PRACTICE A.

Word forms
1. It is easy to see the importance of these .................. interactions in the practice of
medicine. (PHARMACOLOGY)
pharmacological
2. If a patient ................... two drugs and one of them increases the effect of the
other it is .................. that an overdose may occur. (TAKE/ POSSIBILITY)
is taking/ possible
3. If the action of a drug ................. it may cease to have any ... .......... use because
of under dosage. (REDUCE/ THERAPY)
is reduced/ therapeutic
4. The pharmaceutical interactions that are of special ................. to the practice of
medicine are primarily those that have negative .............. for an organism.
(INTERESTING/ AFFECT)
interest/ effects
5. The risk that a pharmacological interaction will appear increases as a function of
the number of drugs ..... to a patient at the same time. (ADMINISTER)
administered
6. It is also possible for interactions ... ..... outside an organism before ............ of
the drugs has taken place. (OCCUR/ ADMINISTER)
to occurl/ administration
7. ............ in the effect of a drug are caused by differences in the absorption,
transport, metabolism or excretion of one or both of the drugs compared with the
expected behaviour of each drug when taken individually. (MODIFY/
DISTRIBUTE)
Modifications/ distribution
8. ............. of drugs is the process through which the body converts drugs into
forms that are more or less or that are ................... for the body to eliminate
through the kidneys. (METABOLIZE/ EASY)
Metabolism/ easier
B. Sentence building
1. Interaction/ two drugs/ may also increasel risk/ that side effect/ occurll
-The interaction of the two drugs may also increase the risk that side effect will
occur.
2. It/ possible/ that/ interaction/ will occur between/ drug/ another substancel
present/ organism/
-It is possible that an interaction will occur between a drug and another substance
present in the organism.
3. Many drug interactions due to alterations/ drug metabolism.
- Many drug interactions are due to alterations in drug metabolism.
4. interaction may increasel orl decreasel effectiveness, drugs/ orl side effects//
- The interaction may increase or decrease the effectiveness of the drugs or their
side effects.
5. The likelihood/ drug interactions/ increases/ as/ number/ drugs/ being taken
increases.
- The likelihood of drug interactions increases as the number of drugs being taken
increases.
6. People/ take many drugs/ at the greatest risk/ interactions.
- People who take many drugs are at the greatest risk for interactions.
7. decreasel enzyme activity/ lead/ increasel drug concentration/effect//
- A decrease in enzyme activity leads to an increase in drug concentration and
effect.

C. Combine the sentences.

1. Drug interactions may be the result of various processes. These processes may
include alterations in the pharmacokinetics of the drug, such as alterations in the
absorption, distribution, metabolism, and excretion of a drug.
- Drug interactions may be the result of various processes which/ that may include
alterations in the...
2. The cytochrome P450 enzymes are a group of enzymes in the liver that are
responsible for the metabolism of most drugs. They are often involved in drug
interactions.
- The cytochrome P450 enzymes which/that are often involved in drug interactions
are a group of enzymes in the liver that are responsible for the metabolism of most
drugs.

D. Mistake
1. When the interaction causes an increase in the effects of one or both of the
A B
drugs, the interaction calls a synergistic effect.
C D
C: is called

2. Two drugs are antagonistic when its interaction causes a decrease in the effects
A B C D
of one or both of the drugs.
B: their

3. The change in an organism's response in administration of a drug is an important

A B C
factor in pharmacodynamic interactions.
D
B: on
4. The effects caused by medicinal plants should be considered in the same way as
A B
that of medicines as their interaction with the organism gives rise to a
C D
pharmacological response.
C: those
5. Once a drug has been administered, absorption, distributing, metabolism, and
A B
excretion will influence the concentration of the drug and its elimination from the
C D
body.
B. distribution
6.Drug interactions contribute to the cost of healthcare because of the costs of
A
medical care that are required to treat problems caused by changes in effective or
B C D
side effects.
D: effectiveness
7. Drugs and certain types of food may increase or decrease the action of
A
cytochrome P450 enzymes and therefore affect the concentration of drugs that are
B C
metabolized by these enzymes.
D
A: activity
8. An increase in the activity of cytochrome P450 enzymes leads to a decrease in
A B
the concentration and affect of an administered drug.
C D
C: effect

What is traditional medicine?

