Bades: Interaction with drugs

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Bades: Interaction with drugs

Section 1: Understanding of dietary supplements and drugs

  • 1.1. Definition and classification of dietary supplements:

    • Bades (biologically active additives) are concentrates of natural or natural biologically active substances that are intended for direct intake or introduction into food products in order to enrich the ration with individual food or biologically active substances and their complexes, as well as to maintain normal or restore impaired body functions.
    • Classification of dietary supplements is carried out according to various criteria:
      • By composition:
        • Nutricevtiki: Sources of indispensable food substances (vitamins, minerals, amino acids, polyunsaturated fatty acids).
        • Parafarmetzetics: Substances that have a regulatory effect on the organs and systems of the body (plant extracts, adaptogens, immunomodulators).
        • Probiotics and prebiotics: Living microorganisms and substances that contribute to the growth of beneficial intestinal microflora.
      • By the form of release: Capsules, tablets, powders, felt, teas, bars, etc.
      • By purpose: To maintain immunity, to improve digestion, to normalize sleep, to increase energy, to maintain joint health, etc.
    • The legal status of dietary supplements differs from medicines. Bades do not go through the same strict clinical trials as medicines, and are not intended for the treatment of diseases. They are positioned as means for maintaining health and prevention.

  • 1.2. Definition and classification of drugs:

    • Medicines are substances or combinations of substances designed for the treatment, prevention or diagnosis of diseases in humans and animals, as well as to change the physiological functions of the body.
    • Classification of drugs:
      • By the pharmacological group: Antibiotics, analgesics, antihypertensive drugs, antidepressants, etc. (depending on the therapeutic effect provided).
      • By the method of application: For oral administration (tablets, capsules, solutions), for injection (intravenous, intramuscular, subcutaneous), for external use (ointment, creams, gels), for inhalation, etc.
      • By a recipe or without a recipe: Prescription drugs are released only according to a doctor’s prescription, over -the -counter – are freely selling.
    • Medicines undergo strict clinical trials to confirm efficiency and safety before being allowed for sale.

  • 1.3. Differences in the regulation of dietary supplements and medicines:

    • Bad: They are regulated by organs responsible for food safety. The process of registering dietary supplements is less strict than in medicines. The emphasis is on security, not on evidence of effectiveness. The marking of dietary supplements should contain information about the composition recommended dose, contraindications and warnings.
    • Medicines: Regulated by the bodies responsible for health care. The process of developing and registering drugs includes preclinical and clinical trials to evaluate effectiveness, safety and side effects. The marking of drugs contains detailed information about the composition, indications, contraindications, side effects, dosage and method of use.

  • 1.4. General ways of metabolism of drugs and dietary supplements:

    • Many drugs and dietary supplements are metabolized in the liver with enzymes of the P450 cytochrome system (CYP). These enzymes play a key role in detoxification and elimination of various substances from the body, including medicines and dietary supplements.
    • Competition for CYP enzymes can lead to interactions. For example, if the dietary supplement inhibits a certain CYP enzyme, which is necessary for the metabolism of the medicine, the concentration of the drug in the blood may increase, which increases the risk of side effects. And vice versa, if dietary supplements are induced by the CYP enzyme, the metabolism of the medicine can accelerate, which will lead to a decrease in its effectiveness.
    • Other metabolism paths include glucuronidation, sulfation and acetylation. Bades and medicines can compete for these paths, which can also lead to interactions.

  • 1.5. Pharmacokinetics and pharmacodynamics: Fundamentals of interaction:

    • Pharmacokinetics He describes what the body does with medicine or dietary supplement (absorption, distribution, metabolism, excretion – ADME). Interactions can affect any of these stages. For example, dietary supplements can affect the absorption of the medicine in the intestines, its distribution in the tissues, its metabolism in the liver or its excretion through the kidneys.
    • Pharmacodynamics He describes that the medicine or dietary supplement makes with the body (action mechanism, therapeutic effects, side effects). Interactions can change pharmacodynamic effects. For example, dietary supplements can enhance or weaken the effect of the drug on a specific receptor or system of organs.
    • Understanding of pharmacokinetic and pharmacodynamic principles is necessary for predicting and preventing interactions between dietary supplements and drugs.

