drug interactions

Food for Thought in an Acute Medicine Environment; Doctors’knowledge of Herbal Medicines Needs to be Better……

Abstract

Introduction: Patients are increasingly taking herbal supplements for a variety of reasons. This has brought into question doctors knowledge about herbal medicines.

Method: A cross-sectional web-based survey of 84 doctors working within the Department of Medicine at a District General Hospital was carried out looking at doctor’s knowledge about herbal medicines.

Results: 53 doctors took part. Of these, the majority were trainees in Medicine (42) 79%. Only (15) 28% routinely ask patients about herbal medicine use when taking a drug history. Doctor’s knowledge about herbal Medicines was poor.

Conclusion: We need to re-examine our current teaching programmes to ensure that education about common herbal medicines and important sources of information are provided to doctors to improve patient safety.

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Problem based review: The patient taking methadone

Methadone Maintenance Treatment (MMT) is an effective therapy for opioid-dependence; its use is based on a harm reduction philosophy and represents one of a range of treatment approaches for opioid-dependent individuals.

The medical literature supports MMT as a well established and cost-effective treatment for opioid-dependence that allows a return-to-normal physiological, psychological and societal functioning. The effectiveness of MMT is enhanced by psycho-social interventions such as contingency management and addressing other co-existing health and social needs. MMT saves lives and reduces violent and non-violent crime, drug use and the transmission of HIV, hepatitis C and other communicable diseases. For some people, MMT may continue for life, while others may eventually be able to discontinue and remain abstinent.

Methadone interacts with numerous drugs and prolongs the corrected QT interval (QTc) with risk of sudden cardiac death. It has a prolonged half-life and premature discharge of patients after methadone overdose may be fatal.

Each patient must be assessed, treated and monitored on an individual basis. Successful outcomes through MMT require knowledge, experience, vigilance, and diligence on the part of the physician, the patient and all of those involved in treatment.

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