Grapefruit inhibits one of the CYP450 isozymes that is important in the metabolism of certain medications. Depending on the medication and how it is metabolized, it can even increase or decrease your blood levels of that medication. It is only Grapefruit (the fruit or the juice), orange juice is perfectly fine.
Grapefruit juice has components which inhibit certain metabolizing enzymes in the liver and gut cells. Alprazolam (the generic name for Xanax) is metabollzed in part by those same enzymes under normal circumstances. Blocking the metabolizing efficacy of said enzymes therefore blocks the breakdown of drugs such as Alprazolam, which can lead to increases in plasma concentration of the drugs in a patient’s body, which generally is directly associated with increased pharmacologic action.
The elderly are particularly at risk since (again as a general rule) their natural ability to metabolize the drug is diminished as compared to younger populations. Add in the enzyme inhibitory effects of grapefruit juice and the elderly are at greater risk of excessive sedation and dizziness (which may contribute to an increased risk of falls/injury among other risks). In the case of some drugs, the regular scheduling frequency of use (ie taking the drug two or three times daily) can result in much higher steady-state levels of a drug in the elderly than it would in a younger adult, which again increases their risk of injury/adverse events.
How do you find Savannah? Really, be honest. I lived there recently and most people thought it was a dream city–southern, friendly and beautiful. As a tourist all of these things are true, but as a resident I found it dangerous, crime ridden and horrific. But, I lived in the historic district which is notorious for that (I found out after I had rented a home there!).
In my experience, female pharmacists at retail don’t worry too much about it since no pharmacist I know of likes to touch a patient’s pills directly, preferring to count them with a spatula. There are, of course, exceptions where direct contact is unavoidable, but they don’t happen too often.
In truth, I’d worry more about cleaning the tray after to prevent residuals from sticking a pregnant female patient’s prenatal vitamins than I would a female counting the pills, though I still (for safety/liability reasons) won’t let pregnant techs count certain meds.
In a hospital or pharmaceutical industrial setting, though, there are areas/activities where a pregnant pharmacist would be encouraged to avoid if possible (nuclear compounding and oncologic compounding as examples).
Question for the pharmacy student:
Have you started to figure out what area of pharmacy you wish to practice in after you graduate? Are you interested in retail pharmacy, hospital pharmacy, or some other area?
Given that your school is probably a heckuva lot different than mine was, have they started to expose you to off-the-beaten trail career paths (such as regulatory pharmacy practice, like with your state board of pharmacy or the FDA, or nuclear pharmacy which was bar-almost-none my favorite rotation, though that was because my preceptors let me do a ton of stuff compared to other rotations)?
Actually, I like it. I’ve spend an entire calender year in Savannah so far, and it is pretty enjoyable. I know there are some areas that have high crime, but I pretty much avoid them. But, I do love having Tybee beach close by, and a downtown where you can carry EtOH openly. I’ve spend many a night downtown drinking, and also exploring the squares while waiting to sober up, and I’ve never felt unsafe.
So far, retail pharmacy. A big part of that is that’s all I’ve actually done. I worked (and am working) at Eckerds/Rite Aid since I was first interested in pharmacy. I am doing my first intermediate rotation right now, at a local independent retail pharmacy. My next rotation (Starting July 13th) is at my local hospital, so that will be my first taste of hospital pharmacy.
I am keeping my options open, I haven’t ruled anything out. I know I could see myself doing retail for the rest of my life, so I’m not worried about that, but I’ll see how I like hospital after I do my rotation there.
Our school has actually been pretty good about showing us the diffrent areas we can practice pharmacy, and our options in our career. One of our first quarter classes (Health Care Systems) taught us how the health care system works in our country, and all the places that Pharmacists are useful. We have a major member of the faulculty that is in the Air Force and works on a military base that has introduced us to the options working for the government, and one of our teacher’s husband is a nuclear pharmacist and did a guest lecture teaching us how nuclear works out. I know at least six of my class mates who are doing a nuclear pharmacy rotation during our intermediate pharmacy practice rotations.
ETA: keturah, one thing I will add about Savannah… The people there CAN NOT DRIVE! They are even worse then drivers in Atlanta!
Is the BBQ Pit available in rectal suppository form?
Thanks! Very helpful! The only one I worried about was levoxyl, as it seems sensitive to moisture.