If you take two different medications for two different reasons, here's a sobering thought: your doctor may not fully understand what happens when they're combined, because drug interactions are incredibly hard to study. In this fascinating and accessible talk, Russ Altman shows how doctors are studying unexpected drug interactions using a surprising resource: search engine queries.
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Before using pharmys, try changing diet, enviroment and join a gym, club, start walking. The pharmaceutical companies dont care about your health, its in their interest to keep you a customer for life x
Ah, loved this talk! I have always wondered about this topic for many different reasons, and from a personal story! Medications in general can have many different and potential risks to them. One medication alone can have anywhere from 1-20+ different types of side effects with it. The more medications you add into the mix, the more complicated things can get.
Altman made a comment that if a patient is on a type of medication, then becomes depressed, a doctor may put that patient on an anti-depressant drug. Sounds great, and could get the job done. Right? Not necessarily. Do those two drugs clash? How will they react with one another? Which makes me think of my mother.
Depression runs in my family. My mom has had depression for as long as I can remember, and a couple of my aunts and uncles have also suffered from depression as well. There was one point in my life where I can remember that my mother was taking 6 different pills a day. All prescribed to her by the same doctor. She didn't think anything of it, rather than that is what her doctor prescribed, so that is what she was taking. However, one pill alone was 875 mg, which is a lot. My mother is a small woman. Just above 5 feet tall, and around 105 pounds, nothing big by any means. Until she was always tired, taking multiple naps throught the day (which was unlike her), and occasionally getting sick a couple times a week. I noticed, but didn't say anything. Until my dad had enough of it, and took her to the doctors. After 7 months of taking 6 pills a day, the doctor cut it back to just two. I had my mother back. She was fine, full of energy and life. So, here is my question, why 6? Six took my mother away, two I gained my mother back. Why do doctors always think more is better? Clearly, they did not know what mixing all of these would do to her tiny body, yet, I thought it was excessive to begin with.
More research and funding needs to go into this topic because it is something almost everyone goes through. I alone take two different pills each day. My brother takes two, and so does my mom. However, there are more people out in society that probably take a handful more than just two a day, that could be potentionaly putting harm to their body by doing so.
Overall, I agree with what Altman is saying when it comes to this topic on mixing medications. More studying needs to go into it, and more eyes need to be focused on this topic.
He is right, media nowadays can be used to check for things like drug interactions. But he has a problem: He just got lucky with those 2 drugs. There are millions of drugs and many of them don't interact. He can't just try out all the interaction combinations, that takes hundreds of years, and not only that, new drugs come out everyday. So unless he has a method of knowing which drugs are more likely to interact with eachother (those who aren't already proven to interact, he is wrong by saying there are no studies of drugs interactions previous to his'), he will be blindly guessing for interactions his whole life.
Who is going to type in 9 different drugs and a side effect into a search query? I can't see most people typing in more than 1 drug and a side effect or series of side effects at a time. If you as doctors really have no idea what happens when 9 drugs interact with one another, maybe its time to rethink the approach of using "the hammer" as a first line treatment, let alone the one and only treatment for every situation and be more open to adding other tools to your toolbox.
The situation always seems to play out like this. Get sick, go see a western medical doctor, doctor tosses drug at you for problem. Some time passes, get sick again, go see the doctor(same or another one) to treat that new problem, doctor tosses drug at you to treat that problem. Eventually you get sick, go see the doctor, they ask what meds you are on and for some reason are shocked when you are on like 5 different meds *face palm*..
how? i bet big pharma is on it already. data collection... these databases he's talking about are, even in the best of cases, so woefully unreliable, with blanks in data in crucial points that examining requires hundreds/thousands of vital research hours. Big data has many huge implications. but data collection isn't even thought about. the point I'm making in a book I'm writing on this topic
In addition to your PDR, I suggest buying:"The Handbook of Drug Interaction" by Ashraf Mozayani, Lionel Raymon. Or you can just read Katzung's Basic & Clinical Pharmacology, which I consider the bible. Your the Dr, you should know. There's a lot I know & a lot I don't. When in doubt, look it up. Don't blame the FDA!
+Brian Dorn Which works out perfectly... Medical school just made me callous. I find a solid 50% of Pts annoying and can do without them. Just to add, your msg should be: "that's why I avoid medication," not physicians!
