Alcohol and Medication Interactions

Alcohol often has harmful interactions with prescription medications, over-the-prescription-and-alcohol-abusecounter drugs, and even some herbal remedies. Alcohol interactions with medications may cause problems such as:

  • Nausea and vomiting
  • Headaches
  • Drowsiness
  • Dizziness
  • Fainting
  • Changes in blood pressure
  • Abnormal behavior
  • Loss of coordination

Mixing alcohol and medications also may increase the risk of complications such as:

  • Liver damage
  • Heart problems
  • Internal bleeding
  • Impaired breathing
  • Depression

In some cases, alcohol interactions may decrease the effectiveness of medications or render them useless. In other cases, alcohol interactions may make drugs harmful or even toxic to the body.

Even in small amounts, alcohol also may intensify medication side effects such as sleepiness, drowsiness, and light-headedness, which may interfere with your concentration and ability to operate machinery or drive a vehicle, and lead to serious or even fatal accidents.

Because alcohol can adversely interact with hundreds of commonly used medications, it’s important to observe warning labels and ask your doctor or pharmacist if it’s safe to use alcohol with the medications and herbal remedies that you take.

Alcohol Interactions: A Significant and Increasing Danger

According to the CDC, about two-thirds of adults over age 18 at least occasionally use alcohol. Of these, 52% are current regular drinkers (defined as at least 12 drinks in the past year), and 14% are infrequent drinkers (defined as up to 11 drinks in the past year).

Use of prescription and non-prescription drugs, as well as herbal remedies, also is extremely prevalent. Partly because of the obesity epidemic and sedentary lifestyle, Kenyans of all ages are taking more drugs to control chronic conditions such as diabetes, high blood pressure, and elevated cholesterol. Because the incidence of chronic conditions increases with age, older Kenyans are especially likely to take prescription medications  often as many as 10 per day many of which likely react adversely with alcohol.

As the population ages, the problems associated with mixing alcohol and medications are certain to increase.

Older Kenyans Are at Special Risk of Alcohol Interactions

In older adults especially, alcohol use may increase the risk for falls, serious injury, and disability related to balance problems. Alcohol use also may trigger or worsen certain medical conditions.

When alcohol use is combined with multiple medications, it may magnify these problems. Older adults don’t metabolize alcohol as quickly as younger adults do, so alcohol stays in their systems longer and has a greater potential to interact with medications.

Even though most people over 65 drink less than the maximum recommended amount, this drinking is still considered harmful in over 50% of them, due to their general condition, medical problems and medications.

Drugs Associated With Alcohol Interactions

Hundreds of commonly used prescription and over-the-counter drugs may adversely interact with alcohol. These include medications used for:

  • Allergies, colds, and flu
  • Angina and coronary heart disease
  • Anxiety and epilepsy
  • Arthritis
  • Blood clots
  • Cough
  • Depression
  • Diabetes
  • Enlarged prostrate
  • Heartburn and indigestion
  • High blood pressure
  • High cholesterol
  • Infections
  • Muscle pain
  • Nausea and motion sickness
  • Pain, fever, and inflammation
  • Seizures
  • Severe pain from injury, post-surgical care, oral surgery, and migraine
  • Sleep problems

Alcohol Detox Programs

Alcoholism is a chronic disease. Like other chronic diseases, if left untreated, alcoholism can have serious, life-threatening consequences. Fortunately, there are effective treatment programs for alcoholism. While details vary from program to program, alcohol detox and alcohol rehab programs share certain essential components.Health-and-Rehabilitation

What Is Alcohol Detoxification?

 Alcohol detox is an important preliminary step in the management of alcoholism. It is a medically supervised period of alcohol withdrawal. During this period, a doctor may administer medications to control symptoms, and the individual is monitored by health professionals to ensure his or her safety. In addition to medical care during withdrawal from alcohol, the person usually also receives education about his or her alcohol problem and its treatment.

Medical management of alcohol withdrawal for people who are alcohol dependent is often necessary, because the symptoms of withdrawal can be dangerous. They can include:

  • Sweats
  • Nausea
  • Vomiting
  • Tremors
  • Anxiety
  • Agitation
  • Paranoia
  • Hallucinations
  • Convulsions
  • Seizures

Not everyone has all these symptoms, and symptom can range from mild to severe. Typically, alcohol detoxification takes place in a regular medical ward of a hospital, a specialized detoxification unit, or in an outpatient clinic. Detox, which may last a few days to more than a week, is an important and necessary preparation for treatment.

