alcohol

Can I drink beer while on medication?

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OSU football is in full swing, and this may mean an increase in alcohol consumption during the months to come. There are many drugs that interact with alcohol to some extent. These interactions can either metabolize medications and decrease the medications effectiveness, or can have the opposite additive effect and increase the risk of toxicity.

Here is a limited chart of studied alcohol-drug interactions and the risk/warnings of combining the two, be sure to ask your pharmacist about any drug-drug interactions before taking your medication:

Common OTC/Prescribed Medications Clinical Effects Recommendations
Pain Medications:
Acetaminophen (can be found in multiple OTC/prescribed drugs) Acute alcohol use in large amounts can increase risk of liver toxicity Do not consume >3 alcoholic drinks/day while taking this medication
Aspirin (Excedrin), ibuprofen (Motrin) and naproxen (Aleve) Increased risk of gastrointestinal bleeding Do not consume >3 alcoholic drinks/day while taking this medication
Codeine, hydrocodone + acetaminophen (Norco, Lortab, Lorcet, Vicodin), oxycodone + acetaminophen (Percocet, Endocet) and tramadol (Ultram) Co-ingestion may lead to respiratory failure, increased dizziness, sedation and can potentially be fatal Avoid alcohol consumption while on these medications
Antidepressants/Seizure medications:
Amitriptyline (Elavil), imipramine (Tofranil), clomipramine (Anafranil); and bupropion (Wellbutrin/Zyban); phenytoin, perampanel (Fycompa) Increased risk of sedation, dizziness, fainting; may also increase risk of seizures; may cause psychiatric effects Minimize or avoid alcohol use, speak to your doctor/pharmacist about alternatives
Diabetic medications:
Glyburide (Diabeta), metformin (Glucophage) and insulin therapies May cause vomiting, nausea, headache, muscle or stomach pain and visual disturbance. Unpredictable effects while on insulin may occur Avoid heavy alcohol consumption (>3 drinks/day)
Antihistamines:
Diphenhydramine (Benadryl, ZZZquil) and doxylamine (Sleep Aids) Increased risk of sedation and dizziness Advise against alcohol consumption, speak to your doctor/pharmacist about alternatives
Antihypertensives:
Amlodipine (Norvasc), nicardipine (Cardene), nifedipine (Procardia), atenolol (Tenormin), and metoprolol (Lopressor, Toprol XL) Increased risk of dizziness and fainting

 

 Advise against heavy alcohol consumption (>3 drinks/day)
Antimicrobials:
Doxycycline (Vibramycin), ketoconazole, metronidazole (Flagyl), and isoniazid May decrease effectiveness of medication, as well as increase risk of vomiting, nausea, stomach pain. Isoniazid and alcohol may cause liver damage Advise to avoid alcohol on all antimicrobial agents ask your pharmacist about interactions with your medications

 

Next time someone hands you an alcoholic drink and you are taking medication, ask yourself… is it worth the risk?

 

Justin Corpus

PharmD Candidate 2018

References:

  1. Alcohol and Drug Interactions. Pharmacist’s Letter/Prescriber’s Letter. December 2015.

Check your calendar, Groundhog!

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USDA.gov

Jogging with tunes

Courtesy cksinfo.com

 February 2.  Your New Year’s resolution is officially 33 days old.  How are you doing?  Did you decide to

  • Eat healthier?
  • Stop smoking?
  • Get more exercise?
  • Party less?
  • Finally address your moodiness and depression?

One challenge of a New Year’s resolution is that it is so permanent.  If you stop smoking on January 1, only to catch yourself with a cigarette on the 3rd, all is lost.  So, how can you make this more productive and less discouraging? 

Well, if the universe can be committed to fair or foul weather for a few weeks by the emergence of a groundhog from its hole, what say you?  Can you set a short term goal for the next 6 weeks? 