+Indrekk Pringi you keep saying stuff like "period" and "end of story" dont you understand that nobody takes you seriously in this comment threat because of that? Look up Ad Hominem fallacy to understand why youre the joke of this comment threat.
I wasted my precious time on him, don't do the same. The healthcare system is far from perfect. It is a mess. But it is not the fault of the physician. The physician tries to provide the best care possible.
It is politicians who have NO medical training whatsoever who are making the rules.
Like medication quotas in the US! ANYONE KNOW THAT? THANK YOU DEA!
The DEA, since they started a database to control certain medications, has lowered "Dr Shopping" ~63% BRAVO! Yet, during the same amount of time, heroin use rates are nearly up by 300% since 2002. If you really look at the numbers, the rates really rose from 2008-2013
Well, I can honestly conclude I'm not lost! (based on what you're saying)
I don't know everything, nor have I ever claimed to. There are areas of medicine I am better at than others, there are areas where others are better than me, which is why there are specialists!
Why don't you ask me why I became a physician?
It was to provide care to those who sacrificed their lives, put themselves in danger to protect me. I became a physician to help wounded solders after seeing family members who where lucky enough to survive a war, yet suffered the rest of their life because of it. It truly breaks my heart and I would not want to see ANYONE go through what I saw. IMHO, they (id est solders) deserve the best healthcare as possible.
Why don't you ask me about charity work?
Hours I spent, many times at my monetary expense, helping others in foreign countries who otherwise have no access to healthcare.
Never once before becoming a physician has the thought of money or wealth crossed my mind. It does now occasionally because that's life. Family expenses, Taxes, Bills, will I have enough to save for retirement yet travel for a week here or there to see family or friends?
I have paid my dues and arrived at the point where I can call you an ignorant idiot as far as healthcare is concerned.
What do you do?
A very enlighten testimony. I hope his ideas will go a long way because more and more people are using the internet trying to help them selves about health issues ... because after all , individual physicians can also make mistakes and/or be mistinformed.
Plenty of interaction checkers VERY FAR before you even thought to talk to Nick or write your little speech. I'm good w/ pharm. Better than the average guy/gal in my class. But no way do I remember "everything"!
Sounds like Nick needs Adderall ! Get a few things straight, plenty of "interaction checkers" online. The biggest & best is the FDA's. Your Dr may not know every med interaction, but if he/she knows the MAJOR ones... What "turns off" CYP450? How about your Dr knows you're an alcoholic, thus, your liver is likely foie gras or cirrhotic, hope he knows (likely) a Statin or Flagyl aren't great choices! He sticks to Penicillins if u need it! Also, IMHO your internist shouldn't be RXing you dozens of scripts! You're depressed, maybe a shrink referral? Let him decide about Paxil! Ok I understand maybe a Statin (for a non-Alc), but what if it then becomes a B-blocker, maybe an ACEi/ARB... I'd say get a Cardiologist referral! MOST Drs r good w/ meds in their specialty, "prototypicals" & "the biggies." Realistically, you can't test EVERY med against EVERY med. You're curious about a combo? PDR! What u described is why there is a "Stage-4". Be fair! U expect every Dr to be a PDR!?!?
i'm worried about the data. it needs to be scrubbed at the minimum. what is to stop the government for looking for some harmless legal activity that correlates with some "undesirable" trait, or some unknown "interaction" that allows people to have effective democracies, and shut it down, or target people who the public would not consider as bad people or undesirable actions?
governments all around the world have long histories of abuse of innocent people. but i am sure they can find a way that everyone is "guilty" so long as they get to write the laws. this can lead to massive amounts of discrimination based on socioeconomic status and wealth distribution.
I'm gonna get my hopes up again and praise ted for having interesting talks instead of the bullshit it's been publishing lately. Hopefully the next talk won't be yet another stupid sjw. Good work for now ted.
I'm completely crippled & bedridden thanks to just twelve FDA-approved Cipro pills prescribed to me in 2009 for a 'suspected' UTI. I haven't been able to walk since and live in agonizing, suicide-level pain 24/7/365 now. I was just 30 years old when that drug ended my life. Keep paying your taxes! I depend on you now for my SSDI benefits--as do tens of thousands of other victims of this class of drugs. Think the FDA is protecting you? Think these drug makers are divulging all of the true side effects of their drugs? Think again.
