North Carolina People; Joe/Terri Graedon, People's Pharmacy

Good evening ladies and gentlemen. What's its take special note of this book People's Pharmacy so well over two and a half million copies. It's a product of your work and meet and talk with such interesting people. Just a few seconds North Carolina people is brought to you by walkover banking investments and financial services for individuals businesses and corporations. We are here. Let's get started. Well I want to ask first Terry how does a politician pharmacologist get together to produce a work like this that great events take place. Well first you fall in love with America. Many years ago back in Ann Arbor Michigan where we were graduate students in

our respective fields and take it from there. Well actually I'm partially responsible for the People's Pharmacy even though I didn't help her right the first one. I drank you know off to Mexico where I could do my dissertation research in medical anthropology. He went willingly. But he came with me and he had a lot of time on his hands he taught pharmacology at the medical school in the morning and the entire afternoon was free. Well there's only so much time you can spend sitting in the hammock. So he started writing the book. Les it's just an incredible story here but Joe when we came home from World War 2 chemistry hadn't invaded medical routine at all. And this explosion what do you attribute this to. Well you know when you really go way back to when my grandfather was a pharmacist there were some herbs and you know the mortar and

pestle he had a big bottle of leeches on his counter which were used for a variety of things that ailed you but there wasn't the kind of pharmacological intervention that we have today and certainly World War 2 was the beginning. Penicillin was the start of it. That was kind of the first magic bullet that came along and it just created such enthusiasm and excitement in the medical community. And then. After that we began developing some blood pressure pills one of the first was something called research. It was kind of an herb from Africa and a few more blood pressure medicines and then antidepressants begin to show up in drugs for schizophrenia before them. We basically had wet sheets in padded cells for people and then starting in the 70s and 80s. I mean it just took off and now we have literally thousands tens of thousands of extraordinary compounds major breakthroughs for everything from really treatments for

arthritis and high blood pressure to depression and anxiety and high cholesterol and some exciting things on the horizon against cancer and the story is just unfolding before us. Terry had the world to you to keep up with this huge flow of information with a struggle. Was there really. There is so much information out there. We do use the computer we use the Internet. We subscribe to a lot of medical journals. We subscribe to certain magazines and newsletters that are just available for the for the lay public and we do our best. We also spend a lot of time on the telephone because in order to stay on top of what's happening not just this week or next month but next year you have to you have to talk to the people who are doing the research you have to talk to the Food and Drug Administration and see what's happening at their end and you have to kind of keep your finger on the pulse. So we try to keep up

with the journals but in addition we have to talk to people who are who are really in the trenches. You write about here the brand name of the generic drug. We all know that it cost millions of dollars to get a drug from it to being on hundreds of million dollars ounce days. What is the economic force. How do you reckon reconcile the right to make it back the investment that sometimes there is so high. Well that there really is a good question because the price of pharmaceuticals has been skyrocketing and the drug industry is one of the most profitable in the country. It sure is. I could tell. Well let's let's take two or three things here that the viewers will want to hear you to talk about hypertension. This is one you just made mention of the next enormous acceleration here but we've gone from one particular drug that the beta blocker to the calcium. What what are we doing. What's what's new.

Well you know I think if you turn back the clock 20 or 30 years in fact in fact if you were to go back to research that African Herb I was talking about it lowered blood pressure pretty effectively. But one of the very serious complications was depression. And people would often become suicidal on that medication. Then we developed a bunch of medications that could lower blood pressure pretty well but there were a lot of side effects stuffy nose dizziness. Just made you feel bad. And so a lot of people decided you know well I'd rather have my high blood pressure than feel so bad. Sex life often went out the window. One of the rather common side effects of blood pressure medication well over the last five or ten years there has been the explosion of new drugs besides the beta blockers the propranolol which was the one of the first ones into ral and then to Norman. Then we developed the calcium blockers drugs like Hard to say and verapamil and pro-car and planned which by

the way interact with grapefruit and I'm sure we'll talk a little bit about the grapefruit drug interactions which is a fascinating story. And then we develop these ACE inhibitors Ace not the ace of spades but a standing for angiotensin converting enzyme. The story behind it is very interesting. The jar aka snake from where is that Brazil is. They isolated the venom from this snake and found that it could have a really important place in lowering blood pressure and these drugs are now cornerstones Vai's attack is one example. Kapiton is another example. What are some of the others prevail monopole. Excellent drugs not just in lowering blood pressure but perhaps in helping diabetics not develop some of the complications there. Now we have a new generation of drugs called costar and highs are which work a little differently but similar sense. And so people can lower their blood pressure without the complications without feeling like they have to trade off the quality of their life

