The dangers of mixing drugs - Céline Valéry

翻译人员: Jessie Zhang 校对人员: Jiasi Hao

这三个人当中 有谁在做危险的事？

Which of these three people is doing something risky?

Is it the one who takes their cholesterol medication with grapefruit juice?

是这个就着葡萄柚汁 吞服胆固醇类药物的人？

还是在外出喝酒前吃 对乙酰氨基酚止疼药

The one who takes Acetaminophen pain relievers

for a sore ankle before going out for drinks?

来缓解脚踝酸痛的人?

Or the one who’s on a blood-thinning medication

又或者是在吃血液稀释剂的同时

and takes an aspirin for a headache?

也在吃阿司匹林治疗头痛的这个人？

Actually, all of them are.

其实，他们都在做危险的事。

Each has inadvertently created a drug interaction that could, in extreme cases,

每个人都在无意中创造了 一种药物相互作用——

在极端情况下， 可能导致肾衰竭、肝损伤，

lead to kidney failure; liver damage;

或内出血。

or internal bleeding.

Drug interactions happen

当一种药物和另一种物质 被同时服用时，

when the combination of a drug with another substance

会发生单独服用这两种东西时 都不会产生的作用，

causes different effects than either would individually.

这就是药物的相互作用。

Foods, herbal supplements, legal drugs, and illicit substances

食物、草药补品、 合法药品以及违禁物质

都可以导致药物的相互作用。

can all cause drug interactions.

Most drug interactions fall into two categories.

绝大部分的药物相互作用 可以分为两类。

Some take place when two substances’ effects influence each other directly.

一类是两种药物的作用 直接构成相互影响。

In other cases, one substance effects how the body processes another,

另一类则是一种物质会影响 身体对另一种药物的处理方式，

like how it is absorbed, metabolized, or transported around the body.

例如它的吸收、新陈代谢 或者被运送到身体各处的方式等。

Blood thinners and aspirin, for example,

比如，血液稀释剂和阿司匹林 有着相似的作用，

have similar effects that become dangerous when combined.

但它们混合到一起时， 这种相似作用会变得很危险。

Both prevent blood clots from forming—

两者都能防止血凝块的形成——

blood thinners by preventing the formation of the clotting factors

血液稀释剂能阻碍 将血凝块固着在一起的

that hold clots together,

凝血因子的形成，

and aspirin by preventing blood cells from clumping into groups

而阿司匹林能阻止血细胞

that become clots.

凝聚成可发展为血凝块的细胞群。

Individually, these effects are usually safe,

在单独服用这两种药时， 这些药效机制通常是安全的，

but taken together, they can prevent blood clotting to a dangerous extent,

但是被放在一起同时服用时， 它们会将阻碍血液凝固的作用，

发展到一个危险的程度， 从而导致内出血。

possibly causing internal bleeding.

While blood thinners and aspirin are generally harmless

虽然分开服用 血液稀释剂和阿司匹林

通常是无害的，

when taken individually,

interactions where one substance exacerbates the effects of another

但同时服用两种各自无害的药物时， 其中一种物质可能会

加强另一种药物的作用， 从而产生药物的相互作用。

can also take place between drugs that are independently harmful.

Cocaine and heroin are each dangerous,

可卡因和海洛因都是危险药品，

and those dangers compound when the two drugs are combined—

而且这两种物质混合物的 危险程度会累加——

即使它们的表现作用看起来 似乎可以互相抵消。

even though their behavioral effects may feel like they cancel each other out.

可卡因是一种兴奋剂， 它的许多药效，比如心率加速，

Cocaine is a stimulant, and many of its effects, like increased heart rate,

cause the body to need more oxygen.

会导致身体对氧气的更大需求。

But heroin, a depressant, slows breathing—

但是海洛因作为一种镇静剂， 会使呼吸减缓——

从而使身体在需要更多氧气时， 降低身体的供氧量。

reducing the body’s oxygen supply just when it needs more.