Healthy eating – Can you add another fruit and vegetable to your daily diet each of the next 6 weeks? Remember, while fresh fruits and veggies have a lot of health benefits, you can also get some of these servings from microwave soups, packaged fruit bars, etc., that may be a bit easier to carry around campus.

Smokers – how about setting March 15 as your planned stop date?  Between now and then, look at your smoking habits, try to wean yourself down on the number of cigarettes used every day, and consider a visit to Student Wellness or the Health Center to talk to a professional about the health benefits. 

Exercise – Are you a couch potato?  Try starting with a twenty-minute walk tonight.  Over the next 6 weeks, see if you can progress to 30 minutes of activity that gets your heart beating a little faster, and do it at least 5 days of the week. 

Alcohol – We all know that alcohol should be used legally and in moderation.  If you occasionally cross the line, try this trick – when you go out, see if you can limit yourself to no more than one alcoholic drink each hour. If you meet your goal, then slip a five-dollar bill into your piggy bank when you get home.  At the end of six weeks, see how many “Abes” you have accumulated.

Depression – The National College Health Assessment reports that more than one in four college students is suffering from depression, but only of third of them have consulted a healthcare professional.  Did you know that in six weeks of treatment, either with medicines, counseling, or both, you can see significant improvements? 

6 weeks.  Enough time to get out there and let the sun shine on your new healthier lifestyle?  Or maybe you want to just stay in your dark, wet, wormy hole in the ground?  It’s your decision.  Will you risk seeing your shadow?

Happy Winter!

Roger Miller, MD (OSU Student Health Services)

Hang Over Sloopy, Sloopy Hang On!

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wikimedia commons

one drink of alcohol

knol.google.com

Where's my liver? (CDC)

The US Centers for Disease Control and Prevention recently published a new report on binge drinking in the US, especially among 18-24 year-olds, and the results are concerning.  Read more about it here.  This brings to mind a question we received from a student a few years ago:

Q: My 21st birthday was yesterday. I went out drinking with my friends and now I have a horrible hangover. What kind of things can I do to get rid of it?

A: Hangovers are still not completely understood by the medical community, but we have a pretty good idea that they come from a combination of dehydration, low blood sugar, and buildup of alcohol breakdown products in your system. Despite all the dubious home remedies out there – a beer in the morning (a little hair of the dog that bit you), those bogus pills sold in gas stations, McDonald’s fish sandwiches (?) – nothing has been scientifically proven to cure hangovers.  However, a few things can help.

The first thing you can do is keep hydrated. Next time you’re at the bar, try to drink a glass of water on the rocks in between drinks. Also remember to drink a nice big glass before you go to bed. This will help counteract the dehydrating effects of alcohol.

The best thing to do on the morning after is replace the glucose and electrolytes that you have lost. This can be done with a glass of orange juice or Powerade. Another thing to do is exercise. Some studies have shown that increasing tissue oxygenation through exercise has a beneficial effect on curing hangovers.

While these steps can help with a hangover, the only proven way to prevent one is to abstain or at least drink in moderation. Party Smart here at Ohio State has more information about responsible drinking, the effects of alcohol and the local laws governing its use.

If you are worried that your drinking is starting to cause you problems, you can talk to us here at Student Health or our friends at the OSU Counseling and Consultation Service and Student Wellness Center. We are all here to help you.

John Vaughn (OSU Student Health Services)

Black Out In a Can

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nydailynews.com

In November, students were appalled when their beloved “black out in a can,” AKA Four Loko, announced that they would be removing the caffeine from their beverages.  The U.S. Food and Drug Administration (FDA) had sent out a warning letter to four manufacturers of alcoholic caffeinated beverages stating that these drinks were unsafe and subject to seizure. 

What’s the big deal?  What’s so dangerous about mixing alcohol and energy drinks?