Section 2: Types of interactions of dietary supplements with medicines

  • 2.1. Pharmacokinetic interactions:

    • 2.1.1. Influence on absorption:
      • Bades can affect the absorption of drugs in the intestines by changing the PH environment, the formation of complexes, the effect of intestinal motility or competition for transport proteins.
      • Examples:
        • Antacids (containing calcium, magnesium or aluminum) can reduce the absorption of some antibiotics (for example, tetracyclines, fluoroquinolons) due to the formation of insoluble complexes.
        • Drill fibers can slow down the absorption of some drugs, reducing their concentration in the blood.
        • Chitosan can reduce the absorption of fat -soluble vitamins and drugs.
    • 2.1.2. Influence on the distribution:
      • Bades can affect the distribution of drugs in the body by changing the binding of drugs with blood plasma proteins or by affecting the permeability of the hematoencephalic barrier.
      • Examples:
        • Substances competing for binding with plasma proteins can increase the concentration of a free (unrelated) form of drug, which can enhance its effect and risk of side effects.
        • Some plant extracts can affect the permeability of the hematoencephalic barrier, which can change the concentration of drugs in the brain.
    • 2.1.3. Influence on metabolism:
      • Dietary supplements can affect the metabolism of drugs by inhibiting or induction of enzymes of the P450 (CYP) cytochrome system in the liver.
      • CYP inhibitors: They slow down the metabolism of drugs, which leads to an increase in their concentration in the blood and increasing the risk of side effects. Examples: grapefruit juice, St. John’s wort, curcumin (in large doses).
      • CYP inducers: Accelerating the metabolism of drugs, which leads to a decrease in their concentration in the blood and a decrease in effectiveness. Examples: St. John’s wort, ginseng (in large doses).
      • Specific examples:
        • St. John’s wort (CYP3A4 inducer) can reduce the effectiveness of antidepressants, contraceptive tablets, anticoagulants and other drugs metabolized by this enzyme.
        • Grapefruit juice (CYP3A4 inhibitor) can increase the concentration of some statins, immunosuppressants and other drugs metabolized by this enzyme, increasing the risk of side effects.
    • 2.1.4. Influence on excretion:
      • Bades can affect the excretion of medicines through the kidneys, intestines or other organs.
      • Examples:
        • Some herbs with a diuretic effect can increase the excretion of drugs through the kidneys, which can reduce their concentration in the blood.
        • Bades affecting intestinal motility (for example, laxatives) can change the rate of excretion of drugs taken inside.

  • 2.2. Pharmacodynamic interactions:

    • 2.2.1. Synergism:
      • Bad and medicine have a similar effect, and their simultaneous use enhances the therapeutic effect, but can also increase the risk of side effects.
      • Examples:
        • The joint use of warfarin (anticoagulant) and dietary supplements with anticoagulant properties (for example, ginkgo bilobe, garlic, ginger) can increase the risk of bleeding.
        • The joint use of antidepressants and dietary supplements that increase the level of serotonin (for example, St. John’s wort, tripophane) can increase the risk of serotonin syndrome.
    • 2.2.2. Antagonism:
      • Bad and medicine have the opposite effect, and their simultaneous use weakens the therapeutic effect of the drug.
      • Examples:
        • The joint use of antihypertensive drugs and dietary supplements that increase blood pressure (for example, licorice, ephedra) can reduce the effectiveness of antihypertensive therapy.
        • The joint use of immunosuppressants and dietary supplements, stimulating the immune system (for example, echinacea) can reduce the effectiveness of immunosuppressive therapy.
    • 2.2.3. Additative effect:
      • Bad and the medicine have a similar effect, and their simultaneous use leads to summation of effects.
      • Examples:
        • The joint use of antidepressants and dietary supplements with a sedative effect (for example, Valerian, Melissa) can enhance the sedative effect and increase the risk of drowsiness.

