Adverse Medical Reactions

waltky · Nov 26, 2012

Granny says, "Hold up on that grapefruit at breakfast...

Grapefruit and pills mix warning
26 November 2012 - Doctors have warned of a "lack of knowledge" about the dangers of mixing some medications with grapefruit.

The fruit can cause overdoses of some drugs by stopping the medicines being broken down in the intestines and the liver. The researchers who first identified the link said the number of drugs that became dangerous with grapefruit was increasing rapidly. They were writing in the Canadian Medical Association Journal.

The team at the Lawson Health Research Institute in Canada said the number of drugs which had serious side effects with grapefruit had gone from 17 in 2008 to 43 in 2012. They include some drugs for a range of conditions including blood pressure, cancer and cholesterol-lowering statins and those taken to suppress the immune system after an organ transplant. Chemicals in grapefruit, furanocoumarins, wipe out an enzyme which breaks the drugs down. It means much more of the drug escapes the digestive system than the body can handle.

Toxic

Three times the levels of one blood pressure drug, felodipine, was reported after patients had a glass of grapefruit juice compared with a glass of water. The side effects are varied depending on the drug, but include stomach bleeds, altered heart beat, kidney damage and sudden death. Dr David Bailey, one of the researchers, told the BBC: "One tablet with a glass of grapefruit juice can be like taking five or 10 tablets with a glass of water and people say I don't believe it, but I can show you that scientifically it is sound. "So you can unintentionally go from a therapeutic level to a toxic level just by consuming grapefruit juice."

The report said: "We contend that there remains a lack of knowledge about this interaction in the general health care community." They added: "Unless health care professionals are aware of the possibility that the adverse event they are seeing might have an origin in the recent addition of grapefruit to the patient's diet, it is very unlikely that they will investigate it." Other citrus fruits such as Seville oranges, often used in marmalade, and limes have the same effect.

Neal Patel, from the Royal Pharmaceutical Society said: "Grapefruit isn't the only food that can cause issues, for example milk can stop the absorption of some antibiotics if taken at the same time. "Although some of these interactions may not be clinically significant, some may lead to more serious outcomes. "Pharmacists are the best port of call for anyone concerned about how their diet may affect their medication. Information about any interactions would always be included in the patient information leaflet that comes with the medicine."

http://www.bbc.co.uk/news/health-20497086
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waltky · Nov 30, 2012

Now Granny lets Uncle Ferd use grapefruit for target practice...

More Drugs Found to Interact Dangerously with Grapefruit
November 30, 2012 - The number of prescription drugs that can have serious adverse side effects when interacting with grapefruit is on the rise, yet many physicians may be unaware of these effects, according to a study in the Canadian Medical Association Journal.

Between 2008 and 2012, researchers say, new drugs capable of adverse interactions arrived on the market annually, driving the total number of medications now known to have side effects when taken with grapefruit from 17 to 43. According to David Bailey, a clinical pharmacologist at the Ontario-based Lawson Health Research Institute, grapefruit contains an enzyme called CYP23A4, which can interact with some medications in the gastrointestinal tract, reducing their effectiveness or raising their potency in the blood stream to dangerously high levels.

Drugs affected by the interaction with grapefruit include cholesterol-lowering medications and some that reduce high blood pressure. Although many drug manufacturers put warnings about interactions with grapefruit on their labels, Bailey says many doctors are not aware of them. Thats our big concern," he said, "that this information needs to get out to the practicing clinicians so that they manage use of these drugs properly in their clinical practice.

All of the drugs that can be affected by grapefruit juice are taken by mouth. Normally, says Bailey, only a small amount of the pills active ingredients enters the bloodstream after theyre swallowed. But he says the drug levels can rise dangerously if grapefruit is consumed, because of the interaction with CY23A4 in the stomach. This is a normal amount of grapefruit juice, were not talking about liters of grapefruit juice here," he says. "But levels can be boosted from the level we want in the body to therapeutic levels that are what we would consider to be high and toxic.

According to Bailey, the interactions between grapefruit juice and some drugs can cause bleeding in the gastrointestinal tract, respiratory failure and sudden death even a long time after the fruit or fruit juice is consumed. Bailey says people should ask their doctor or pharmacists whether its OK to consume grapefruit or grapefruit juice with a particular drug.

Source
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waltky · Feb 13, 2013

Monitoring kidney tumors vs. surgery...

Study questions kidney cancer treatment in elderly
Feb 12,`13 - In a stunning example of when treatment might be worse than the disease, a large review of Medicare records finds that older people with small kidney tumors were much less likely to die over the next five years if doctors monitored them instead of operating right away.

