting substances that may reduce the effectiveness of blood-thinning medicines like warfarin. Drug interactions with food and beverages, for example, taking quinolone antibiotics such as ciprofloxacin with food and drinks such as colas, coffee, and chocolate that contain caffeine may cause excitability and nervousness. There can be a potentially fatal increase in blood pressure if food containing tyramine is eaten when taking monoamine oxidase inhibitors, drugs that treat mood disorders.
Although medicines can make you feel better and help you get well, it's important to know that all medicines, both prescription and over-the-counter, have risks as well as benefits. The benefits of medicines are the helpful effects you get when you use them, such as lowering blood pressure, curing infection or relieving pain. The risks of medicines are the chances that something unwanted or unexpected could happen to you when you use them. Risks could be less serious things, such as an upset stomach, or more serious things, such as liver damage. To obtain the benefits of riding in a car, you think through the risks. You consider the condition of your car and the road, for instance, before deciding to make that trip to the store. The benefit and risk decision is sometimes difficult to make. The best choice depends on your particular situation. You must decide what risks you can and will accept in order to get the benefits you want. In many situations, the expert advice of your doctor, pharmacist, or other health care professionals can help you make the decision. You have to always tell your doctor if you are or might become pregnant, or if you are nursing a baby. Always ask questions about any concerns or thoughts that you may have. Before use a medicine make sure you understand the directions; ask your doctor if you have questions or concerns. Always double check that you have the right medicine. Read and follow the directions on the label and the directions from your doctor, pharmacist, or other health care professional. If you stop the medicine or want to use the medicine differently than directed, consult with your health care professional. Ask your doctor always if there are interactions with any other medicines or dietary supplements (including vitamins or herbal supplements), beverages, or foods. Use the same pharmacy for all of your medicine needs, whenever possible.
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