Edecrin

The doctor of chiropractic needs to know that not only can prescription drugs have adverse reactions when taken according to label instructions1, but more often than not, there is a nutritional price to pay, one that can dramatically affect the patient's health and well-being. The doctor of chiropractic is encouraged to study this topic in depth through the National University of Health Sciences DABCI Online Program at 630/889-6620. The doctor of chiropractic should be aware of all the prescription and overthe-counter medications (OTCs) that a patient is taking, as well as botanical medicines, homeopathic preparations, vitamins, minerals, and supplements. This information should be obtained during the patient's first visit. It must be understood that drug-nutrient depletions are common and may be the cause of the patient's presenting health condition.

Some examples are: the NSAID ibuprofen (Motrin) depletes folic acid, which may cause birth defects, anemia, cardiovascular disease, and cervical dysplasia. I find that ibuprofen is the most common medication that patients use for self-medication prior to consuiting my practice for a neuromusculoskeletal condition.

Antibiotics, such as aminoglycosides, cephalosporins, fluoroquinolones, macrolides, and penicillin, deplete B vitamins and vitamin K. Short-term depletion effects are minimal, but failure to re-inoculate the GI tract with beneficial bacteria (probiotics) often results in dysbiosis, which may cause gas/bloating and decrease the digestion and absorption of nutrients. Everyone, young and old, is encouraged to take probiotics twice daily with meals for two weeks following a course of antibiotics.

Loop diuretics such as furosemide (Lasix), bumetadine (Bumex), and ethacrynic acid (Edecrin) deplete calcium, magnesium, potassium, vitamins B1 and B6, vitamin C, sodium, and zinc (see chart). Blood pressure beta-blocker medications such as propanolol (Inderal), atenolol (Tenormin), and metoprolol (Lopressor) deplete Co-Q10 and melatonin, which may cause various cardiovascular problems, a weakened immune system, low energy, and insomnia, and create an increased cancer risk and increased freeradical aging damage.

What does this all mean? Our patients often present with a constellation of problems and complaints. Awareness of the medications being taken and their dosages is an important aspect of patient care. Geriatric patients may be getting too much medication -even though they are following label instructions. As we age into our 60s and 70s, drug half-lives increase due to a reduction in kidney excretory function and decreased Phase I and Phase II activity in the liver. What this means is that the geriatric patient can be taking the recommended amount and suffer toxicity and nutrient depletions due to the increased time that the drug circulates within the body, and the impaired drug breakdown and excretion through the kidneys and liver.

Reference:

1. Physician's Desk Reference (PDR) 2001 Published by Medical Economics

BY REINER G. KREMIR, DC, DABCI, NMD

Dr. Kremer practices in Franktown, Colorado, and is past president of the ACA Council on Family Practice

Copyright American Chiropractic Association Sep 2001
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