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Sunday, July 7, 2002



Events explore
medicine mixing

Presentations will stress the
importance of consulting experts

Dangerous combinations


By Helen Altonn
haltonn@starbulletin.com

Residents who use both prescribed drugs and alternative or complementary medicines have a chance this month to learn if the combination is safe.

The Hawaii Medical Service Association is sponsoring an educational program, "Managing Your Medications," for the second year.

"The problems are that nutritional supplements are not for everyone because a lot of these substances need to be cleared through the kidneys or liver," says Joseph Pepping, president of Wellness Institute International. "So if people have pre-existing kidney or liver disease, they can be at risk for serious problems."

Also, he said, several herbs and nutritional supplements interact with prescription medicines, and some lower the body's natural levels of important chemicals and molecules.

"So, the take-home lesson is, don't do anything without checking with your doctor or a health-care professional who knows how these things interact and how they can affect your general health," he said.

Longs Drugs, Times Super Markets, Good Neighbor Pharmacies and various independent pharmacies throughout the state are offering free consultations with residents about their medications from July 15 to Aug. 15.

People should check with their neighborhood pharmacy to see if it is participating and make an appointment to see a pharmacist, HMSA said.

They should take all their prescribed drugs and over-the-counter medications to the pharmacist for review and information about potential problems of mixing them.

Pepping, a clinical pharmacist who specializes in nutritional pharmacology and pain management, and Dr. Shari Kogan, medical director of geriatrics at the Queen's Medical Center, will participate in four public seminars on medications this month.

"Everybody's doing it (mixing prescribed and alternative remedies) but not telling their doctor," Pepping said.

He said the presentations will stress the importance of patients telling doctors what they are taking and of doctors asking patients "in a nonthreatening way" if they are taking any supplements.

"In the U.S. it's over a $20 billion business," Pepping said. "Some are good; some are terrible. The quality is up for grabs unless you know the company you're dealing with. You may be buying something worthless or, worse yet, toxic."


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Dangerous drug combinations

Samples of alternative medications with potential harmful interactions if mixed with prescribed drugs:

>> Ginkgo biloba, promoted as a natural supplement to improve memory and blood flow, may increase the risk of bleeding for patients using aspirin, Warfarin (an anti-coagulant) or other blood-thinning medications.

>> St. John's wort, commonly used for depression, could have unintended side effects if taken with other anti-depressive medications such as Paxil, Zoloft or Serzone. It could cause irregular menstrual bleeding in some women if taken with oral contraceptives and increase sun sensitivity reactions if taken with some antibiotics, like Achromycin, Sumycin, Cipro or Bactrim.

>> Ma huang (or ephedra), often found in herbal products advertised for weight loss, asthma, energy, sexual enhancement and euphoria. Adverse reactions may increase when taken with other stimulants, such as caffeine (coffee or cola drinks) and decongestants (Dristan, Actifed and Sudafed). It may cause nervousness, insomnia, headache, hypertension, arrhythmia, heart attack, stroke and death.

>> Antacids, iron and dairy products, used with antibiotics (Achromycin and Sumycin), may decrease absorption of the antibiotics and reduce the effectiveness of the drug prescribed by the doctor.

Source: Hawaii Medical Service Association


Seminars will address
management of medications


Star-Bulletin staff

Joseph Pepping, president of Wellness Institute International, and Dr. Shari Kogan, medical director of geriatrics at the Queen's Medical Center, will speak this month at four public seminars on managing medications.

The Oahu presentation will be from 9 a.m. to noon Saturday, South Pacific Ballroom, Hilton Hawaiian Village. Call 948-5260 to register for the free seminar. Validated self-parking is $3. There will be refreshments and door prizes.

The neighbor island events will be held as part of county conferences for caregivers as follows:

>> Maui: 8:30 a.m. to 3 p.m. July 22, Kalama Heights Retirement, Kihei. The fee is $5, including lunch. Friday is the deadline to reserve a seat. Call 270-7755.

>> Hilo: 8:30 a.m. to 3 p.m. July 23, Nani Mau Gardens. The $10 fee includes lunch. Call 327-3597.

>> Kauai: 8:30 a.m. to 3 p.m. July 24, Holiday Inn Sunspree Resort, Waialua. Conference fee is $10, including lunch. Call 241-6400.



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