1/8/8
A friend who worked in community pharmacy once told me the tale of how he helped out a customer who ran into problems with pineapple extract.
A customer came in with an FP10 one day, with quite a subtantial increase in the strength of her asthma medications. Her asthma had rapidly deteriorated, causing at least one admission and quite substantial impact on her daily living. Nothing could be found to have trigger this deterioration - no new medicines, no potential new allergens, no lifestyle changes. My friend the community pharmacist tried a few extra questions.
It turns out this customer had also been taking some nutritional supplements (not a medicine in her eyes), including one by the name of Bromelain, which is a natural enzyme from pineapples retailing today at £8.49 for 20 days supply.The customer had been recommended by a friend for her arthritis.
Normally that patient's arthritis would be treated with NSAIDs, but they weren't suitable for her on account of the 21% risk of that patient having their asthma aggravated by the NSAID. My friend the community pharmacist saw the similarity between NSAIDs and bromelain in terms of the effects (improved arthritis symptoms) and side-effects (aggravated asthma), advised the patient to discontinue the bromelain; with the consequence of her asthma improving.
Now I don't know if anyone's found COX enzyme inhibitors in pineapple plants, but the end result is one patient whose asthma is much better and one yellow card to the people who look closely into things like this.
