轉載自 #游佩雯藥師🌕柚到中秋~柚柚柚
每到中秋節,就是好多柚子交互作用嚇死寶寶啦!
嫦娥藥師姬先說結論:
「柚子與藥物的交互作用可能不是隔開兩小時就可以解決的!」
待藥師姬娓娓道來~
這次雖然有很多專有名詞,
但藥師姬在社區跟長輩演講他們都有聽懂,
相信大家都可以的!
藥物交互作用是某些物質或狀態,可能影響藥物在身體中濃度的干擾機制。
所以有:
⭕️藥物與藥物交互作用(Drug-drug interaction)
⭕️藥物與食物交互作用(Drug-food interaction)
⭕️藥物與疾病交互作用(Drug-disease interaction)
......
干擾就來自於藥物動力學最基本的ADME環節(解釋請看圖文相片),無論哪一個環節被影響了,就可能讓藥物在體內的週期打亂喔!
藥物在身體裡停留的時間長短,以及它有活性的時間長短就影響了藥效。 但無論被影響到ADME哪個環節,都可能讓藥效變差或是變強,過強的藥效有時候就變成副作用了!
吃藥當然是想要「藥效」但不想要「副作用」,
這不僅是人性,也是天經地義!
這也是為什麼我們很在乎交互作用的關係喔~
再回來這次的正題!
🌿柚子跟藥物的交互作用。
平常我們看到在媒體或網路資料上寫的都是從葡萄柚衍生來的清單,不完全是直接研究柚子的結果喔~
的確柚子具有類似葡萄柚的CYP酵素抑制能力,也有P-醣蛋白抑制功能。可能會讓許多藥物濃度過高,藥效過長,出現副作用。
但奇怪的是,研究家發現柚子和藍色小藥丸一起吃反而效果減低40%。可能有其他的成分影響吸收,還須等待更多研究證實。
🌿講一大圈,到底可不可以吃?
如果是服用一些利用細胞色素CYP450與P-醣蛋白機制代謝相關的藥物的民眾,
像是某些心血管用藥、免疫抑制藥物、抗癲癇藥⋯等,可以看 聰明用藥健康吃 (藥害救濟基金會)的資料,可信度佳!
👩🏻⚕️勸君聽藥師姬一言,
想吃柚子的慢性病朋友「呷氣味」就好。
吃一小瓣還算安全,吃太多就母湯囉~
祝大家中秋節快樂❤️
同時也有1部Youtube影片,追蹤數超過361萬的網紅Dan Lok,也在其Youtube影片中提到,In this video, Dan Lok interviews Brandon Carter, and you’ll discover how Brandon went from being a drug dealer, having nothing, to starting a 7 figur...
drug interaction 在 Dr 文科生 Facebook 的最佳解答
《非主流意見》
最近係CUHK見到有preclinical醫學系二年級嘅同學抱怨無限個lectures同考試成日會考萬幾張slides裡面其中一個角落嘅minute details
首先,其實講粗口我覺得真係無乜所謂。私人生活同工作要有嘅專業形象係可以分開。不過要小心嘅係日後要確保真係私人生活同it won’t come back and bite you,呢一行好窄同好多人對粗口敏感,而你嘅事業好取決於同行對你嘅評價。
我覺得成件事有幾個好重要嘅點值得所有人反思下
1. 考試內容有無必要考d偏到無得再偏嘅details
全世界醫學院考試都有類似嘅題目,問一些上堂其中一張slide個角落嘅其中嘅minute detail。好多人話靠這些題目可以分辨邊d學生係精英中嘅精英,邊d學生值得攞distinction
我同意要有differentiating questions,但如果條題目問你AdenoCa Lung with EGFR mutation T790M應該用邊隻TKI時,呢類嘅題目又係唔係適合去分一個學生嘅能力?係咪今日無背到個mutation panel係咪代表你唔係好學生,係咪差過其他有背到張Slide嘅同學?