Kinds of Alcohol Rehab Programs

Alcohol rehabilitation takes place in a variety of settings:Rehabilitation concept.

Hospital- or medical-clinic-based programs. These programs offer both alcohol detox and alcohol rehab on an inpatient basis in specialized units.

Residential rehab programs. These programs can last from a month to more than a year and take place in a residential environment. Often, the treatment is divided into a series of stages that the person goes through. For instance, in the beginning, a patient’s contact with others, including friends and family, is strictly limited. The idea is to develop a primary relationship with the other residents who are also recovering from alcoholism. Eventually, the person will be allowed more contact with people outside the residential community and may even go back to work or school, returning home to the treatment facility each day.

Partial hospitalization or day treatment. These programs provide four to eight hours of treatment a day at a hospital or clinic to people who live at home. They typically run for three months and work best for people with a supportive family and a stable home environment.

Outpatient programs. These are run at hospitals, health clinics, community mental health clinics, counselor’s offices, and residential facilities with outpatient clinics. Attendance requirements vary, and many of them are run in the evenings and on weekends to allow people to be able to continue working.

Intensive outpatient programs. These programs require nine to 20 hours of treatment per week and run for two months to one year. They work best for people who are motivated to participate and who have supportive families and friends.

 

Alcohol Abuse and Alcohol Dependence

Alcohol abuse means having unhealthy or dangerous drinking habits, such as drinking aaevery day or drinking too much at a time. Alcohol abuse can harm your relationships, cause you to miss work, and lead to legal problems such as driving while drunk (intoxicated). When you abuse alcohol, you continue to drink even though you know your drinking is causing problems.

If you continue to abuse alcohol, it can lead to alcohol dependence. Alcohol dependence is also called alcoholism. You are physically or mentally addicted to alcohol. You have a strong need, or craving, to drink. You feel like you must drink just to get by.

You might be dependent on alcohol if you have three or more of the following problems in a year:

  • You cannot quit drinking or control how much you drink.
  • You need to drink more to get the same effect.
  • You have withdrawal symptoms when you stop drinking. These include feeling sick to your stomach, sweating, shakiness, and anxiety.
  • You spend a lot of time drinking and recovering from drinking, or you have given up other activities so you can drink.
  • You have tried to quit drinking or to cut back the amount you drink but haven’t been able to.
  • You continue to drink even though it harms your relationships and causes physical problems.

Alcoholism is a long-term (chronic) disease. It’s not a weakness or a lack of willpower. Like many other diseases, it has a course that can be predicted, has known symptoms, and is influenced by your genes and your life situation.

Alcohol is part of many people’s lives and may have a place in cultural and family traditions. It can sometimes be hard to know when you begin to drink too much. You are at risk of drinking too much and should talk to your doctor if you are:1

  • A woman who has more than 3 drinks at one time or more than 7 drinks a week. A standard drink is 1 can of beer, 1 glass of wine, or 1 mixed drink.
  • A man who has more than 4 drinks at one time or more than 14 drinks a week.

Signs of alcohol abuse or dependence

Certain behaviors may mean that you’re having trouble with alcohol. These include:

  • Drinking in the morning, often being drunk for long periods of time, or drinking alone.
  • Changing what you drink, such as switching from beer to wine because you think it will help you drink less or keep you from getting drunk.
  • Feeling guilty after drinking.
  • Making excuses for your drinking or doing things to hide your drinking, such as buying alcohol at different stores.
  • Not remembering what you did while you were drinking (blackouts).
  • Worrying that you won’t get enough alcohol for an evening or weekend.

 

Oral Care

Dental Health and Bad Breath
Bad breath, medically called halitosis, can result from poor dental health habits and may be a sign of other health problems. Bad breath can also be made worse by the types of foods you eat and other unhealthy lifestyle habits.

What You Eat Affects Breath
Basically, all the food eaten begins to be broken down in your mouth. As foods are digested and absorbed into the bloodstream, they are eventually carried to your lungs and given off in your breath. If you eat foods with strong odors (such as garlic or onions), brushing and flossing even mouthwash merely covers up the odor temporarily. The odor will not go away completely until the foods have passed through your body.

Poor Habits Cause Bad BreathdTreoBoEc
If you don’t brush and floss teeth daily, food particles can remain in your mouth, promoting bacterial growth between teeth, around the gums, and on the tongue. This causes bad breath. Antibacterial mouth rinses also can help reduce bacteria. In addition, odor-causing bacteria and food particles can cause bad breath if dentures are not properly cleaned.

Smoking or chewing tobacco-based products also can cause bad breath, stain teeth, reduce your ability to taste foods, and irritate your gums.