Combining alcohol and caffeine creates a “wide-awake drunk” – because of the stimulating effect of the caffeine, you don’t feel the fatigue that you normally do with alcohol consumption alone.  In other words, you don’t feel as drunk as you really are.  So you end up knocking a few more back than you might otherwise and keeping the party going way longer than it should. 

The problem is that your blood alcohol level goes up the same whether your drinks contains caffeine or not; all you’re doing is adding the nasty risks of caffeine intoxication to the already dangerous risks of alcohol intoxication – horrible hangover, insomnia, vomiting, palpitations, dehydration, elevated blood pressure and even cardiovascular failure (otherwise known as death).  Scary stuff.

On top of that, a 2008 study of college students showed that mixing alcohol and energy drinks led to a higher prevalence of being taken advantage of (or taking advantage of someone) sexually, getting into a car with a drunk driver and suffering injuries that require medical treatment. 

If you and your friends are still looking to get a little “loko” this weekend, here are some tips to follow that will hopefully keep you a little safer.    

  • Split the drink with a friend
  • Dilute your drink with soda, juice, or lots of ice
  • Don’t drink on an empty stomach
  • Drink lots of water throughout the night

Alexandra Hinkley
Senior, School of Allied Medical Professions
The Ohio State University

John A. Vaughn, MD
Student Health Services
The Ohio State University

How do you decide when to let your friend leave the party with that guy?

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youthoria.org

So you’re out partying with your girlfriend, and a cute guy invites her back to his place.  She’s getting ready to take off with him, but she’s had a lot to drink and you’re not so sure this is a good idea.  Do you:

  1. Try to persuade her not to go by telling her she’ll regret it in the morning?
  2. Tell her to have fun and call you tomorrow?
  3. Make sure she gets home safely?

Well the good news is that according to a recent study published in Communication Education, approximately 80% of college students would choose option “3” and not let their intoxicated female friend go home with a male acquaintance.  The goal of the study was to figure out how they made that decision and what they would do to back it up.  Here’s what they found out:

Relationships are more important to you than health risks

All kinds of bad things can happen to people when they get drunk and hook up – sexual abuse, unsafe sex, and decreased self-esteem among others – but those weren’t as big a deal to the students who were polled as the relationships between the people involved.  They were more willing to let their friend go home with the guy if they or their friend knew him. 

You’re not afraid to use shame, deceipt or even confrontation to help out a friend

Some students would tell their friend what going home with the guy could do to her reputation.  Others would simply try to trick her into leaving with them by telling her they were taking her to the guy’s house but take her home instead.  Many would even confront their friend directly to keep her from making a mistake, even if it meant physically dragging her out of there.

So what’s the take home message? 

The good news is that most of you would do whatever it takes to keep your friends safe.  The bad news is that you might let your guard down a little if you feel like you “know” the guy.  Bottom line – if you think your friend is making a dangerous decision when she (or he) isn’t thinking clearly, don’t hesitate to step in no matter who is involved.  That’s what friends are for, right?

Cheryl Czapla, Med IV
College of Medicine
The Ohio State University

John A. Vaughn, MD
Student Health Services
The Ohio State University

Why do Asian people turn red when they drink alcohol?

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sloonart2008.blogspot.com

Q: I turn really red after drinking alcohol.  I’ve been told it’s because I’m Asian.  Is that true and if so, is there anything I can do to prevent it?

A:  Unfortunately, it is true and a fairly common problem – it’s estimated that 50% of people of Asian descent suffer from the “Asian flush” when drinking.  Some have it worse than just turning red; more severe reactions can include swelling, nausea, vomiting, chest pain, vertigo, palpitations and low blood pressures.   

The problem arises from an inactive enzyme called acetaldehyde dehydrogenase, which breaks down a toxic byproduct of alcohol metabolism called acetaldehyde.  When acetaldehyde accumulates in the body it causes the symptoms mentioned above.  While this can be annoying, there is no evidence to suggest any long-term side effects from the buildup.  The amount of alcohol needed to produce the reaction varies from person to person.

