Newspaper Page Text
THE ISLANDER, AUGUST 31, 2009, PAGE 7
‘Bews to tfeCp
The Best is Yet to Be
By Clark Gillespie M.D.,
Professor Emeritus, the University of Arkansas
Pills, tablets, capsules and the like - and Us
Our bulging senior population is
the single greatest collection of oral
medication-takers that ever existed.
On average, we all take at least three
each day - and about 30% of our ranks
average five.
These medications are designed to
prolong our lives in a livable and a
worth-living state against the assault
from a multitude of senior bodily health
predators.
Usually prescription drugs lead the
pack but over-the-counter medications
(OTC) are also very widely used, and
the actions and interactions of these
two friendly devils play a large part in
our joie de vivre - and in vivre itself.
Let’s see.
First, we need to see where all this
stuff is going once we get it down with
a glass of water, or better still, a glass
of wine.
First, our stomachs shake the medi
cine up with its own agents that begin
to make it absorbable, and then it
generally pushes this mash into our
intestines where most of it is absorbed
into our blood stream. It is there car
ried for inspection purposes directly to
our livers which pitch a deal of it out
before allowing the remainder to get
into our general circulation and our
body systems.
Some medications are severely
depleted in the liver in its protective
drive and so must be given in larger
doses to compensate for this loss. A sig
nificant change which accompanies our
moving on up senior hill is a reduction
in our liver’s ability to dispose of these
medications and so they remain within
us longer.
That’s worth remembering - and
so are these following tidbits about
qualifying and quantifying our little
rescuers:
• The Food and Drug Administra
tion (FDA) is our country’s guardian
against dangerous or destructive foods
and drugs that constantly surface on
our shores. It is a vast and growing
responsibility which the FDA manages
bountifully.
Disregarding the massive food chal
lenges that arise, there is a constant
and vast traffic of new medications pre
sented to them to evaluate and accept or
reject based upon findings and studies
presented therewith. These works and
many other related subjects concerning
a new drug are thoroughly studied by
the FDA - whose responsibilities, by
the way, are rapidly outstripping its
resources and funding.
Occasionally a new drug may get by
and into general use before an unknown
side-effect comes to light. Usually it is
because long term studies - over two
years - cannot be waited for by a press
ing medical and business environment.
The FDA makes but a few mistakes in
this demanding environment - it is just
an easy target.
• Drug - body interactions. Many
of our drugs that have passed muster
have serious and not uncommon side-
effects but their therapeutic good out
weighs such problems. These happen
ings still, however, must be anticipated
and guarded against.
The statin drugs have serious mus
cular side effects, for instance, which
are rare but very serious. This group of
drugs, however, has marvelous health
benefits which vastly outweigh the
risks. Even the most famous OTC drug
- aspirin - can produce serious stomach
problems in a few of us with significant
bleeding and significant risks.
About one in five of us have at some
time experienced a serious enough side-
effect event from a particular agent to
require medical intervention.
• Drug-drug interaction. As our
stable of drugs grows larger and
more diversified, so do the interac
tions between them. These interactions
include prescription to prescription,
prescription to OTC, and OTC to OTC
medications.
OTC medications here include
dietary supplements of many variet
ies. The risk of any such interactions
increase as we age and as our stable
of mixed agents multiplies. Here are
but a few examples of common interac
tions.
This first one is between two pre
scription drugs. Tricor - a drug effective
in reducing dangerous blood triglycer
ide levels can and does interfere with
the controlled effects of oral anti-coagu
lation drugs.
Then our famous OTC aspirin will
complicate the anti-coagulation effects
of prescription Plavix. Finally, using
our beloved aspirin once more, another
OTC agent now growing in variable
use for some reason - namely Ginko
Biloba - has been shown to interfere
with aspirin’s therapeutic largesse.
This segment of our oral medication
report only opens a few of the cans here
involved.
Let's continue with Back Boxes,
generic substitution, pill-splitting, gen
der differences and more.
We have taken a frugal and super
ficial look at the thousands of oral
medications - both over the counter
(OTC) and prescription morsels - that
have become a part of our lives as well
as our bodies.
It was clear that these medications,
therapeutic as they may be, can have
very serious side-effects upon us, as
well as equally serious interactions
with one another and then with us.
Now, let’s move on to more about pills.