Health Problems Are Associated With Bad Breath
Persistent bad breath or a bad taste in the mouth may be a warning sign of gum (periodontal) disease. Gum disease is caused by the buildup of plaque on teeth. Bacteria cause the formation of toxins to form, which irritate the gums. If gum disease continues untreated, it can damage the gums and jawbone.

Other dental causes of bad breath include poorly fitting dental appliances, yeast infections of the mouth, and dental caries (cavities).

The medical condition dry mouth (also called xerostomia) also can cause bad breath. Saliva is necessary to moisten the mouth, neutralize acids produced by plaque, and wash away dead cells that accumulate on the tongue, gums, and cheeks. If not removed, these cells decompose and can cause bad breath. Dry mouth may be a side effect of various medications, salivary gland problems, or continuous breathing through the mouth.

Many other diseases and illnesses may cause bad breath. Here are some to be aware of:
•    Respiratory tract infections such as pneumonia or bronchitis,
•    Chronic sinus infections,
•    Postnasal drip,
•    Diabetes,
•    Chronic acid reflux,
•    Liver disease
•    Kidney disease

Tonsils or Adenoiditis

We all have gotten a sore throat from time to time, and sometimes the tonsils in our mouths become infected. However, tonsils are not the only vulnerable glands in our mouth. Adenoids, located higher up in the mouth, behind the nose and roof of the mouth can also get infected. Enlarged and inflamed adenoids are referred to as adenoiditis and can be painful and make breathing difficult.Adenoids
What Are Adenoids?
Adenoids are a mass of tissue that, along with our tonsils, help keep us healthy by trapping harmful germs that pass through the nose or mouth. Our adenoids also produce antibodies to help our body fight infections. Unlike tonsils, which can be easily seen by opening our mouth, you cannot see the adenoids. A doctor has to use a small mirror or special instrument with a light to see the adenoids. Sometimes X-rays may be taken to see them more clearly.

While adenoids play an important role in keeping a person healthy, as you get older, adenoids become less important because our body is able to fight infection in other ways. In fact, adenoids often get smaller around age 5 or 6 and virtually disappear by the teen years.

Adenoiditis
Even though adenoids help filter out germs from our body, sometimes they can get overwhelmed by bacteria and become infected. When this happens they also get inflamed and swollen. This condition is called adenoiditis. It is most commonly seen in children, but sometimes affect adults.

Symptoms
Symptoms of adenoiditis can vary depending on what is causing the infection but may include:
•    sore throat
•    stuffy nose
•    swollen glands in the neck
•    ear pain and other ear problems

When the nose is stuffy, breathing through it can be a challenge. Other symptoms of adenoiditis related to nasal congestion include:
•    breathing through the mouth
•    speaking with a nasal voice, as if you are speaking with a pinched nose
•    difficulty sleeping
•    snoring or sleep apnea (a condition where you stop breathing for a short amount of time during sleep)
•    poor feeding and weight loss/ failure to thrive

Treatment for Adenoiditis
Adenoiditis is treated with antibiotics. However, if a child has frequent infections, including ear and sinus infections, or antibiotics do not help, or if the child has ongoing breathing problems, surgery may be needed to remove the adenoids. This procedure is called an adenoidectomy.

A pediatrician may also recommend the tonsils be removed at the same time since adenoiditis and tonsillitis often go hand in hand. Surgery to remove the tonsils is called a tonsillectomy.

Together, you and your child’s doctor can discuss the pros and cons of surgery and determine if it is necessary.

Exercise for People with Heart Failure

Overview

The heart is fundamentally a blood pump. It pumps blood from the right side of the heart to the lungs to pick up oxygen. The oxygenated blood returns to the left side of the heart. The left side of the heart then pumps blood into the circulatory system of blood vessels that carry blood throughout the body.

The heart consists of four chambers.

•    The two upper chambers are called atria and the two lower chambers are called ventricles.
•    The right atrium and right ventricle receive blood from the body through the veins and then pump the blood to the lungs.
•    The left atrium and left ventricle receive blood from the lungs and pump it out through the aorta into the arteries, which feed all organs and tissues of the body with oxygenated blood.
•    Because the left ventricle has to pump blood to the entire body, it is a stronger pump than the right ventricle.

Heart failure as a term sounds frightening because it can be misconstrued to mean that the heart just stops working. Heart failure means the tissues of the body are temporarily not receiving as much blood and oxygen as needed. With advancements in diagnosis and therapy for heart failure, patients are feeling better and living longer.