An article that I recently read in Time Magazine suggested that the reaction is actually a trait that evolved in the ancient Asian population to protect against alcoholism.  Recent studies do show that there is a much lower rate of alcoholism in individuals with the inactive enzyme, for obvious reasons.  In fact, there is a medication used to treat recovering alcoholics called Disulfiram (“Antabuse”) that blocks the acetaldehyde dehydrogenase enzyme to cause an artificial “Asian flush” reaction and therefore make drinking alcohol less appealing.

Inheriting the inactive enzyme is genetic, so one or both of your parents also probably has the condition.  Since there is no way (yet) to replace the inactive enzyme, the only way to avoid the flush is to avoid alcohol.  That may make for a lame New Year’s Eve, but at least now you know what causes your redness and you have a good excuse to abstain the next time your friends want to go out drinking. 

Adam Brandeberry, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

photo: sloonart2008.blogspot.com

Can’t drinking alcohol be good for you?

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one drink of alcohol

Q: I heard “moderate” alcohol use is good for you.  Is that true? 

A:  We typically define moderation as no more than 1 alcoholic drink per day for women and 2 drinks per day for men.  How do you define one drink? 12 oz beer (one regular can/bottle), 5 oz wine or 1.5 oz hard liquor (one shot).  This isn’t averaged over the week, by the way – if you have 7 drinks on Saturday night and nothing the rest of the week, that doesn’t count!

So are there benefits to drinking in moderation?  It is true that moderate alcohol consumption reduces your risk of having a heart attack, stroke, gallstones, and possibly even the risk of developing diabetes.  But put that bottle down!  This is great news for your Dad, but not so much for you.

All of those diseases are much more common in men, old people and people with significant risk factors for heart disease.  For young adults – i.e. YOU – moderate alcohol use increases the risk of the most common causes of death (like trauma and breast cancer) and is unlikely to provide any significant health benefit.  And it’s not just about life span either; alcohol use can lead to injuries, unsafe sexual practices (and their ensuing infections) and other kinds of yuckiness that can make life less pleasant.

You ladies out there should be especially careful when it comes to booze.  There is evidence that drinking more than 1 drink per day in your 20s and 30s can increase your lifetime risk of breast cancer. Studies have shown that taking folate supplements decreases this risk – but you should be taking daily folate anyways, since it reduces risk of birth defects, and we know that 50% of pregnancies are unplanned! Alcohol use during pregnancy can also lead to miscarriage and fetal alcohol syndrome: the #1 preventable cause of mental retardation in children.  Unfortunately, many women don’t even know they are pregnant until the damage has been done. 

So how do you know if your level of drinking is a problem?  Signs of problem drinking may include:

  • You’ve ever felt the need to cut down on your drinking
  • You’ve been annoyed by people telling you that you need to cut down on your drinking
  • It’s caused problems in your relationships, school, work, or especially the law
  • You’ve ever felt guilty about your drinking
  • You’ve ever needed a drink first thing in the morning to cure a hangover or steady your nerves (“hair of the dog,” “eye opener”)

If you’ve ever experienced any of these issues, please talk to the staff at Student Health Services or the counselors at the Student Wellness Center.  We are here to help!

Angela Walker, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS)

What are the negative side effects from moderate alcohol usage?

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wikimedia commons

Q: What are the negative side effects from moderate alcohol usage?

(Editor’s note: this is the very first question submitted to our new BuckMD question/comment box in the lobby of the Student Health Services pharmacy!  Jotting questions down on scraps of paper isn’t exactly high tech, but we figured knowing that you’ll be completely anonymous might make it easier to ask some things that you always wanted to know but were afraid to ask.  Please swing by the SHS pharmacy and put the comment box to good use!  Now on to your question…)

A: First let’s define moderate alcohol use.  No more than 1 drink per day for women and no more than 2 drinks per day for men.  A “drink” is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of 80-proof distilled spirits.