The World Health Organization defines traditional medicine as "the sum total of
the knowledge, skills, and practices based on the theories, beliefs, and experiences
indigenous to different cultures, whether explicable or not, used in the maintenance
of health as well as in the prevention, 'diagnosis, improvement or treatment of
physical and mental illness".
Traditional medicine may sometimes be considered as distinct from folk medicine.
Folk medicine can be longstanding remedies passed on and practiced by lay
people. Folk medicine consists of the healing practices and ideas of body
physiology and health preservation known to some in a culture, transmitted
informally as general knowledge, and practiced or applied by anyone in the culture
having prior experience.

Home remedies
A home remedy is a treatment to cure a disease or ailment that employs certain
spices, vegetables, or other common items. Home remedies may or may not have
medicinal properties that treat or cure the disease or ailment in question, as they are
typically passed along by laypersons. Many are merely used as a result of tradition
or habit or because they are effective in inducing the placebo effect.
One of the more popular examples of a home remedy is the use of chicken soup to
treat respiratory infections such as a cold or mild flu. In earlier times, mothers were
entrusted with all but serious remedies. Historic cookbooks are frequently full of
remedies for dyspepsia, fevers, and female complaints. Components of the aloe
vera plant are used to treat skin disorders. Many European liqueurs were originally
sold as medicinal remedies. In Chinese folk medicine, medicinal congees (long-
cooked rice soups with herbs), foods, and soups are part of treatment practices.

TRADITIONAL DONG Y (EASTERN MEDICINE) THEORIES

- Traditional Chinese and Traditional Vietnamese Medicine differ in practice, yet
they share the same theoretical foundation.
- The cornerstone of Dong Y theories is based on the observed effects of Qi
(energy).
- There are as many different forms of Qi (Digestive, Immune, Mental state)
- They are all related to the original Source or Essence and Food Qi.
- The Essence is inherited from our parents.
- Food Qi is extracted from food.
- Qi represents both the potential or stored energy as well as the kinetic energy.
- The counterpart of Qi is Blood. It is thought of as a nourishing substance that
carries Qi to every part of the body.
- However, in practice Blood and Qi are just of one entity, like two faces of the
same coin.
- The functions of Qi can be summarized as:
1) providing movement,
2) defending the body from pathological factors,
3) supporting/promoting growth and development.
- The functions of Blood can be summarized as nourishment and moistening.
- Blood nourishes Qi and Qi moves Blood.
- One can deplete one's Qi by strenuous work, poor diet and lifestyle.
- One can also harvest energy from the universe by maintaining optimal health and
by exercises like Qigong and Tai-Chi.
- Dong Y's major theories are: Yin and Yang, Five Elements(ngũ hành).
- Health is viewed as balance between these five entities, each depending on as
well as regulating one another similar to how our endocrine(nội tiết) system
functions.

• Yin and Yang is probably the oldest and the most significant theory in Dong Y.
- It describes the existence of and the importance for balance between opposite
states (cold and hot, inaction and action.
- Yin and Yang can be divided into three divisions:
Cold versus Hot
Interior versus Exterior
Deficiency versus Excess.
- Yin types of illnesses are typically manifested(biểu hiện) by symptoms of cold,
interior, and deficiencystates like malnutrition.
- Yang conditions are typically manifested by symptoms of heat, exterior, and
excess.

DIAGNOSIS & TREATMENTS

- Dong Y practitioners typically assess patient's Qi and Blood by taking a medical
history, observing the patient's affects, and by feeling her pulses and examining the
shape, size, and color of her tongue.
- By examining the pulses and tongue, a picture of disharmony (sự đối lập between
different elements within one's body can be pieced together.
- Dong Y practitioners mostly focus their therapies on correcting syndromes rather
than individual complaints.
- It utilizes food, herbs, minerals, acupuncture, and exercises with the goal of
providing long-lasting effects.