This combination strains the organs and can cause respiratory failure and death.

这种结合会使器官负担过重， 甚至会导致呼吸衰竭及死亡。

The interaction between grapefruit juice and certain medications

葡萄柚汁和一种叫他汀的

in class of cholesterol-lowering drugs called statins,

降胆固醇类的药物之间的相互作用，

has to do with drug metabolism.

与药物的新陈代谢作用有关。

The liver produces enzymes, molecules that facilitate the breakdown of substances

肝脏合成酶，

它是一种可降解 进入身体的物质的细胞。

that enter the body.

Enzymes can both activate drugs,

酶可以通过 将药物从复杂的分子结构

by breaking them down into their therapeutic ingredients

降解至有效治疗成分 从而激活药物；

from more complex molecules, and deactivate them,

也可以通过将有害的化合物

by breaking harmful compounds down into harmless metabolites.

分解成无害的代谢物， 从而失活药物。

有许多许多不同的酶，

There are many, many different enzymes,

each of which has a binding site that fits a specific molecule.

每一种酶都有一个 适用于特定细胞的结合部位。

Grapefruit binds to the same enzyme as statins,

葡萄柚和他汀都能和同一种酶结合，

making less of that enzyme available to break down statins.

这使得能降解他汀的酶变少。

So combining the two means that a greater concentration of the drug

因此混合服用这两种药物意味着

血液中药物浓度变高， 停留时间变长，

stays in the bloodstream for a longer period of time,

potentially causing kidney failure.

从而带来肾衰竭发生的潜在可能。

Alcohol can also alter the function of the enzyme that breaks down Acetaminophen,

酒精也能改变一种 能降解对乙酰氨基酚的酶的功能。

the active ingredient in pain relievers like Tylenol and paracetamol.

乙酰氨基酚是如泰诺和扑热息痛等 止痛药的一种活性成分。

When someone takes Acetaminophen, some of it is converted into a toxic substance.

当对乙酰氨基酚被吞服时， 它的一部分转化成了有毒物质。

At the recommended dose,

在推荐用量内，

there isn’t usually enough of this toxic byproduct to cause harm.

通常这种有毒副产物的量 不足以造成伤害。

但是大量饮酒却会使酶的活性发生变化。

But heavy drinking can alter enzyme activity

so more of that byproduct is produced,

即便只是服用乙酰氨基酚的安全用量，

potentially causing liver damage

因饮酒而被分解出更多的 副产物得以残留，

even with what’s usually a safe dose of acetominophen.

进而可能会导致肝损伤。

Meanwhile, the herbal remedy Saint John’s Wort increases the liver’s production

同时，金丝桃草作为一种草药， 能促进肝脏中

of a particular enzyme.

一种特定酶的产生。

That means the drugs this enzyme is responsible for breaking down

这意味着 能被这种酶分解的药物的

get metabolized faster—

新陈代谢速度加快了——

sometimes too fast, before they can have their therapeutic effects.

有时候可能变得过快， 而来不及发挥药物应有药效。

In spite of the dizzying number of possible interactions,

然而尽管药物相互作用的 潜在数目多到令人头晕目眩，

most of the dangerous interactions with commonly used drugs are well known.

大多数常用药物之间 危险的相互作用却是已知的。

And new developments in science are helping us keep better track

并且科学的进步使我们 能比过去更好地

追踪这些药物的相互作用。

of drug interactions than ever.

Some researchers are developing AI programs that can predict the side effects

已经有学者正通过

你身体中蛋白质相互作用的信息，

of drug interactions before they occur,

正在开发能预测药物相互作用 副作用的 AI 程序。

using information about the landscape of protein interactions within your body.

For the new drugs that are being developed all the time,

对于当前的正在开发的新药，

supercomputers are being used to find potential interactions

在研发阶段， 人们已经开始利用超级计算机

while those drugs are still in development.

去寻找那些药物潜在的相互作用了。