The patient did’nt overdose the drug but drinked grapefruit juice.
A 42-year-old woman almost didn’t respond when her husband brought her to the emergency room. His heart rate was slowing down and his blood pressure was dropping. The doctors had to wear a breathing tube and a pacemaker to revive her.
Overlooked: The patient’s husband said that he had a migraine he had taken, and that he had taken the medication for the tension, verapamil, to help prevent headache. But the blood tests showed in his system that there was a scary amount of five times the level of drug safety.
Overdose? Was she trying to commit suicide? Only the doctors could be understood after joining the story.
Professor of Nephrology, Unni Pillai said “The culprit was grapefruit juice.” “She loves grapefruit juice, she had such a bad migraine with nausea and vomiting, he couldn’t tolerate anything else.
In the previous week, she was drinking mainly grapefruit juice. He then received verapamil, a drug that, when taken with grapefruit, significantly increased its potency (therapeutic power when the drug was used). In his case, the interaction was life-threatening.
Last month, a Canadian researcher who described this interaction the first twenty years ago. David Bailey has published an updated list of medicines affected by grapefruit. There are currently 85 drugs on the market that he said; Widely used in cholesterol-lowering drugs, new anticancer agents, some synthetic opiates and psychiatric drugs, some immune system suppressing drugs by organ transplant patients, some AIDS medications, and some birth control pills and estrogen treatments. (The full list is online; your browser must be configured to process PDF files.)
“What caused us to write this article was the number of new drugs that have emerged over the last four years,” he said. For the first time in 1990, Dr. Bailey, a clinical pharmacologist at the Institute of Health Research, discovered the interaction with the accident.
How often such reactions occur and how often people who consume fruit juice are often triggered in this scientific community. Bailey believes that many cases have been kidnapped because the doctors don’t think about asking them if they consume grapefruit or grapefruit juice.
Even if such events are rare, Dr. Bailey argued that they were predictable and completely preventable. Many hospitals no longer receive juice and some prescriptions warn patients to avoid grapefruit.
”As a result, even if the frequency is low, the results can be terrible,“ he said.
For 43 of the 85 drugs currently on the list, Dr. Bailey said, the consumption of grapefruit could be life-threatening. Many are associated with an increase in heart rhythm, known as torsade de pointes, which can result in death. It can occur even without underlying heart disease.
When taken with grapefruit, other drugs such as fentanyl, oxycodone and methadone may cause fatal respiratory depression. Interaction can also result from other citrus fruits including Seville oranges, limes and pomelos; A published case report suggested that pomegranate could increase the strength of certain drugs.
Older people may be more vulnerable because they are more likely to take medication and drink more grapefruit juice. Experts say the body’s ability to cope with drugs also weakens with age.
Under normal conditions, drugs are metabolised in the gastrointestinal tract and are relatively less absorbed because an enzyme in the gut called CYP3A4 inactivates them. But grapefruit, called furanocoumarins, contains natural chemicals that inhibit the enzyme, and without it absorbs much more of the intestine, a drug and the blood.
For example, a person receiving a simvastatin (Zocor brand) drinking 200 grams of grapefruit juice once a day for three days or 200 grams of grapefruit juice can see the blood levels of the drug triplet that increases the risk of rhabdomyolysis, and the result can be muscle breakdown causing kidney damage.