  • 2.3. Examples of specific interactions:

    • 2.3.1. Anticoagulants (warfarin, apixaban, rivaroxaban):
      • Ginkgo bilobe, garlic, ginger, fish oil (high doses) can enhance the anticoagulant effect and increase the risk of bleeding.
      • Vitamin K can reduce the effectiveness of warfarin.
      • Coenzyme Q10 can reduce the effectiveness of warfarin.
    • 2.3.2. Antidepressants (SIOSS, SioZSN):
      • St. John’s wort can cause serotonin syndrome when jointly used with SIOS/SIOZSN.
      • Triptophanes can increase the risk of serotonin syndrome when jointly used with SIOS/SIOZSN.
      • Ginseng can interact with some antidepressants.
    • 2.3.3. Antihypertensive agents:
      • A licorice can increase blood pressure and reduce the effectiveness of antihypertensive agents.
      • Ephedra (prohibited in most countries) can increase blood pressure and reduce the effectiveness of antihypertensive agents.
      • Potassium (in large doses) can interact with some antihypertensive agents (for example, with potassium -saving diuretics).
    • 2.3.4. Statin (Atorvastatin, Simvastatin):
      • Grapefruit juice can increase the concentration of statins in the blood and increase the risk of side effects (for example, myopathy).
      • Red yeast rice contains Monacoline K, which is the same substance as Lovastatin (Statin). Its joint use with statins can increase the risk of side effects.
      • Coenzyme Q10 can reduce statins and cause muscle pain.
    • 2.3.5. Broadcasting tablets:
      • St. John’s wort can reduce the effectiveness of contraceptives.
    • 2.3.6. Immunocationthretarite:
      • Echinacea can stimulate the immune system and reduce the effectiveness of immunosuppressants.
      • St. John’s wort can reduce the concentration of some immunosuppressants.
    • 2.3.7. Offidiabetic drugs:
      • Chrome can enhance the effect of insulin and increase the risk of hypoglycemia.
      • Cinnamon can affect blood sugar and interact with antidiabetic drugs.

Section 3: Factors affecting the risk of interactions

  • 3.1. Dose and duration of dietary supplements:

    • The risk of interactions increases with an increase in the dose and duration of dietary supplements. High doses can have a more pronounced effect on CYP enzymes and other metabolic pathways. Long -term use can lead to cumulative effects and increase the risk of interactions.

  • 3.2. Dose and duration of medication:

    • The risk of interactions also depends on the dose and duration of medication. High doses of drugs or prolonged use can increase sensitivity to interactions with dietary supplements.

  • 3.3. Patient age:

    • Elderly people are more susceptible to interactions due to age-related changes in the function of the liver and kidneys, a decrease in metabolic activity and frequent administration of several drugs at the same time (polypragmasis). Children can also be more susceptible to interactions due to immaturity of metabolic systems.

  • 3.4. Patient health status:

    • Patients with liver diseases, kidneys, cardiovascular system or other chronic diseases are more susceptible to interactions. Violation of the function of organs can change the pharmacokinetics and pharmacodynamics of drugs and dietary supplements.

  • 3.5. Genetic factors:

    • Genetic polymorphisms of CYP enzymes can affect the metabolism of drugs and dietary supplements and determine individual susceptibility to interactions. For example, people with slow metabolism of certain drugs can be more susceptible to interactions with CYP inhibitors.

  • 3.6. Simultaneous reception of several dietary supplements:

    • Taking several dietary supplements simultaneously increases the risk of interactions, since each dietary supplement can affect the metabolism of drugs.

