Name: 薬剤師だけど「薬・醫薬品」について質問ある？ (薬剤師だけど「薬・医薬品」について質問ある？| Tech Support | WIRED Japan)
Uploaded: 2025-05-23T08:03:38.000Z
Duration: 19 min 32 s

I'm Dr. Christina Madison, a clinical pharmacist.

我是克里斯蒂娜-麥迪遜博士，臨床藥劑師。

I'm here to answer your questions from the internet.

我在這裡回答你們從網上提出的問題。

Purcell would like to know, what is it about grapefruit that makes it so dangerous to mix with so many medications?

珀塞爾想知道，究竟是什麼原因讓柚子與這麼多藥物混合在一起如此危險？

Like, bam, grapefruit goes through the liver.

比如，"砰 "的一聲，柚子就會進入肝臟。

It's part of something called the cytochrome P450 system.

它是細胞色素 P450 系統的一部分。

What that means is that it can disrupt the metabolism of medications.

這意味著它會擾亂藥物的新陳代謝。

It can alter the absorption of that drug, meaning that more of the drug will remain in your bloodstream and you'll be more likely to experience the toxicity associated with that drug and experience side effects.

它會改變藥物的吸收，這意味著更多的藥物會留在你的血液中，你將更有可能體驗到與藥物相關的毒性和副作用。

Tech with Taz asks, expiration dates on medications.

塔茲的技術人員問，藥物的有效期。

Are they similar to a bust by situation or what?

Expiration dates are what we know to be safe and effective.

有效期是我們所知道的安全有效的日期。

I like the term best buy, but ultimately there are some drugs that if you don't use them by their expiration date, they can become toxic.

我喜歡 "最划算 "這個詞，但歸根結底，有些藥物如果不在有效期內使用，就會產生毒性。

Doxycycline starts to break down and the chemical that's left can be very toxic to you if you ingest it.

強力黴素開始分解，如果攝入，剩下的化學物質會對人體產生劇毒。

Most medications, however, do not become toxic.

不過，大多數藥物不會產生毒性。

You may have to take more, which means you possibly could take an inaccurate dose or have an overdose because you're taking more medication that's needed because it's not as effective.

您可能需要服用更多的藥物，這意味著您可能會服用不準確的劑量或過量，因為您服用了更多的藥物，而這些藥物的療效並不理想。

So the key here is whenever possible, please try not to take any expired medications.

是以，關鍵在於只要有可能，請儘量不要服用任何過期藥物。

E Shodan would like to know, why is botulism toxin, the most lethal toxin known, purposefully injected into humans for cosmetic surgeries, such as Botox?

E Shodan 想知道，為什麼肉毒桿菌毒素這種已知最致命的毒素會被有目的地注射到人體內，用於肉毒桿菌毒素等美容手術？

Is there nothing else that could be used?

Botulism toxin in the environment, yes, can be very toxic.

是的，環境中的肉毒桿菌毒素毒性很強。

However, what we currently use for therapeutic uses, like cosmetic purposes, or for things like migraine headaches, is a very small dose that's targeted, localized, and causes limited effects.

然而，我們目前用於治療用途（如美容或偏頭痛）的藥物劑量非常小，具有針對性和局部性，產生的效果有限。

It's gonna cause localized paralysis, so no more wrinkles, but the toxin itself is not gonna get into my bloodstream and cause me to be sick or ill.

它會導致局部麻痺，所以不會再有皺紋，但毒素本身不會進入我的血液，導致我生病或不適。

Zarithi asks, how exactly do extended release pills work?

Zarithi 問：緩釋藥片究竟是如何發揮作用的？

So there's a few different things going on here.

是以，這裡有幾種不同的情況。

Oral medications are unique in the fact that they may undergo something called first pass metabolism.

口服藥物的獨特之處在於，它們可能會經歷一種叫做 "首過代謝 "的過程。

So medications are comprised of chemicals transformed through actions of our body.

是以，藥物是由人體作用下轉化的化學物質組成的。

So one of the ways that that happens is through first pass metabolism, where it gets metabolized in the liver.

發生這種情況的途徑之一是通過首過代謝，即在肝臟中進行代謝。

The chemical structure that is left after it goes through that process is called a substrate.

經過這一過程後留下的化學結構稱為基質。

So some of the time what we do in order to make the medication last longer is that we use a precursor to that substrate, which allows for the main medication or the active ingredient to get metabolized after first pass metabolism and become the active medication.

是以，在某些情況下，為了延長藥物的療效，我們會使用底物的前體，使主要藥物或有效成分在經過第一次代謝後被代謝掉，成為有效藥物。

The other thing too that we can do to extend the likelihood or the length of duration of therapy is going to be using a different type of container to hold the medication.

我們還可以做的另一件事是使用不同類型的容器來盛放藥物，以延長治療的可能性或持續時間。

There's tablets, there's capsules, all different types of coatings that can go over the tablet that allow for it to be dissolved or metabolized more slowly once it hits the acid of your stomach.

