An expert is a man who has made all the mistakes which can be made in a very narrow field.

Niels Bohr

How to evaluate health information

The Internet has changed the way we live, work and shop. The growth of the Internet has made it possible to compare prices and buy products without ever leaving home. But when it comes to buying medicine online, it is important to be very careful. Some websites sell medicine that may not be safe to use and could put your health at risk.

Be sure your privacy is protected: look for privacy and security policies that are easy-to-find and easy-to-understand. Don't give any personal information such as social security number, credit card, or medical or health history, unless you are sure the website will keep your information safe and private.

Make sure the site requires a prescription and has a pharmacist available for questions.

Precautions for over-the-counter medicine

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.

Drug interactions may make your drug less effective, cause unexpected side effects, or increase the action of a particular drug. Some drug interactions can even be harmful to you.

It used to be that the only way to test for drug interactions was in people. Now drug companies can take five test tubes with the five major pathways for metabolism and put their drugs in to see whether it's metabolized by CYP450. This allows to generate a list of possible interactions based on their findings.

This phase of research in test tubes, known as in vitro studies, allows researchers to perform drug-interaction studies in labs by testing a drug with other drugs that have the same route. This has made the research faster and more accurate. If two drugs go through the same enzyme, the presence of one drug can prevent the metabolism of the other. So this allows you to look at the worst-case scenarios and ask: 'What if we put this drug with that one, knowing that they have the same route?'"

Not everything that happens in a test tube will become meaningful in humans, though. Results from these test-tube studies can tell us whether need to do further testing in people to find out if an interaction is clinically significant.

Three phases of clinical trials in humans must happen before a drug can be marketed. Phase 1 studies focus on a drug's side effects and how the drug is metabolized and eliminated from the body. Phase 2 studies focus on a drug's effectiveness. And Phase 3 studies gather more information on safety and effectiveness, which includes using the drug in combination with other drugs.

Researchers say there are several important variables that affect individual differences in how drugs are metabolized, including race, gender, age, and health conditions. For example, people with kidney or liver disease don't eliminate drugs from their system as well as people who are healthy. Very young children and older people have slower drug metabolism than others, and women may metabolize drugs differently than men in some cases.

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.

Some antibiotics, such as rifampin, can lower the effectiveness of birth control pills. Sildenafil, the active ingredient in the erectile dysfunction drug Viagra, should not be taken with nitrates for heart treatment because of the potential for dangerously low blood pressure.

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.

Some specific ways to obtain the full benefits of medicines

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.

Before using any medicine--as with many things that you do every day--you should think through the benefits and the risks in order to make the best choice for you.

The same is true before using any medicine. Every choice to take a medicine involves thinking through the helpful effects as well as the possible unwanted effects.

In many situations, the expert advice of your doctor, pharmacist, or other health care professionals can help you make the decision.

You need keep an up-to-date, written list of ALL of the medicines (prescription and over-the-counter) and dietary supplements, including vitamins and herbals, that you use--even those you only use occasionally.

Important things is tell to your doctor about any allergies or sensitivities that you may have. Tell about anything that could affect your ability to take medicines, such as difficulty swallowing or remembering to take them.

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.

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.

Before starting any new medicine or dietary supplement (including vitamins or herbal supplements), ask your doctor again if there are possible interactions with what you are currently using.

You always have to pay attention to how you are feeling; note any changes. Write down the changes so that you can remember to tell your doctor, pharmacist, or other health care professional.

You have to know what to do if you experience side effects and when to notify your doctor, and know when you should notice an improvement and when to report back.

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