for the ability to reduce their risk of heart attacks and strokes so it's really been a marvelous improvement. Well I think that it's part of what happened with the drug companies realize that quality of life is important to patients and they started looking to develop compounds that would give you the medical benefit without making you feel so terrible. In this book you have a lot to say to me though about exercise diet sleep nature's plan is always probably the best isn't doing those things really are important. And you know our current society we often tend to forget them or overlook them or think that we can take them for granted. You really can't take them for granted. They're crucial. It's so fascinating to me that when we started out. Over 20 years ago we focused primarily on the medicines prescription drugs and over-the-counter remedies and what we have discovered over the last 10 years is that our listeners and our readers are absolutely fascinated

with the lifestyle issues that you just mentioned. Well should I be eating salt and butter is that better than margarine or what about some of those other spreads. How about olive oil and what kind of exercise and what about herbs. Is St. John's Wart OK for depression and what about gingko for my memory. Should I be eating garlic in gin saying so we've kind of switched a lot of our emphasis from just prescription medicines to a whole range of issues and so you'll find in the People's Pharmacy both in our books and our newspaper columns as well as on our radio show that we are now talking about issues of spirituality. We're talking about issues of natural healing and we're finding it very rewarding. The alternative medicine that is is really getting into the conversation is it really isn't in a lot of ways. Alternative medicine people are using it not so much as an alternative but as a as a supplement a complement perhaps. So perhaps we should

say complimentary medicine. People really are using all the resources that they've got available. If that means including vitamins including herbs including the medicines that their doctors prescribe. But one mistake that some people make that they should know is they tend not to tell their doctors what they're doing. That he didn't or she didn't prescribe. And they sometimes don't tell their chiropractor or naturopath what they're taking that the doctor prescribed. And those health professionals need to be informed of everything. What we've discovered of course is that things interact. And we've written about how drugs can interact you know for example the Tylenol that you take for your headache might have a profound influence on the Coumadin that you take to prevent a blood clot to cause a heart attack or a stroke. Well those kinds of interactions can also occur between vitamins vitamin C in your hormone replacement therapy or between your herbs.

You're going to go for example in your Coumadin. So the idea of communicating this information to all of your health professionals is extremely important. Pharmacists as well as physician. And then you need to do your own homework. Hope this deadly drug interactions this issue published last year right. What you just said really was the reason behind getting this text out was it really us we we had been interested in the topic for the last 20 years it's been included in all our peoples pharmacy books but we felt it's so crucial that it had to have its own reference. And so whether it's grapefruit which does interact with my goodness now cholesterol lowering drugs as well as astrogation as well as Sandomir which is a very important medicine generic name a cyclist foran that people who have had organ transplants take to prevent their body from rejecting the organ. Well when I read what you wrote about grapefruit I became an orange juice

a lot. Why one and not the other. Well let us just say that we don't have anything against grapefruit. In fact I love Great Lakes your tastebuds up in the morning. Unlike anything else and the problem with grapefruit is that if you're taking the wrong medicines it really can lead to serious if not deadly consequences we know of one man who did die apparently of a Seldane overdose that histamine because of the grapefruit juice he drank. There is an ingredient in grapefruit. We used to think we knew what it was the flavonoids. First it was what Terry. I think their engine was the first candidate that the scientists thought was responsible for this grapefruit effect and it's now clear that although their engine which is a flavonoid in grapefruit and not in any of those other citrus juices has an impact. It's not the whole story. And then they said well it's really