Even though nearly all of these tumors turned out to be cancer, they rarely proved fatal. And surgery roughly doubled patients' risk of developing heart problems or dying of other causes, doctors found. After five years, 24 percent of those who had surgery had died, compared to only 13 percent of those who chose monitoring. Just 3 percent of people in each group died of kidney cancer. The study only involved people 66 and older, but half of all kidney cancers occur in this age group. Younger people with longer life expectancies should still be offered surgery, doctors stressed.

The study also was observational - not an experiment where some people were given surgery and others were monitored, so it cannot prove which approach is best. Yet it offers a real-world look at how more than 7,000 Medicare patients with kidney tumors fared. Surgery is the standard treatment now. "I think it should change care" and that older patients should be told "that they don't necessarily need to have the kidney tumor removed," said Dr. William Huang of New York University Langone Medical Center. "If the treatment doesn't improve cancer outcomes, then we should consider leaving them alone." He led the study and will give results at a medical meeting in Orlando, Fla., later this week. The research was discussed Tuesday in a telephone news conference sponsored by the American Society of Clinical Oncology and two other cancer groups.

In the United States, about 65,000 new cases of kidney cancer and 13,700 deaths from the disease are expected this year. Two-thirds of cases are diagnosed at the local stage, when five-year survival is more than 90 percent. However, most kidney tumors these days are found not because they cause symptoms, but are spotted by accident when people are having an X-ray or other imaging test for something else, like back trouble or chest pain. Cancer experts increasingly question the need to treat certain slow-growing cancers that are not causing symptoms - prostate cancer in particular. Researchers wanted to know how life-threatening small kidney tumors were, especially in older people most likely to suffer complications from surgery.

They used federal cancer registries and Medicare records from 2000 to 2007 to find 8,317 people 66 and older with kidney tumors less than 1.5 inches wide. Cancer was confirmed in 7,148 of them. About three-quarters of them had surgery and the rest chose to be monitored with periodic imaging tests. After five years, 1,536 had died, including 191 of kidney cancer. For every 100 patients who chose monitoring, 11 more were alive at the five-year mark compared to the surgery group. Only 6 percent of those who chose monitoring eventually had surgery. Furthermore, 27 percent of the surgery group but only 13 percent of the monitoring group developed a cardiovascular problem such as a heart attack, heart disease or stroke. These problems were more likely if doctors removed the entire kidney instead of just a part of it.

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Richard Powell · Feb 15, 2013

Medical reaction occur in people due to their metabolic reaction with medicines you have taken. The set of information presented in this post is quite effective and useful

waltky · May 25, 2013

Statins are part of many people's daily routine...

Some statins 'raise diabetes risk'
24 May 2013 - Some drugs taken to protect the heart may increase the risk of developing type-2 diabetes, according to researchers in Canada.

Their study of 1.5 million people, in the British Medical Journal, suggested powerful statins could increase the risk by 22% compared with weaker drugs. Atorvastatin was linked to one extra case of diabetes for every 160 patients treated. Experts said the benefits of statins still outweighed any risks. Statins are a group of commonly prescribed drugs that lower the levels of bad cholesterol in the blood. This reduces the chances of a heart attack or stroke. All drugs come with side-effects, but a team of researchers from hospitals in Toronto said there had been controversy around the risk of diabetes with different statins.

They looked at medical records of 1.5 million people over the age of 66 and compared the incidence of diabetes between people taking different statins. Their report said: "We found that patients treated with atorvastatin, rosuvastatin, or simvastatin were at increased risk of new onset diabetes compared with those treated with pravastatin. "Clinicians should considers this risk when they are contemplating statin treatment for individual patients. "Preferential use of pravastatin... might be warranted."

Benefit

Commenting on the study, Prof Risto Huupponen and Prof Jorma Viikari, from the University of Turku, in Finland, said: "The overall benefit of statins still clearly outweighs the potential risk of diabetes." However, they said, the different statins should be targeted at the right patients. They said: "The most potent statins, at least in higher doses, should preferably be reserved for patients who do not respond to low-potency treatment, but have a high total risk of cardiovascular disease."

Maureen Talbot, from the British Heart Foundation, said: "Statins are taken safely by millions in the UK and protect those at high risk of developing coronary heart disease. "Although this study suggests an increased risk of older people developing diabetes when taking certain statins, other risk factors like being overweight, family history and ethnicity may have played their part. "There are benefits and risks with all medicines so if you're worried, discuss your concerns with your GP."

http://www.bbc.co.uk/news/health-22636666
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Adverse Medical Reactions

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