HeartExercise
Figure 1: Heart failure Image courtesy of Bryan Moss at Scott and White Hospital, and David A. Smith, MD.

The heart is a pump that works together with the lungs. The heart pumps blood from the veins through the lungs where oxygen is added and then moves it on to the arteries. This pumping action creates a relatively high pressure in the arteries and a low pressure in the veins. Heart failure is an illness in which the pumping action of the heart becomes less and less powerful. When this happens, blood does not move efficiently through the circulatory system and starts to back up, increasing the pressure in the blood vessels and forcing fluid from the blood vessels into body tissues. Symptoms depend on which area of the body is most involved in the reduced pumping action.

•    When the left side of the heart (left ventricle) starts to fail, fluid collects in the lungs (pulmonary edema). This extra fluid in the lungs (pulmonary congestion) makes it more difficult for the airways to expand as a person inhales. Breathing becomes more difficult and the person may feel short of breath, particularly with activity or when lying down.
•    When the right side of the heart (right ventricle) starts to fail, fluid begins to collect in the feet and lower legs. Puffy leg swelling (edema) is a sign of right heart failure, especially if the edema is pitting edema. With pitting edema, a finger pressed on the swollen leg leaves an imprint. Non-pitting edema is not caused by heart failure.
•    As the right heart failure worsens, the upper legs swell and eventually the abdomen collects fluid (ascites). Weight gain accompanies the fluid retention and is a reliable measure of how much fluid is being retained.

Although heart failure is a serious medical condition, there are many causes and the outcome can vary from person to person. Heart failure may develop gradually over several years, or more quickly after a heart attack or a disease of the heart muscle. Congestive heart failure (CHF) is generally classified as systolic or diastolic heart failure and becomes progressively more common with increasing age. In addition, patients with risk factors for heart disease are more likely to develop congestive heart failure.

Exercise Tips in heart failure

Getting Started
Always check with your doctor first before starting any exercise program. Your doctor will advise you on a program that matches your level of fitness and physical condition. To start the doctor should help you determine and plan;

    How much exercise you can do each day
How often you can exercise each week
What type of exercise you should do
What type of activities you should avoid

When you start:

•    Be sure any exercise is paced and balanced with rest.
•    Avoid isometric exercises, such as pushups and sit-ups. Isometric exercises involve straining muscles against other muscles or an immovable object.
•    Don’t exercise outdoors when it is too cold, hot, or humid. High humidity may cause you to tire more quickly. Extreme temperatures can interfere with circulation, make breathing difficult, and cause chest pain. Better choices are indoor activities, such as mall walking.
•    Make sure you stay hydrated. It is important to drink water even before you feel thirsty, especially on hot days. But be careful not to drink too much water. Follow your doctor’s guidelines about how much fluid you can have in a day.
•    Extremely hot and cold showers or saunas should be avoided after exercise. These extreme temperatures increase the workload on the heart.
•    Steer clear of exercise in hilly areas unless you have discussed it with your doctor. If you must walk in steep areas, make sure you slow down when going uphill to avoid working too hard.
•    If your exercise program has been interrupted for more than a few days (due to illness, vacation, or bad weather, perhaps), make sure you ease back into the routine. Start with a reduced level of activity, and gradually increase it until you are back where you started.

Exercise Precautions
There are some precautions you must keep in mind when developing an exercise program. Here are some tips.

•    Stop the exercise if you become overly fatigued or develop chest pain. Discuss the symptoms with your doctor, or schedule an appointment for evaluation.
•    Do not exercise if you are not feeling well or have a fever. You should wait a few days after all symptoms disappear before restarting the exercise program, unless your doctor gives other directions.
•    If you experience shortness of breath or increased fatigue during any activity, slow down or stop the activity. Elevate your feet when resting. If you continue to have shortness of breath, call your doctor. The doctor may make changes in medications, diet, or fluid restrictions.
•    Stop the activity if you develop a rapid or irregular heartbeat or have heart palpitations. Check your pulse after you have rested for 15 minutes. If it’s still above 100 beats per minute, call the doctor for further instructions.

If you experience pain:
Don’t ignore it. If you have chest pain or pain anywhere else in the body, do not continue the activity. Performing an activity while in pain may stress or damage the joints.

Warning
Stop exercising and call your doctor if you have any of the following symptoms:

•    Chest pain
•    Weakness
•    Dizziness or lightheadedness
•    Unexplained weight gain or swelling
•    Pressure or pain in your chest, neck, arm, jaw, or shoulder
•    Any other symptoms that cause concern