Doctor Launches Educational Hot Line on Drugs' Side Effects

Times Staff Writer

You may not know it, but:

- The effectiveness of an IUD, which works by creating an inflammatory process in the uterus, will decrease by taking aspirin, which is an anti-inflammatory agent.

- Drinking too much alcohol will deplete the body of Vitamins B1 and B6. Both vitamins have an effect on the nervous system and Vitamin B6 also is responsible for a substance in the body that brings about the restful state that precedes sleep.

- Eating such foods as cheese or pickled herring while taking certain drugs for depression and hypertension can cause a life-threatening rise in blood pressure.

- Quinidine and digitalis--two drugs used to control the rhythm of the heart--can, when combined, cause an irregularity of the heartbeat and possibly result in death.

Dr. Jerome Blum, an Anaheim weight control and nutrition expert, says most people are unaware of these and other potentially serious side effects that may occur when drugs interact with each other or with food and alcohol.

By being ignorant of such chemical facts of life, people are playing what Blum refers to as "bio-nutritional Russian roulette."

"The fact that there are so many various and sundry drugs and interactions that are present, the ignorance of the individual can result in perhaps them causing serious difficulty to their body, resulting in sickness, hospitalization or even death," said Blum, a doctor of osteopathy on staff at Placentia Linda Community Hospital and founder of the Right-weight Medical Group.

"You have to remember that the body is a complete chemical factory," Blum said. "Everything that happens--your very thoughts, your actions--has to be mediated through biochemical reactions in the body. If the chemistry is not complete, or if any of the ingredients to make these chemicals in the body are absent, then we have less than the efficiency that the body could have."

On Monday, Blum launched what he hopes will help curb ignorance over the effects of drugs--at least in Orange County.

He calls it the Bio-Nutritional Hotline.

The hot line is a free educational service that will, Blum said, apprise the public of problems that might arise as a result of drug-to-drug and drug-to-food interactions.

The hot-line procedure is simple. Calls made to the number, (714) 776-0920, during office hours at the Rightweight Medical Group office in Anaheim will be answered by a staff member who will take down the caller's name, age, height, weight and a list of medications the person is taking.

The information will then be fed into a computer that will provide a brief report that details the more serious interactions. Blum said it also will show how some of the drugs interfere with sexual function and how some medications affect the body with exposure to sunlight.

Although it will take the computer only about a minute to print out the information, Blum said the report will be mailed to the caller rather than read over the phone. For legal reasons, he said, the report will include a written disclaimer noting that the report is for informational purposes only and that any information in the report should not be relied upon without first seeking advice from a physician.

A Way to Avoid Dangers

"The message they (callers) should be receiving is that before anyone continues to take the bag of medicine they might have acquired over the years, they should certainly check them out with their physician so that these obvious potential dangers can be avoided," Blum said.

The reason behind offering the hot line is in the numbers: According to Blum, there are now 16,000 different prescription drugs on the market, and new ones are coming out all the time.

"There's not one doctor that I know who could keep in mind the various interactions of these drugs," Blum said. "It's impossible. There are just too many. And then you have to take into consideration the drugs people buy over the counter, and they don't even tell the doctor (they're taking them). And people forget that when you take cigarettes, food and alcohol, that these are absolutely drugs that interfere with some of the drugs your physician prescribed."

Commercially Available

The Bio-Nutritional Hotline would not be possible without a new, commercially available computer program that Blum said contains just about every prescription drug and over-the-counter drug now available. New drugs will be added to the program periodically as they come on the market, he said.

"Without having some way of being able to quickly discover these interactions, do you know how long it would take each time a patient came in if I had to, by hand, check the various medications and their interactions with each other? Physically, you couldn't do it," he said.

The idea for such a hot line grew out of Blum's experience with obese patients in his weight-control program. Blum said at least 70% of his patients are damaging their health from disastrous drug and food combinations when he first sees them.

