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@lgbtqnation @MyFabDisease “The most important thing that I learned from a decade of using the medical profession is that you need to supervise your doctors.” ― Steven Magee
@lgbtqnation @MyFabDisease The saddest part of Mark King’s tale is that he is allowing his doctors to overdosing him. Most doctor don’t know the first thing about drug interactions. ‘Primum non nocere’ is supposedly their first rule. “Primum lenocinor medicamina” is much more likely.
@lgbtqnation @MyFabDisease His bad reaction sounds like orthostatic hypotension. The means, when you get up, your blood pressure crashes & you collapse. It is almost always caused by drug interactions.
@lgbtqnation @MyFabDisease I know the above because it happened to me in two years ago. I got up in the morning & crashed, smashing my eye. My eye socket had to be rebuilt. It will never be totally functional again. No doctor has ever, in two years, admitted what caused it.
@lgbtqnation @MyFabDisease But the package insert for the drug Alfuzosin clearly warns not to mix it with “P450 C3A4 inhibitors” (& so does the FDA). What does that mean? I researched it.
@lgbtqnation @MyFabDisease Most drug interactions are pharmacokinetic or pharmacodynamic. The first is mixing drugs w/ the same aim or side effects –sleeping pills, blood pressure meds. The side effects will be additive. The second occurs while cramping too many drugs through the same liver enzyme.
@lgbtqnation @MyFabDisease Almost all drugs are metabolized (for elimination) by the liver, via a set of enzymes called the Cytochromes P450. Humans have ten involved in drug metabolism (though there are other types of metabolism). Enzymes 3A4, 2C9 & 2D6 are most critical. They metabolize 75% of drugs.
@lgbtqnation @MyFabDisease Most drugs are metabolized by more than one of these enzymes. But most interaction problems occur in just one enzyme. 3A4 breaks down at least half of all drugs, & many foods & herbs as well. Cramping too much through one enzyme is trouble by itself.
@lgbtqnation @MyFabDisease But some drugs, inhibitors, slow the metabolism of other drugs processed in that enzyme. This is the pharmacodynamic problem. You mention that you are one med that “boasts everything”. Not “everything”, but it inhibits all other drugs metabolized by the 3A4 enzyme.
@lgbtqnation @MyFabDisease It turned out, in 2017, I was on ten 3A4 inhibitors, & a number of substrates (users of an enzyme that do not inhibit).
@lgbtqnation @MyFabDisease Even worse–an inhibitor inhibits itself while inhibiting other drugs. No research has explored the total effect. Indeed, persons with other medical problems (like high blood pressure) are specifically excluded from clinical trials. (Heaven forbid they provide vital information.)
@lgbtqnation @MyFabDisease I believe that I was getting 5-10 times the effective dosage of all drugs using 3A4. Which means I was overdosing on all of them, producing intense side effects.
@lgbtqnation @MyFabDisease At least half of the medical journals articles on new drugs are written by PR firms of Big Pharma (according to JAMA). If you allow them, doctors will add one drug after another, overdosing you, as most of them interact.
@lgbtqnation @MyFabDisease Then doctors will prescribe more drugs to deal with those side effects (i.e., his high blood pressure is probably caused by his other meds). This has a medical name – the #PrescribingCascade - causing more interactions & side effects.
@lgbtqnation @MyFabDisease In 2018 a cohort study of 50K aging Veterans (VACS) noted that those on numerous medications vastly more (than expected by their ailments) ER visits, hospitalizations. early deaths, & other intense reactions.
@lgbtqnation @MyFabDisease Drug interactions should be Medicine 101. But most Docs heard it mentioned in med school & not since. For most Docs, the only Continuing Ed requirement is reading that bs in those journals. In other words, they know less medicine than I do my high school Spanish (i.e., nada).
@lgbtqnation @MyFabDisease The worst inhibitor is the drug to which he refers, #Cobicistat. This #DemonDrug has no antiviral effect whatever. It was artificially created to be a super inhibitor. A #FrankensteinDrug, artificially created, & deadly in the wrong hands (i.e., doctors).
@lgbtqnation @MyFabDisease People with HIV take a ‘cocktail’, a combo of drugs used to fight HIV. For those on no other meds, Cobicistat may be a blessing. For example, if you combine it with Selzentry, you half the dosage of Selzentry, because it inhibits it.
@lgbtqnation @MyFabDisease (In technical terms, it creates a higher peak concentration (Cmax) & average concentration (Cavg). It also increases the time Selzentry is in the body (AUC, “area under the curve”). So, doctors following the idiot ‘HIV standard of care’ would never consider NOT using it.
@lgbtqnation @MyFabDisease But think about that. Half the dosage. That means that Cobicistat doubles the effects of Selzentry. So, what it is doing to all the other drugs you are taking? & what is the cumulative effect? You found out one effect in that hospital bed.
@lgbtqnation @MyFabDisease The package insert: “Cobicistat, a CYP3A inhibitor…may increase plasma concentrations of medications metabolized by CYP3A. (This) may lead to SEVERE, LIFE-THREATENING, OR FATAL events from higher exposures of concomitant medications.”
@lgbtqnation @MyFabDisease To prescribe it to someone on numerous medications is reckless, negligent, irresponsible & deadly. Yet, that is the HIV ‘standard of care”. Pure insanity. Ἰατρέ, θεράπευσον σεαυτόν!
@lgbtqnation @MyFabDisease Another medical #ConJob is that drugs that worked fine before they developed Cobicistat, may not now be used without being ‘boasted’. The logic escapes me. Yet virtually every infectious disease doctor believes such nonsense.
@lgbtqnation @MyFabDisease The fact that most doctors are receiving payoffs from Big Pharma is the only thing that explains it. Like so many politicians, they are whores.
@lgbtqnation @MyFabDisease Computer programs can warn about combining any two drugs. But they say nothing on what to do about it. Specifically, what blood pressure, statin or reflux drugs, etc., do not use 3A4? I had to develop that spreadsheet for myself. & what happens if you mix numerous drugs?
@lgbtqnation @MyFabDisease I spent two years, going from doctor to doctor, trying to switch to less deadly combos. Just a week ago, in fact, I found my final specialist. He understands the problem & is willing to work with me. I was completely startled. That rarest of beings - a #CompetentDoctor.
@lgbtqnation @MyFabDisease Primum quaestione medicus. # @threadreaderapp unroll.