  • 3.7. Individual sensitivity:

    • Individual sensitivity to interactions can vary depending on many factors, including genetic characteristics, health status, lifestyle and other drugs and dietary supplements taken by the patient.

Section 4: Prevention of interactions of dietary supplements with drugs

  • 4.1. Information of the doctor and pharmacist:

    • The most important step in preventing interactions is to inform the doctor and pharmacist about all medicines and dietary supplements that you take, including vitamins, minerals, herbs and other additives. This will allow them to evaluate the risk of interactions and give appropriate recommendations.

  • 4.2. Careful reading instructions for medicines and dietary supplements:

    • Carefully read the instructions for medicines and dietary supplements to learn about possible interactions and contraindications. Pay attention to warnings about interaction with other drugs or food.

  • 4.3. Avoiding the simultaneous administration of dietary supplements with drugs affecting blood coagulation:

    • Be especially careful when taking dietary supplements with anticoagulants (for example, warfarin, apixban, rivaroxaban) or anti -signs (for example, aspirin, clopidogrel), since some dietary supplements (for example, ginkgo biloba, garlic, ginger, fish oil) can increase the anticoagulant effect and increase the risk of bleeding.

  • 4.4. Caution when taking dietary supplement affecting blood sugar:

    • People with diabetes should be especially careful when taking dietary supplements affecting blood sugar (for example, chrome, cinnamon), since they can interact with antidiabetic drugs and cause hypoglycemia.

  • 4.5. Consultation with a doctor before taking new dietary supplements:

    • Before you start taking new dietary supplements, especially if you take any medicines, consult a doctor or pharmacist. They can evaluate the risk of interactions and give individual recommendations.

  • 4.6. Health monitoring:

    • If you take dietary supplements and medicines at the same time, carefully monitor your health state and inform the doctor about any unusual symptoms or side effects.

  • 4.7. Compliance with dosage recommendations:

    • Follow the recommended doses of drugs and dietary supplements. Do not exceed the recommended doses, as this can increase the risk of side effects and interactions.

  • 4.8. Buying dietary supplements from trusted manufacturers:

    • Buy dietary supplements only from trusted manufacturers who comply with quality and safety standards. Do not buy dietary supplements from unreliable sources, as they may contain not declared ingredients or be polluted.

  • 4.9. Message about all changes in the intake of dietary supplements and medicines to the doctor:

    • In case of any changes in the intake of dietary supplements and drugs (the beginning of taking a new Bad, the termination of dosage, a change in dosage) immediately report this to the attending physician.

Section 5: Frequent errors and myths about the interactions of dietary supplements with medicines

  • 5.1. Myth: “Bades are natural products, so they are safe and cannot interact with medicines.”

    • Even natural substances can have a strong effect on the body and interact with drugs. Many dietary supplements contain biologically active substances that can affect the metabolism of drugs, enhance or weaken their effect.

  • 5.2. Myth: “If dietary supplements are sold without a prescription, then it is safe and cannot interact with medicines.”

    • Right -coded status of Bad does not guarantee its safety and lack of interactions. Bades do not go through the same strict clinical trials as medicines, and may contain substances that interact with drugs.

  • 5.3. Error: underestimation of potential interactions due to insufficient information:

    • Many patients and even some doctors are not sufficiently aware of potential interactions of dietary supplements with medicines. This can lead to the fact that patients do not report the administration of dietary supplements to the doctor, and doctors do not take into account the possibility of interactions when prescribing drugs.

  • 5.4. Error: self -medication and uncontrolled reception of dietary supplements:

    • Self-medication and uncontrolled intake of dietary supplements can be dangerous, especially if the patient takes any medication. Without consulting a doctor or pharmacist, it is difficult to evaluate the risk of interactions and choose a safe dosage.

  • 5.5. Myth: “All dietary supplements of the same type act the same way.”

    • The composition and quality of dietary supplements can differ significantly among different manufacturers. Even if dietary supplements contain the same basic ingredient, the concentration of this ingredient and the presence of other substances can affect its effectiveness and safety.