Americans right. Which actually are found in quite a few other plants. So if if it is the fear on the Qumran side are responsible for this grapefruit effect then we need to be watching for the grapefruit effect with with some other things that we eat and then they said well it's actually. And so we don't know for sure exactly what it is that's responsible for a great period having this very very significant effect on the enzymes in your body that are used to metabolize. Maybe as many as half of the drugs that are of their own take I mean things as simple as medicore and Socor and Lippa tour that millions of people take for high cholesterol can be profoundly affected by grapefruit but the good news is aren't used doesn't have that effect. So you can say well you know one of the reviews of your books if it was stated that a hundred thousand people die a year because of this kind of misinformation

not keeping up with what they're told. Isn't that incredible I mean I find that a star you know if you actually add up all of the projected deaths from prescription medicines people who die in the hospital because of the medicines they get. The people who die because of mistakes the wrong drug or the wrong combination the people who die at home from side effects is probably somewhere in excess of 200000 people. Now that makes medicines the drugs that we take to cure us to relieve our suffering to get our cholesterol down and control our blood pressure and relieve the pain of arthritis that makes these medicines. The third leading cause of death in this country after heart disease and cancer. And it's like a jumbo jet crashing every day day in and day out for a whole year it's just mind boggling. Now that's not to say throw away your medicines right. Because if a jumbo jet were crashing every day pretty soon people would stop flying. We don't want people to stop taking their medicines but they do need to be aware

of what the risks are and how to avoid those risks to the best of their ability. And what about our old friend the aspirin the wonder drug. It is an aspirin. It is amazing. It has so many affects so many effects I should say because it has so many benefits it does have some some downside too. And the doses that which should have these effects range so widely you'd be astonished that the same drug could do all these things. Well think about it. You know for years there was that old joke. Take two aspirin and call me in the morning. And many people will take two aspirin to relieve the headache and it works very well thank you. But in addition to the regular relieve your headache your aches and pains we now know of course that as little as 30 milligrams. Now keep in mind your headache dose is six hundred fifty milligrams as little as 30. So like 1 20th or less may reduce your risk of a heart attack or a stroke. Now doctors are still debating what the best

dose is for some. The recommendation is one aspirin every other day. For others it's a baby aspirin which is 81 milligrams and it depends on your particular situation. Now there are million people in North Carolina and I know this other states too. But over 65 years of age you've done a book about older folks what cautions do you do or experience to those of us who take more medication as you get older. Well one of the things you need to remember is that the more medicines you take the more vulnerable you are to interactions. So you really do need to be more careful about drug interactions as you get older and add pill bottles to the lineup by. Our breakfast table and the other thing that you need to remember is that the dose that was appropriate for you when you were 58 or 62 may not be appropriate any longer once you get to be 75 or 83. You really do need to have the

physician monitoring the dose because some medications do become quite dangerous in overdose. Jackson is a classic example. KNOX In one of the most prescribe medicines in the world in fact comes from North Carolina originally from the Burroughs welcome company now Glaxo welcome. Still as far as I know from from the plant from the Fox plant valuable drug but the dose is critical. And as you get older your body changes the way it processes the NOx and so you may need a different dose. It can also interact with foods by the way high fiber foods. A big bowl of oatmeal in the morning might affect your little rant. Right with brand might affect your Lin Utzon. So whether it's the Noxon or whether it's Coumadin or whether it's Zocor Lippert or Prozac older people need to be very careful and that includes over-the-counter drugs because the older person who takes Tylenol PM at bedtime and says OK this will help me get to sleep and then has to get up in the middle of the night to go to the bathroom. Well that p.m.

part is Typhon hydrazine an anti-histamine and it may make you dizzy. And it may make you less stable on your feet. And if somebody were to fall when you're after age 50 or 60 that can be a tragic event. So older people are more vulnerable and they have to do their homework and be very vigilant so the medicine is there to help them doesn't end up hurting them. Terri would just say and Joe argues that you should be very attentive and have an annual visit with your doctor if not more frequently as you get older. Yes for this reason that's absolutely a good idea. And they other thing to remember is that those basics we were talking about a little while ago the sleep the exercise the diet. Those are just as important for older people as they are for the young ones. Of course one of the things that worries the male population Joe desperately these days is prostate cancer. Read about. The advent of chemistry here. What's a fact. Well prostate problems are very common for older men

and clearly going in having that PSA test is absolutely essential and yes even a physical exam may be not a pleasant thing to think about but absolutely critical. And there are drugs that are coming along that are very very helpful. I mean one of the most interesting is a drug called Proscar. It doesn't it doesn't prevent prostate cancer yet although the research is now underway to find out if it will and I'm kind of keeping my fingers crossed that it might. By the way that same drug is being used in a lower dose to grow hair on men's heads under the name pro-peace very popular they use the name alopecia which is the medical term for baldness. So that's just one example there are a number of drugs that are coming along for prostate enlargement and ultimately we hope to reduce the risk of prostate cancer just as we are developing drugs to reduce the risk hopefully for breast cancer in women drugs like to mock Safin and Vista. Terry Are women better at sticking with drug routines and men.

