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Which of these three people is doing something risky?
这三个人当中有谁在做危险的事？
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？
The one who takes Acetaminophen pain relievers for a sore ankle before going out for drinks?
还是在外出喝酒前吃对乙酰氨基酚止疼药来缓解脚踝酸痛的人？
Or the one who's on a blood-thinning medication and takes an aspirin for a headache?
又或者是在吃血液稀释剂的同时，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, lead to kidney failure; liver damage; or internal bleeding.
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，或内出血。
Drug interactions happen when the combination of a drug with another substance causes different effects than either would individually.
当一种药物和另一种物质被同时服用时，会发生单独服用这两种东西时都不会产生的作用，这就是药物的相互作用。
Foods, herbal supplements, legal drugs, and illicit substances can all cause drug interactions.
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。
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, like how it is absorbed, metabolized, or transported around the body.
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，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, have similar effects that become dangerous when combined.
比如，血液稀释剂和阿司匹林有着相似的作用，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 that hold clots together,
血液稀释剂能阻碍将血凝块固着在一起的凝血因子的形成，
and aspirin by preventing blood cells from clumping into groups that become clots.
而阿司匹林能阻止血细胞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, possibly causing internal bleeding.
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。
While blood thinners and aspirin are generally harmless when taken individually,
虽然分开服用血液稀释剂和阿司匹林通常是无害的，
interactions where one substance exacerbates the effects of another can also take place between drugs that are independently harmful.
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。
Cocaine and heroin are each dangerous, and those dangers compound when the two drugs are combined
可卡因和海洛因都是危险药品，而且这两种物质混合物的危险程度会累加，
even though their behavioral effects may feel like they cancel each other out.
即使它们的表现作用看起来似乎可以互相抵消。
Cocaine is a stimulant, and many of its effects, like increased heart rate, cause the body to need more oxygen.
可卡因是一种兴奋剂，它的许多药效，比如心率加速，会导致身体对氧气的更大需求。
But heroin, a depressant, slows breathing -- reducing the body's oxygen supply just when it needs more.
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。
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 in class of cholesterol-lowering drugs called statins, has to do with drug metabolism.
葡萄柚汁和一种叫他汀的降胆固醇类的药物之间的相互作用，与药物的新陈代谢作用有关。
The liver produces enzymes, molecules that facilitate the breakdown of substances that enter the body.
肝脏合成酶，它是一种可降解进入身体的物质的细胞。
Enzymes can both activate drugs, by breaking them down into their therapeutic ingredients from more complex molecules,
酶可以通过将药物从复杂的分子结构降解至有效治疗成分从而激活药物；
and deactivate them, by breaking harmful compounds down into harmless metabolites.
也可以通过将有害的化合物分解成无害的代谢物，从而失活药物。
There are many, many different enzymes, each of which has a binding site that fits a specific molecule.
有许多许多不同的酶，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, making less of that enzyme available to break down statins.
葡萄柚和他汀都能和同一种酶结合，这使得能降解他汀的酶变少。
So combining the two means that a greater concentration of the drug stays in the bloodstream for a longer period of time, potentially causing kidney failure.
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，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, the active ingredient in pain relievers like Tylenol and paracetamol.
酒精也能改变一种能降解对乙酰氨基酚的酶的功能，对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, there isn't usually enough of this toxic byproduct to cause harm.
在推荐用量内，通常这种有毒副产物的量不足以造成伤害。
But heavy drinking can alter enzyme activity so more of that byproduct is produced,
但是大量饮酒却会使酶的活性发生变化，因饮酒而被分解出更多的副产物得以残留，
potentially causing liver damage even with what's usually a safe dose of acetominophen.
即便只是服用对乙酰氨基酚的安全用量，也可能会导致肝损伤。
Meanwhile, the herbal remedy Saint John's Wort increases the liver's production of a particular enzyme.
同时，金丝桃草作为一种草药，能促进肝脏中一种特定酶的产生。
That means the drugs this enzyme is responsible for breaking down get metabolized faster
这意味着能被这种酶分解的药物的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, most of the dangerous interactions with commonly used drugs are well known.
然而尽管药物相互作用的潜在数目多到令人头晕目眩，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 of drug interactions than ever.
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。
Some researchers are developing AI programs that can predict the side effects of drug interactions before they occur,
已经有学者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.
依据是通过你身体中蛋白质相互作用的信息。
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 while those drugs are still in development.
在研发阶段，人们已经开始利用超级计算机去寻找那些药物潜在的相互作用了。