Very interesting work with great potential but this highlights that we really have no idea about drug interactions. Yet millions of people are on multiple drugs thinking that their doctor or pharmacist knows that it's safe and that it's somehow been studied. Know well that they don't and it hasn't.
Hey does anyone know if there's any websites out there that i can put my medical info, so that it can be used by students and projects just like this? In the past, i've been scared that my info is either going to be locked down and proprietary, or will be shared with marketers and other assholes i don't want to help.
i'm diabetic (etc), and for a variety of years i have been tracking my medications, alcohol intake, exercise, weight, sleep patterns, mood, etc. But i have no-where useful to put this data.
I heard about websites like this in a past TED talk iirc, but that was a while ago. Maybe by now the landscape is more mature and the choice is more obvious. Anyone heard of anything?
As a medical doctor, I am part of an ever shrinking group of professionals who truly understand the medicine that they're prescribing. I do not give or prescribe any medication to my patients without fully understanding its effects, how it works with other medications, post-market observations, etc. Too many doctors in my profession are just dishing out medicine left and right without fully understanding it.
+Paul Brosnan Well, it doesn't take much knowledge of drug interactions to figure out that a medication that can cause bleeding should be avoided if someone is on warfarin unless it's absolutely necessary, although warfarin is a pain in general when it comes to drug interactions.
+Primalxbeast Generally, doctors tend to know what they're doing. However, as was mentioned in the talk above, they know how drugs work by themselves, but, we tend not to know how they work with others. I have taken the liberty of educating myself on how drugs work, as have most of the doctors in my practice (I work in a private hospital so we tend to be at the top of our game, public hospitals however simply don't have the qualified and educated staff that they need).
+Paul Brosnan And then they get mad when question anything they prescribe. I've lost count of how many times I've been prescribed antibiotics when I didn't have an infection. One of the times he did this, the pharmacist immediately called him to make sure he wanted me taking that specific antibiotic with blood thinners when it could cause bleeding. I just didn't take it because knew I didn't even need it.
not just mixing medications with other medications, also mixing medications with exposure to hazardous workplace fumes, food/drink ingredients, skin care products, whatever bodybuilders are ingesting, etc. This stuff was obvious to me when I was a teenager and I've avoided pharmaceuticals like the plague ever since in case I actually need to take a medication someday. I haven't even taken tylenol in a decade and I'm feeling pretty great about that
the solution to headaches is to eat healthy and don't be dehydrated btw; i probably average one tiny headache every 3 years, even with my stressful life -> it's just that you're never going to see a commercial telling you to drink some water instead of an advil commercial. Telling people to drink water and get exercise and eat fruits and vegetables isn't a business and can't support marketing efforts like big pharma or 'healthy' fast food
Commonsense remains uncommon.
Any drug can cause any short-term adverse effect and also unrecognized late adverse effects.
The most common response of medical doctors is to dismiss clients' reports of adverse symptoms. Human biochemistry is too complex and individual for protocols & pattern recognition approaches.
+Kwabena Kesseh Common belief, though "Insight" is already gratis to all: self-responsibility through lifestyle.
See Published statement by Richard Horton, Editor in Chief, Lancet 385, Apr 11 2015.
"It's easier to fool people than to convince them that they are being fooled." - Mark Twain
+Fazia A True but for the time being with start with these "individual for protocols & pattern recognition approaches" and build on, do further research and improve and improve on the approaches. With brilliant people like the presenter and others hard at work on research, we might be able get more insight to human biochemistry.
As a Public Services Librarian and Institutional Data Oracle, I found this FASCINATING.
As someone who lost a friend due to drug interactions (from a MD who prescribed the drugs together, and my friend had an adverse reaction), I think this kind of research is long overdue.
I feel bad for TED. An amazing track record of quality free content for years, but as soon as a couple of questionable talks get posted the internet turns into a whiney entitled brat acting like TED owes them something.
Community pharmacists are the health professionals most accessible to the public. They supply medicines in accordance with a prescription or, when legally permitted, sell them without a prescription. In addition to ensuring an accurate supply of appropriate products, their professional activities also cover counselling of patients at the time of dispensing of prescription and non-prescription drugs, drug information to health professionals, patients and the general public, and participation in health-promotion programmes. They maintain links with other health professionals in primary health care.