  • 5.6. Error: ignoring the symptoms that can be associated with interactions:

    • Patients often ignore the symptoms that can be associated with interactions between dietary supplements and drugs, such as unusual bleeding, changes in blood pressure, digestive disorders, drowsiness, dizziness or skin rash. It is important to inform the doctor about any unusual symptoms, especially if you take dietary supplements and medicines at the same time.

  • 5.7. Myth: “If dietary supplement helps one person, he will certainly help others.”

    • The effectiveness of dietary supplements can vary depending on the individual characteristics of the body, health status, drugs taken and other factors. What helps one person will not necessarily be effective or safe for another.

  • 5.8. Error: taking dietary supplement instead of drugs prescribed by a doctor:

    • Never replace the medicines prescribed by a doctor without consulting a doctor. Bades are not intended for the treatment of diseases and cannot replace medicines that have proven their effectiveness and safety in clinical trials.

Section 6: The role of doctors and pharmacists in the prevention of interactions

  • 6.1. Active collection of information about the dietary supplement taken by the patient:

    • Doctors must actively ask patients about what dietary supplements they take, including vitamins, minerals, herbs and other additives. This will help to identify potential interactions and take appropriate measures.

  • 6.2. Assessment of the risk of interactions when prescribing drugs:

    • When prescribing drugs, doctors should take into account the possibility of interactions with dietary supplements that the patient takes. It is necessary to check the medicinal reference books and databases for possible interactions and adjust the dosage or choose alternative drugs, if necessary.

  • 6.3. Informing patients about possible interactions:

    • Doctors must inform patients about possible interactions between drugs and dietary supplements, as well as the symptoms that should be paid to.

  • 6.4. Cooperation with pharmacists:

    • Doctors must cooperate with pharmacists to ensure patient safety. Pharmacists can help identify potential interactions and give recommendations on the safe use of drugs and dietary supplements.

  • 6.5. Maintaining documentation on the dietary supplement taken by the patient:

    • Doctors must conduct documentation on dietary supplements that the patient accepts in order to have complete information about his drug therapy.

  • 6.6. Increased awareness of the interactions of dietary supplements with drugs:

    • Doctors and pharmacists must constantly increase their awareness of the interactions of dietary supplements with medicines, participating in educational programs and reading scientific literature.

  • 6.7. Formats:

    • Provide consultations on compatibility of dietary supplements and prescribed drugs.
    • Conduct a screening of recipes for potential interactions.
    • Inform patients about the safe use of dietary supplements and drugs.

Section 7: future areas of research in the field of interactions of dietary supplements with medicines

  • 7.1. Development of more accurate methods for forecasting interactions:

    • Further studies are needed to develop more accurate methods for predicting the interactions of dietary supplements with medicines that take into account the individual characteristics of patients, genetic factors and other variables.

  • 7.2. Studying the influence of dietary supplements on CYP enzymes:

    • Further research is needed to study the influence of various dietary supplements on the activity of CYP enzymes and other metabolic pathways.

  • 7.3. Conducting clinical trials to evaluate interactions:

    • Clinical trials are needed to evaluate interactions between specific dietary supplements and drugs in different groups of patients.

  • 7.4. Development of educational programs for doctors and patients:

    • Educational programs for doctors and patients are needed, aimed at increasing awareness of the interactions of dietary supplements with medicines.

  • 7.5. Creation of databases on interactions of dietary supplements with drugs:

    • Databases containing information about the interactions of dietary supplements with medicines that would be available to doctors and pharmacists are needed.

  • 7.6. Studying the influence of microbioma on interaction:

    • Studies of the effect of intestinal microbioma on the metabolism of drugs and dietary supplements and on the occurrence of interactions.

  • 7.7. Personalized approach:

    • Development of personalized recommendations for the use of dietary supplements and drugs based on genetic data and other individual factors.

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