有藥片，有膠囊，還有各種不同類型的塗層，可以覆蓋在藥片上，使其在遇到胃酸後溶解或代謝得更慢。

I don't think people understand how dangerous it is taking Tylenol regularly.

我認為人們不瞭解經常服用泰諾有多危險。

Most over-the-counter medications are safe and effective when used as directed.

大多數非處方藥遵醫囑使用都是安全有效的。

However, Tylenol can be toxic specifically to your liver.

然而，泰諾尤其會對肝臟產生毒性。

So there is a maximum amount of Tylenol that you should consume within a 24-hour period.

是以，24 小時內服用泰諾的量是有上限的。

However, for safety, most pharmacists would tell you you really shouldn't take more than three grams within a 24-hour period in order to avoid any injury or toxicity to your liver.

不過，為了安全起見，大多數藥劑師都會告訴你，24 小時內的服用量確實不應超過 3 克，以避免對肝臟造成任何傷害或毒性。

The reason why this is important is because there's so many different over-the-counter cough and cold preparations that contain the active ingredient in Tylenol, which is called acetaminophen.

這一點之所以重要，是因為有許多不同的非處方咳嗽和感冒製劑都含有泰諾的活性成分，即對乙酰氨基酚。

So if you've got cough and cold preparation over here, and then you have some regular Tylenol over here, you have to add the two together and make sure it doesn't go over that three gram in a day limit.

是以，如果你這裡有咳嗽和感冒藥，這裡有普通的泰諾，你必須把這兩種藥加起來，確保不會超過一天三克的限制。

The only one left would like to know, why do some vaccines require a booster shot a few weeks later after the first one?

唯一想知道的是，為什麼有些疫苗需要在第一次接種後幾周再加強注射？

There's a couple of reasons why this may occur.

The first is whether or not the person has been exposed to the vaccination in the past.

首先是接種者過去是否接觸過該疫苗。

For example, most childhood vaccinations require lots of booster doses because it's new to their immune system, and we want them to develop an appropriate response.

例如，大多數兒童疫苗都需要大量的加強劑量，因為這對他們的免疫系統來說是全新的，我們希望他們能產生適當的反應。

Same thing with the influenza vaccine or the COVID-19 vaccine.

流感疫苗或 COVID-19 疫苗也是如此。

Once you receive it, we're basically priming the pump, and then we give you a booster in order for your immune system to be able to recognize it if it sees it in the environment.

一旦你接受了它，我們基本上就是在給它 "打底"，然後再給你注射強心劑，以便你的免疫系統在環境中看到它時能夠識別它。

From OKAXIS3286, how do y'all count your pills?

來自 OKAXIS3286，你們都是怎麼數藥片的？

From Winsad5408, is it beneficial to get HPV vaccine after you have HPV?

來自 Winsad5408，感染 HPV 後接種 HPV 疫苗是否有益？

HPV, or human papillomavirus, is a type of infection that can just be transmitted from skin to skin, and it is the leading cause of cervical cancer, vulvovaginal cancer, penile cancer, and anal cancer, as well as genital warts.

人乳頭瘤病毒（HPV）是一種可以通過皮膚傳染的病毒，是宮頸癌、外陰陰道癌、陰莖癌、肛門癌和生殖器疣的主要致病原因。

All of those are caused by different strains of the HPV virus.

所有這些都是由不同的 HPV 病毒株引起的。

Six and 11 have been associated with genital warts.

16 and 18 have been associated with cervical cancers and other types of cancers, including anal cancer and penile cancer.

16 和 18 與宮頸癌和其他類型的癌症（包括肛門癌和陰莖癌）有關。

The vaccine that we have now has multiple strains that it protects against.

我們現在使用的疫苗可預防多種菌株。

So even if you've had HPV, you've probably only had one, maybe two of those strains, and you can be still protected by the other strains that are included in the current vaccination.

是以，即使您曾感染過 HPV，您可能只感染過其中的一種或兩種毒株，您仍然可以受到目前疫苗中其他毒株的保護。

Toby the Robot asks, how does a pharmaceutical company come up with new drugs?

機器人託比問：製藥公司是如何研製出新藥的？

Do they just try various chemicals on animals until something shows promise?

他們是否只是在動物身上嘗試各種化學物質，直到有希望為止？

Pharmaceutical companies take a lot of pride in their research and development.

製藥公司對自己的研發工作引以為豪。

It costs millions of dollars in order for them to develop a new drug.

他們開發一種新藥需要花費數百萬美元。

It can come from natural sources, it can come from synthetic compounds or chemicals.

它可以來自自然界，也可以來自合成化合物或化學物質。

Typically, it's done from clinical trial work, looking at compounds that have been known to cause therapeutic effects in other disease states, and then we try it and see if it works in others.

