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Speaking Point: 1) From Elvis Pressley to Eddie Sedgwick to River Phoenix to Anna Nicole Smith to Heath Ledger to Michael Jackson to Tiger Woods to Brittany Murphy, and now Corey Haim, there appears to be a common theme of potential Drug-Drug Interactions which may result in Combined Drug Intoxication or Multiple Drug Intake. The fortunate exception is that Tiger Woods is still alive.

Speaking Point: 2) As a former Cardiovascular/Diabetes pharmaceutical sales representative for drug giant Bristol-Myers Squibb, I was trained, directed and financially rewarded to off-label promote and market the billion dollar blockbuster drug called “Pravachol.” Subsequently, my colleagues and I promoted to physicians, pharmacists and patients that Pravachol was superior to its competitors (Lipitor and Zocor) because they were metabolized by the common metabolic pathway known as the Cytochrome P450 3A4 enzyme system. Essentially, when taken concomitantly with other drugs, Lipitor and Zocor may increase their plasma concentrations with serious side effects such as Myopathy and Rhabdomyolysis (another competitor called Baycol was pulled from the market in 2001 after numerous reports of Rhabdomyolysis).

Speaking Point: 3) Generally, drug interactions occur when two medicines interact with each other resulting in side effects and/or adverse reactions. For example, taking a sedative or sleeping pill with an anti-allergy or antihistamine may impair ones reactions causing automobile driving or machine operation too risky. The antihistamine “Hismanal” has been withdrawn from the market in the most countries (including U.S.) because of rare but potentially fatal interactions with CYP3A4 enzyme inhibitors (i.e. erythromycin, grapefruit juice).

Speaking Point: 4) Drug toxicity increases as our metabolic pathway becomes inhibited. It is comparable to all traffic exiting the 10 Freeway at La Cienega Boulevard during rush hour. Watch out and be alert about your medication interactions! Ask your healtcare professional!

Speaking Point: 5) Concomitant use of drugs such as Ambien (sleep) and Vicodin (pain) may cause reduced alertness and motor coordination as was alleged in the matter of Tiger Woods. According to the documents obtained by such media outlets as TMZ, Florida Trooper Evans report contains the witness (wife Elin Nordegren) statement that “the driver was prescribed medication (Ambien and Vicatin [sic]). Impairment of the driver is also suspected due to the carless driving that resulted in the traffic crash.” (11/30/09 -“Request for Investigative Subpoena From State Attorney, 9th Circuit” Case#FHPD09OFF105628 to obtain “Medical Blood Results”).

Speaking Point: 6) A common inhibitor of the P450 3A4 system is grapefruit juice which may inhibit drug metabolism up to twenty four (24) hours resulting in potential drug toxicity and a delay in onset of action. Some of these commonly prescribed drugs include but are not limited to Viagra (erectile dysfunction), drug Buspar (anti-anxiety) and previously stated Lipitor and Zocor (HMGs).

Speaking Point: 7) Notwithstanding celebrities, the elderly, debilitated and diabetic patients who are on multiple medications may also be at risk of potentially dangerous drug-drug interactions. Do you know if you are at risk?

Speaking Point: 8) Even less drastic consequences of drug-drug, herbal-drug and food-drug interactions include but are not limited to mood swings, loss of appetite, nausea and gastrointestinal problems may reduce one’s quality of life.

Speaking Point: 9) The patient has a right to ask his healthcare professional about any prescription or over the counter medications that he may be taking. And, in today’s digital age, the mass media, as well as the internet, provide important information about health matters such as drug-drug interactions. Empower yourself!