• Inside the Box. As a further protec
tive halter, the FDA has instituted the
“black box” warning system - a promi
nently displayed black-framed box that
is part of the extensive printed infor
mation which must legally accompany
all new prescriptions (but not refills) of
contentious drugs.
Inside the box is a further warn
ing of that captioned drug’s dangerous
side-effect or effects and/or it’s signifi
cant potential for enhancing or neutral
izing other drugs or body functions.
Not all drugs require a black box
- but if you see one with a new pre
scription, read it carefully and save
it. Evidence shows that many on both
sides of this prescribing duty have let it
come to naught.
• “You get what you pay for!” This
popular admonition and warning has
been part of our instructive litany to
our growing and departing children as
they moved on in their personal adven
tures. This reproof, however, does not
appear to apply in the field of generic
medicine.
Pharmaceutical companies spend
enormous sums to develop and test
a new and successful drug - often
after many failures. They are shielded
by our patent system which provides
them with copy protection for as long
as ten years after the drug is first mar
keted. When this protection expires,
any other manufacturer may copy and
market this particular agent at, of
course, much lower cost.
This represents great savings for
us -but is that generic equal to the
original?
Our laws demand that these gener
ics contain the same active ingredients
as the original, be identical in strength
and dose form, work the same way,
and meet the same standards for iden
tity, strength and quality, and follow
the same protective FDA rules. Study
after study, all well-controlled, have
supported the equal worth of generic
replacements all of which represents
a marvelous saving for a multitude of
us.
• Pill splitting. Breaking a medica
tion in two is sometimes physician-
advised and for some of us splitting a
high dose pill saves us money because
these pills are cheaper than two of
their lower dosage pals. Whatever the
reasoning behind this fracturing, there
are situations when splitting is unwise
or impossible.
For instance, certain pills are coated
to reduce the oral and stomach irritation
of their contents, certain others contain
delayed action cores which must be left
as is, and some pills crumble too read
ily when division is attempted. There
are relatively inexpensive pill splitting
devices that your pharmacist can intro
duce to you and, unless a pill is grooved
for easy separation, you should always
use one of these little guillotines.
I’ve tried splitting unmarked pills by
hand and by sight and that exercise,
besides ending in a vulgar expletive
display, provided a melange of thera
peutic junk. Our senior hand-eye cir
cuitry is limited to such simple things
as pouring a drink. Carefully.
• Gender. As might be expected,
women do not always react to medica
tion just as men do. After all, they go
their own way in many areas of life and
this is but one of them.
A simple example is their reaction to
daily protective aspirin. We men take
it for heart protection and it is mainly
very effective in carrying out this chore.
When women take daily aspirin, how
ever, their main proven protection is
against stroke - heart protection is
there too, but stroke is the leading
crunched aggressor!
Speaking of hearts, it also appears
that the common antibiotic erythromy
cin, is significantly more likely to cause
heartbeat irregularities in women and
that women are less protected by the
fabulous statins if they have had no
previous heart ailment.
There is a great deal more involved
in pill-taking problems that we must
look at sometime later - but for now
just be careful to read and to follow
all provided instructions. - unlike the
poor man who asked his pharmacist for
something to help his itchy skin.
Returning the next day to the drug
store, he informed the inquiring drug
gist that the bath salts he was given
tasted OK but they weren’t as good as a
tub bath in relieving his itchy skin.
Two article reprinted from, the Janu
ary 26 and February 2 editions of the
Islander. “I
Tips for keeping kids
healthy and eating
nutritious foods
• Parents should always set a good
example by following good eating hab
its.
• Meals should be offered that
include different colors and textures
and are eye-appealing.
• Parents should start introduc
ing new tastes from a very early age,
around six months, in the form of a
variety of baby foods.
• Children should never be coerced,
punished, or forced to eat foods. Parents
should encourage them to try at least
one bite to see if they like it.
• High-sugar snacks should be
avoided because they will prevent the
child from being hungry for meals. □
For everything from greeting cards
and beauty products to prescription
drugs and over-the-counter
medications, we hope you’ll continue
to make us your first choice. We
certainly appreciate your business.
Tommy Bryan - Pharmacist/Owner
Andy Ledford - Pharmacist
Longview Shopping Center
Frederica Rd • St. Simons Island
912-638-8676
Open Seven Days