KEY
I. Match the word
1A 2C 3B 4E 5F 6D
II. Supply the correct form
1. Drug interactions may make your drug less............, cause unexpected side
effects, or increase the action of a particular drug. (AFFECT)
effective
2. Reading the label every time you use a ......... or ............drug and taking the time
to learn about drug interaction may be critical to your health. (PRESCRIBE)
prescribed/ unprescribed
3. If the action of a drug is reduced it may cease to have any ...............use because
of under dosage. (THERAPY)
therapeutic
4. Drug interactions may be the result of various processes which may
include ............. in the pharmacokinetics of the drug. (ALTER)
alteration
5. Many factors affect the speed at which the body ..............and processes drugs.
(ABSORPTION)
Absorbs

1. Read "Mechanisms of drug interactions" and answer the following

questions.
1. How are drugs interactions frequently characterized?
2. What do pharmacokinetic interactions influence? What do they involve?
3. Why do pharmacokinetic interactions seldom produce serious clinical
consequences?
4. What are they associated with?
5. What may provide useful information about potential interactions?
READING
I. Read "Mechanisms of drug interactions" and answer the following
questions.
1. How are drugs interactions frequently characterized?
Drug interactions are frequently characterized as either pharmacokinetic or
pharmacodynamic.
2. What do pharmacokinetic interactions influence? What do they involve?
- Pharmacokinetic interactions influence the disposition of a drug in
the body.
- They involve the effects of one drug on the absorption, distribution, metabolism,
and excretion of another.
3. Why do pharmacokinetic interactions seldom produce serious clinical
consequences?
Pharmacokinetic interactions seldom produce serious clinical
consequences due to large inter- and intra-patient variability in drug disposition.
4. What are they associated with?
They are frequently associated with changes in
plasma drug concentrations.
5. What may provide useful information about potential interactions?
Observing the clinical status of the patient as well as monitoring serum drug levels
may provide useful information about potential interactions.

II. Read "High-risk drugs" and decide if the statements are true or false.
T 1. Drugs with a narrow therapeutic index, a steep dose-response curve, and
potent pharmacologic effects are considered to have the highest risk of being
involved in a clinically important interaction.
F 2. Narrow index pharmaceutically means that the toxic dose is much greater than
the therapeutic dose.
T 3. When you use a drug with steep dose-response curve a large increase in
clinical effects may result from a small change in dose.
F 4. A slight decrease in the plasma level of drugs with a steep dose-response
curve has no effect on therapy.
F 5. It doesn't matter that patients receiving drugs with a narrow therapeutic index
are monitored routinely.

III. Fill in each gap with one suitable word from the list.
An awareness of the problems (1) that may arise due to drug interactions is vital
for the practicing pharmacist. Today, with the increasing complexity (2) of
therapeutic agents available, and widespread poly pharmacy, the potential for drug
(3) interactions is enormous. Thus, the importance of drug interactions to the
clinical (4) pharmacist today primarily involves knowing or (5) predicting those
occasions when a potential (6) drug interaction is likely to have (7) clinically
significant consequences, and if so, the step which (8) may be taken to (9) avoid
them, or alternative (10) treatments must be considered.

WRITING
I. USE the words and phrases given to make complete sentences.
1. Pharmacodynamic interactions/ difficult/ classify/ but/ effects/ predicted/ when/
pharmacology/ co-administered drugs/ known//
- Pharmacodynamic interactions are difficult to classify but their effects can be
predicted when the pharmacology of co-administered drugs is known.
2. effect/ a drug/ modified/ food/ smoking/ alcohol/ environmental pollutants//
- The effect of a drug may be modified by food, smoking, alcohol or environmental
pollutants.
3. probability/ drug interaction/ increase/ number/ drugs/ received/ patient//
- The probability of a drug interaction increases with the number of drugs received
by a patient.
4. There/ situations/ where/ drugs/interact/ unique mechanisms//
- There are situations where drugs interact with the unique mechanisms.
5. Pharmacokinetic interactions/ occur/ one drug/ alter/ absorption/ distribution/
metabolism/ elimination/ another drug.
- Pharmacokinetic interactions may occur when one drug alters the absorption,
distribution, metabolism, or elimination of another drug.

II. Turn into passive

1. Adverse drug interactions can cause a loss in therapeutic effect, toxicity or
unexpected increases in pharmacologic activity.
A loss in therapeutic ... activity can be caused by adverse drug reactions.
2. Monitoring therapy and making appropriate adjustments in the drug regimen
may circumvent a potentially serious drug interaction.
A potentially serious drug reaction may be circumvented by monitoring therapy
and making appropriate adjustments in the drug regimen.
3. Most important interactions involve the effect of one drug on the metabolism of
another.
The effect of one drug on the metabolism of another is involved in most important
interactions.
4. Scientists have done a lot of studies to estimate the incidence of drug
interactions.
A lot of studies have been done to estimate the incidence of drug