Blum points out that while obesity itself is a disease, it is also responsible for high-blood pressure, heart disease, gall bladder disease, back problems, hardening of the arteries, varicosities, diabetes and a host of other problems.

'Not the Doctor's Fault'

Consequently, Blum said, overweight people typically go to several doctors for their various ailments, and by the time he sees them, it's not uncommon for patients to "come in with their brown bag filled with drugs and spill them out on the table."

"It's absolutely a shame that these people are able to procure so many various different drugs, and it's not the doctor's fault because he doesn't know what the other doctors prescribed," Blum said.

"I dare say I will have physicians call (the hotline) because I don't think physicians are going to have this (computer) program and they might want to know where to get the program or (ask to) help them on some of their more difficult situations. We can do it for physicians, we can do it for small hospitals, nursing homes--it just depends on how much time it's going to involve."

Anaheim pharmacist Lee Meyer, a member of the Orange County Pharmacists Assn., said he believes that "such a hot line is necessary . . . it sounds like a valid idea as long as the information that he (Blum) gets to load into his computer is from valid sources."

The problem of dangerous drug interactions, Meyer said, is "a frequent occurrence, more frequent than I think anyone realizes. As pharmacists, this is one of the issues we're concerned with all the time as a profession. Pharmacists are the interface between the physician and the patient and traditionally have been the source of that type of information."

Jess Martinez, president of the pharmacists association, said they now spend 80% of their training in pharmacy school studying pharmacology (the science dealing with the effect of drugs on living organisms), whereas a physician "probably gets one semester or maybe less in pharmacology, so I think it (the hot line) is a good avenue for any physician to be able to dip into these types of resources to get technical information."

Cause of 10% of Admissions

Martinez said he recalls hearing that 10% of the admissions into hospital emergency rooms across the United States four years ago were due to interactions between prescribed drugs. He said two primary reasons account for that.

Not only are physicians who prescribe a drug often unaware that the patient is taking medication from another doctor, but, Martinez said, "we're finding out that with the advent of health maintenance organizations and other channels of centralized health care services, the community practitioner is losing patient visits. Therefore, to make up for that lost revenue, they're dispensing medications out of their offices."

In so doing, Martinez asserts that "they're not following the checks and balances of the way the health care delivery system occurs traditionally--having the pharmacist cross check and make certain the medication is appropriate for the therapy and the patient. The alarming thing to us pharmacists is that these medications in most cases are not properly labeled, which creates a dangerous situation for the patient."

Although he emphasizes that providing information about drug interactions is a service that has been traditionally offered by the community pharmacist, Martinez nevertheless believes that the Bio-Nutritional Hotline is "a good service."

He expressed concern, however, over what Blum's intent is in offering the service.

"Is his motive for better patient information about drugs, or is it to draw that patient clientele into his practice?"

Blum acknowledges that he hopes the hot line, which he plans to advertise in a local newspaper and on an Anaheim-area cable TV channel, might increase his practice.

But he said the reason he's offering it is because "I'm just very up-tight about what's going on in medicine today. I think it's time for people to start taking responsibility for their own health.

Hopes Service Will Spread

"We're offering this service, I think, because it's very important. I would hope that this would spread nationally, not through me, but I think it should be offered" in other locales.

In offering a bio-nutritional hot line, Blum said, "I think it has to be done with finesse. We don't want to injure any doctor--his reputation or his ego. It's not my job to say, 'See, Dr. Jones did wrong.' But I think people should be aware. Until people are aware and want to take some charge with their well-being, they're in big trouble. So we're going to do this (the hot line) and see what it does."

As for the contention that pharmacists provide free drug information to the public on a daily basis, Blum said: "That's what they say, but they don't, believe me. A good pharmacist will, there's no question. But they're few and far between. I maintain that these people that work for these large companies and are very busy have little or no time to look up drug interactions.

"I think there should be someplace where people can forever get this information for free because I don't think doctors are going to have the time to look them up," Blum said. "Someone has to give them (patients) this information."

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