Well a lot of the experts will tell you that they are. Apparently women are more likely to save their health care professional on a regular basis than women are little. In general now. But this doesn't hold for every woman and doesn't hold for every man in general women are a little more likely to follow through if the doctor says you know you need to take this until one drug bill VI Agora. Yeah men were not too good about going to the doctor until VI Agora came along and all of a sudden are knocking on the door and saying Doctor could I have an appointment please. I mean bagger has been the most extraordinary drug in the history of the pharmaceutical industry but by the way it does interact with a whole handful of medicines there's been quite a few deaths associated with the Agra nitroglycerine type part medicines but also interacts with Tagamet and antibiotic and maybe even great for. Oh well it's got there so swiftly with it it's time to do

the checking. That's right that's often a problem when I you. You have a lot say in here about if something's a good deal. I was astounded to discover that if we engage in prevention in some ways with our health patterns we could reduce the medical costs in society by 40 50 percent. Absolutely. Or does the drug industry enter into this as a prevention process or are you seeing more of that coming in the future. Well there really are a number of drugs now that are being used. Prevent problems for example there are a couple of medications that are being prescribed to women once they're past menopause to try to keep them from getting osteoporosis because once a woman's bones are thin and brittle it's really difficult to build them back up again but if you can keep them from getting that way you may be able to prevent a hip fracture. And that actually in many ways can prevent years of disability and suffering.

What I'm hoping for Bill is to see the pharmaceutical industry begin to think more in terms of prevention not just with their medicines but with a whole program of exercise and diet anxiety reduction. Love to see Glaxo Wellcome enter into a program to help people prevent migraines not just use their wonderful drug in the tracks but to help people who are vulnerable come up with strategies and I think drug companies are beginning to think in those directions. You know you probably have the greatest collection. The evidence of the utilization of drug cop out and about in the country. All I can read that is the experience factor. You get two thousand and Griese a week sometimes more now with e-mail it just is like this tide never stop. What's the is there a consistent line that people ask you about what do they want consistency and that is that people are not getting the information that they need by a larch from their health care professionals or if they are sometimes a conflict people

do write to us. They say the pharmacist told me one thing the doctor told me another thing or one doctor told me one thing in the other one told me something else and I don't know what to believe what's right. People want to know about how to take their medicine with food on an empty stomach. Which foods can they take it with which foods can they not take it with. They want to know about common side effects they want to know about the really serious side effects that are so serious that you need to go to the emergency room immediately. They want to know about these interactions they want to take a greater control of their own health. They want to know what foods to eat in general what kind of exercises spece we have just seen a real change build that people are really active. You know once upon a time you drop your car at the garage and you came back at the end of the day and whatever they said that was it or you went to the bank and you put your money in a bank savings deposit account and that was the end. Now people say that's not good enough and the same thing is true for their health.

You know as I looked through the book again today I can run my finger down whether to eat food. Have the drug with food I think that's why this book is so valuable. Because you've done the work thousands of hours trying to teach us all out of this. What about the next edition what's coming up. Well believe it or not we are involved in a really huge project with regard to herbs and home remedies. You know one of the things that that we have collected over the last 20 years are home remedies from all over the country actually all over the world some of them some of our favorites of course from North Carolina up in the mountains. And people love home remedies. I mean it's sort of the collected folk wisdom. Yeah we call them old wives tale. They are wonderful practical information everything from our golden raisin remedy for arthritis with a little gin to our search and grape juice you know it's always amusing to me when people go what search. And you go this new generation doesn't know how to can do that.

Grandma knew little monster. So that's the next project allows that means that you know when you referred to some of this and say Take note of the fact when you're worrying about interaction that someone 150 proof that alcohol some of these deals that move across the back and forth Well we've used up all of our time available today but you're going to start doing some television work already I hear and that's just wonderful. The millions of people that read by and you and listen to you on radio as you are in a great and noble service and for all of us Terry and Joe Graydon. Thank you and this is the book you want in your library. Good evening. The

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