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TAKING OVER-THE-COUNTER DRUGS: DRUG INTERACTIONS
Sharing medications, using outdated prescriptions, taking higher doses than recommended or using medications as a substitute for dealing with personal problems may result in serious health consequences. But so may engaging in poly-drug use: taking several medications or illegal drugs simultaneously may result in very dangerous problems associated with drug interactions. The most hazardous interactions are synergism, antagonism, inhibition and intolerance.
A synergistic interaction is most likely to occur when central nervous system depressants are combined. Included in this category are alcohol, opiates (morphine, heroin), antihistamines (cold remedies), sedative hypnotics (Quaaludes), minor tranquilizers (Valium, Librium, and Xanax), and barbiturates.
The worst possible combination is alcohol and barbiturates (sleeping preparations such as Seconal and Phenobarbital) because the combination of these depressants leads to a slowdown of the brain centers that normally control vital functions. Respiration, heart rate, and blood pressure can drop to the point of inducing coma and even death.
Prescription drugs carry special labels warning the user not to combine the drug with certain other drugs or with alcohol. Many OTC (over-the-counter) preparations carry similar warning labels. Because the dangers associated with synergism are so great, you should always verify any possible drug interactions before using a prescribed or OTC drug. Pharmacists, physicians, drug information centers, or community drug education centers can answer your questions. Even if one of the drugs in question is an illegal substance, you should still attempt to determine the dangers involved in combining it with other drugs. Health care professionals are legally bound to maintain confidentiality even when they know that a client is using illegal substances.
Antagonism, although not usually as serious as synergism, can produce unwanted and unpleasant effects. In an antagonistic reaction, drugs work at the same receptor site so that one drug blocks the action of the other. The \"blocking\" drug occupies the receptor site, preventing the other drug from attaching, and this creates alterations in absorption and action.
Inhibition is a type of interaction in which the effects of one drug are eliminated or reduced by the presence of another drug at the receptor site. One common inhibitory reaction occurs between antacid tablets and aspirin. The antacid inhibits the absorption of aspirin, making it less effective as a pain reliever. Other inhibitory reactions occur between alcohol and contraceptive pills and between antibiotics and contraceptive pills. Alcohol and antibiotics may diminish the effectiveness of birth control pills for some women.
Intolerance occurs when drugs combine in the body to produce extremely uncomfortable reactions. The drug Antabuse, used to help alcoholics give up alcohol, works by producing this type of interaction. It binds liver enzymes (the chemicals the liver produces to break down alcohol), making it impossible for the body to metabolize alcohol. As a result, the user of Antabuse who drinks alcohol experiences nausea, vomiting, and, occasionally, fever.
Cross-tolerance occurs when a person develops a physiological tolerance to one drug and shows a similar tolerance to selected other drugs as a result. Taking one drug may actually increase the body\'s tolerance to another drug. For example, cross-tolerance can develop between alcohol and barbiturates, two depressant drugs.
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GENERAL HEALTH
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