如果要differentiate一個學生嘅能力,我會覺得complicated clinical presentation +/- multiple comorbidity同藥物相沖etc去睇下個學生會點clinically prioritize同workup個病人,會更加能夠分辨到精英中嘅精英。
如果preclinical basic science嘅題目我倒唔覺得有幾需要分辨有背到minute details同無背到嘅同學,反而更加應該加多少少clinical relevance on basic sciences例如pharmacology, microbiology, drug interaction, disease presentation with regards to physiology etc
2. 真係唔好睇考試睇得太重
醫學唔係淨係科學,同時係充滿人性嘅一門藝術。傳統考試並唔代表d乜嘢,考得好考得差,合格嘅你就係醫生。
Don’t ever be defined by exam
你需要嘅係合格,達到醫學界對醫生知識嘅最低要求同埋擁有應對困難嘅能力。當刻你醒唔起lecture 134第48張slide嘅內容唔代表你唔識,亦唔代表你之後會醫死人,會係庸醫。考試其間有種種因素,時間嘅壓力、大腦突然mind blank、一時諗唔通等等,令你答錯呢條題目。
呢個並無咩咁大不了,如果你真心唔識嘅,就吸收呢次經驗同知識,be better next time 。如果你係識但因種種原因答錯嘅,唔緊要,下次更小心就好,無須覺得自己比別人低等。
香港學校好容易會出現一種互相比較嘅氣氛,really there is no need for such culture,相信自己嘅能力,記著,你唔需要一份筆試去定義你嘅人生。
*不過當然你仍然要合格,只係無必要去同人競爭鬥高分
當你看開d唔再區泥分數時,就算你無背到d rare minute details時,你一樣會合格會progress,呢d古怪題目唔會佔多過10-20%
我明好多時會覺得個考試唔公平,覺得個分數唔能夠充分反映你嘅努力同能力。
你絕對entitle你對考試內容不滿嘅感受,this should be acknowledged and not dismissed and framed as you are just a whining child
3. 基本重要defining features你其實真係要識
你未必需要知道concurrent chemoRT for NPC個platinum based regimen係乜嘢,但你起碼都要知個mainstream treatment係乜,chemo要be aware of neutropenic fever,RT個概念係乜嘢,呢d真心同你以後日常工作有關嘅知識
你的確可以以後睇症時up to date所有嘢,但你起碼要有個概念先知要uptodate乜嘢,如果唔係真係search到2046無都未搵到個答案。
至於whole genome sequencing其實我覺得你唔需要知得好詳細,但都可以了解下到底迎l近年醫學因為基因學嘅發展而有幾大嘅進步,癌症同autoimmune等疾病嘅治療近年咁大嘅改變,基因研究功不可沒。
都係果句,唔識或答錯唔緊要,從中學習睇下知識,只份卷10%嘅題目真係唔會令你唔合格。
4. 好多前輩們其實可以諗諗你覆個學生嘅objective係乜嘢
如果你只係想開心share呀叔同老娘當年都係狂背書,呢d嘢係well expected嘅時候,你想achieve d咩嘢
現實就係有學生覺得考試唔能夠全面評核佢地嘅知識同能力,呢個係一個legitimate嘅感受。當我地立即judge佢嘅心態再下埋判決覺得佢唔會survive medical career,覺得佢無做醫生嘅資格或質素,甚至叫佢quit U or transfer,你係無address過個root cause and culprit
當然你絕對有權去覺得新世代都係whining child,心態有問題,但當你睇症時都可以嘗試去從病人角度出發再adjust your approach時,點解面對師弟師妹又唔可以呢?
我唔同意單憑一個secret post就落judgement去判一個人死罪再圍鞭一輪。
的確世界唔係圍繞一個人而轉,世界亦未必會為咗一個人而改變,但如果我地真心覺得有地方值得改善,係唔應該submit to the culture or system
The world might not change for you
But if you believe a change is needed
Be that change yourself
非主流意見遇咗實有人會唔同意
最後只想同所有讀緊醫嘅同學們講
Preclinical係好悶,clinical years會好好多。唔好睇考試睇太重,the last one who passes is still a doctor
相信自己嘅能力,捱過難關後便會有另一番天地
Don’t ever be defined by exams or other people
drug interaction 在 揚揚藥師 Facebook 的精選貼文
[年節分享-過年常見藥品與食物交互作用]
每逢過年,家人朋友聚在一起,把酒言歡,分享過去一年的往事。高興之餘難免不忌口食用較多的醃製類與加工肉品。
甚至過年中常會飲用到的"酒"、"蘋果汁/柳橙汁";食用到"高酪胺食物"、"高鉀食物"都有可能與藥品產生交互作用,導致藥物的治療效果有所差異。
揚揚藥師從[Drug Interaction Facts 2010/Micromedex]蒐集資料整理出來,提醒各位好朋友,盡可能適當的飲食或是拉長服用藥物與食物的間隔 ,也歡迎大家分享給自己的親友了解,以避開可能的風險。
像是過年送禮中常見的中藥補品人參,就會與降低利尿劑Furosemide的藥效,與干擾強心劑Digoxin的藥物濃度。中醫中常用調和諸藥作用的甘草,更與9成的西藥有交互作用。
所以過年小酌可以,但不要過量;品嘗尚可,但不要吃得太多。
年假期間與家人分享喜悅是最幸福的事情;揚揚藥師也提前與大家拜個早年。
祝福~
牛年健康
牛年吉祥
牛年如意
牛年大吉
牛年順利
drug interaction 在 Dan Lok Youtube 的最佳解答
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This video is about How This Ex-Drug Dealer Started From Nothing To Build A 7-Figure Business
https://youtu.be/WvwJOV2rhg8
https://youtu.be/WvwJOV2rhg8
drug interaction 在 Updates on FDA's Drug-Drug Interaction Final Guidances 的推薦與評價
The two final guidances are In Vitro Drug Interaction Studies - Cytochrome P450 Enzyme- and Transporter-Mediated Drug Interactions and ... ... <看更多>