通常情況下，我們從臨床試驗工作出發，研究已知能在其他疾病狀態下產生治療效果的化合物，然後進行嘗試，看看是否對其他人有效。

It's not really this, what you're saying, throw it at the wall and see if it sticks.

其實不是這樣的，你的意思是，把它扔到牆上，看看能不能粘住。

Next is FunnyReputation454, favorite animal-derived drug fact.

下一位是 FunnyReputation454，最喜歡動物衍生藥物的事實。

One of the things that we know when we think about drug development and drug discovery is that a lot of the medications derive from venoms or toxins that are produced by animals or biological sources like viruses and bacteria.

當我們考慮藥物開發和藥物發現時，我們知道的一件事是，很多藥物都來自動物或病毒和細菌等生物源產生的毒液或毒素。

One of our popular diabetes medications comes from the saliva of a Gila monster.

我們常用的一種糖尿病藥物來自吉拉怪獸的唾液。

So one of my favorite animal-derived drugs is from Gila monster spit, not corn emoji, would like to know, why does DoorDash need my ID for cold meds?

我最喜歡的動物源藥物之一來自吉拉怪獸的唾液，而不是玉米 emoji，我想知道，為什麼 DoorDash 需要我的身份證才能購買感冒藥？

LOL, what do you think I'm going to do with it?

Cough and cold preparations may include an active ingredient called pseudoephedrine.

止咳藥和感冒藥可能含有一種叫做偽麻黃鹼的活性成分。

Those medications, even though they're technically considered over the counter would be behind the counter in the pharmacy.

這些藥物，即使在技術上被認為是非處方藥，也會放在藥房的櫃檯後面。

The reason for this is that we have to document how much pseudoephedrine you're purchasing on a daily basis.

原因是我們必須記錄您每天購買了多少偽麻黃鹼。

Why would I need to know how much pseudoephedrine you're buying in a day?

我為什麼要知道你一天要買多少偽麻黃鹼？

Before we had this restriction, pseudoephedrine was being used to fuel the methamphetamine processing in different areas of the country.

在我們實行這一限制之前，偽麻黃鹼在全國不同地區被用來助長甲基苯丙胺的加工。

We need to keep track of who's purchasing it in order to hopefully stem the production of illegal drug production.

我們需要跟蹤誰在購買毒品，以便有望阻止非法毒品的生產。

So the reason why we have this requirement is so that we don't have more meth labs.

是以，我們之所以有這樣的要求，是為了避免出現更多的安非他命實驗室。

Croy Celtic, Alexa, show me how penicillin was discovered.

克羅伊-凱爾特人，阿萊克莎，告訴我青黴素是如何被發現的。

弗萊明博士於 1928 年發現了它。

He's a Scottish biologist that was working in a hospital in London and discovered after looking at a Petri dish that had some mold growing on it that the Staphylococcus that was on that Petri dish was not growing in the place where the mold was.

他是一位蘇格蘭生物學家，當時在倫敦一家醫院工作，在觀察了一個長滿黴菌的培養皿後發現，培養皿上的葡萄球菌並沒有在長滿黴菌的地方生長。

Ultimately, we discovered one of the most powerful antibiotics by mistake.

最終，我們錯誤地發現了一種最強大的抗生素。

Zara Toro VT would like to know, is melatonin dependency bad?

Zara Toro VT 想知道，褪黑素依賴性不好嗎？

So the first thing is is that melatonin, you can't really become dependent on melatonin.

是以，首先是褪黑激素，你不能真正依賴褪黑激素。

However, too much melatonin can be a bad thing.

不過，褪黑激素過多也不是好事。

There was an instance about a year ago where several children became sick or ill because of overdoses of melatonin from the use of melatonin gummies.

大約一年前，曾有幾名兒童因服用過量褪黑素軟糖而生病或不適。

It really should not be used on a regular basis.

You should not be using this continuously for sleeping.

Cindy Hindren 2 would like to know, why hasn't a cure for the common cold been found?

辛迪-欣德倫 2 號想知道，為什麼還沒有找到治療普通感冒的方法？

The common cold is often caused by a rhinovirus.

普通感冒通常是由鼻病毒引起的。

However, there's been 200 separate viruses and organisms that have been attributed to the causes of the common cold.

然而，已經有 200 種不同的病毒和生物體被認為是普通感冒的病因。

So it does make a bit of a moving target.

是以，這確實有點像一個移動的目標。

In addition to rhinoviruses, the common cold can also be caused by coronaviruses like COVID-19 as well as respiratory syncytial virus and RSV.

除鼻病毒外，冠狀病毒（如 COVID-19）以及呼吸道合胞病毒和 RSV 也可引起普通感冒。

And the good news is, is although we may not have a cure for those, we do have a vaccine for them.

好消息是，雖然我們可能無法治癒這些疾病，但我們有疫苗可以治療。

是以，如有疑問，請注射疫苗。