Drinking in moderation is typically low-risk unless you are:

  • under 21 years of age
  • pregnant or considering pregnancy
  • unable to limit drinking to low levels
  • planning to drive, operate machinery, or take part in other activities that require attention, skill, or coordination
  • taking medication that interacts with alcohol (for example, Tylenol)
  • alcohol dependent or recovering from alcoholism
  • being treated for a medical condition which is worsened by alcohol use, like diabetes

Negative side effects from alcohol use tend to occur more with heavy or binge drinking, which is defined as 5 or more drinks on a single occasion for men or 4 or more drinks for women.  Examples of negative effects from binge drinking include:

  • unintentional injuries (car crashes, falls, burns, drowning… jumping into mirror lake)
  • intentional injuries (firearm injuries, sexual assault, domestic violence)
  • alcohol poisoning
  • sexually transmitted infections
  • unintended pregnancy
  • Giving birth to children with Fetal Alcohol Spectrum Disorders
  • high blood pressure, stroke, and other cardiovascular diseases
  • liver disease
  • neurological damage
  • sexual dysfunction

For more information you can check out the CDC and NIH websites, or stop in and talk to us at the Student Wellness Center. 

Amanda Blake, MPH (OSU Student Wellness Center)

John A. Vaughn, MD (OSU SHS)

Hang Over Sloopy, Sloopy Hang On!

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wikimedia commons

one drink of alcohol

knol.google.com

Where's my liver? (CDC)

Q: My 21st birthday was yesterday. I went out drinking with my friends and now I have a horrible hangover. What kind of things can I do to get rid of it?

A: First things first… BuckMD does not support binge drinking in any way. Its advers effects on the body are numerous, and it can lead to poor decisions that have serious consequences for your future.

Now that the mini-lecture is out of the way, let’s talk about hangovers. They are not completely understood by the medical community. We have a pretty good idea that they come from a combination of dehydration, low blood sugar, and buildup of alcohol breakdown products in your system. Despite all the dubious home remedies out there – I’ve heard everything from more beer in the morning (a little hair of the dog that bit you) to those bogus pills sold in gas stations to McDonald’s fish sandwiches – nothing has been scientifically proven to cure hangovers.  However, a few things can help.

The first thing you can do is keep hydrated. Next time you’re at the bar, try to drink a glass of water on the rocks in between drinks. Also remember to drink a nice big glass before you go to bed. This will help counteract the dehydrating effects of alcohol.

The best thing to do on the morning after is replace the glucose and electrolytes that you have lost. This can be done with a glass of orange juice or Powerade (yes, BuckMD also has to support Coca-Cola products). Another thing to do is exercise. Some studies have shown that increasing tissue oxygenation through exercise has a beneficial effect on curing hangovers. It will also help you shed those extra pounds you’re gaining through drinking.

While these steps can help with a hangover, the only proven way to prevent one is to abstain or at least drink in moderation. More information about responsible drinking, the effects of alcohol and the local laws governing its use can be found at http://partysmart.osu.edu/.

-BuckMD

The cost of drunk driving

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Our friends over at the Student Wellness Center are hosting a discussion and presentation on what happens if someone is arrested for drinking and driving.  Bill Graver, formally of Buckeye Real Estate, will share his story on April 6, 2009, at 6:30 p.m. in the Gateway Event Center.  Bill cares a great deal about Ohio State students and wants to share his story with others to encourage better decision making in regards to alcohol use.  I would encourage all students to attend.  Here’s all the relevant info: 

What does a night out cost?

Having fun this weekend? It’s what college students look forward to all week. Let’s make each weekend fun, make it safe, and then, make it home! Join us for a discussion on drinking and driving.

Date: Monday, April 6th
Time: 6:30pm

Location: The Event Place (Next to Ugly Tuna at the Gateway Theater)

Soda and snacks will be provided

The first 100 students get a free t-shirt!!