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MEDICATION SAFETY FOR THE CLASS OF '57

"Medicines" for the purpose of this discussion include all drugs prescribed by your doctors, over-the counter drugs you may take at your own discretion (claritin for your allergies, tylenol for headaches, melatonin for jet lag etc), herbal medications, and dietary supplements.

We are now on a new playing field. As we get older, our bodies may react to medications in atypical ways. Kidney and liver ailments increase the likelihood of unusual reactions. We are taking more medications. It is said that people over 65 take an average of 5. Many of the newer drugs are large molecules with more chance of side effects. Of the 20-30 drugs approved by the FDA each year, 2-3 will be off the market in 3 years and 50% will have additional warnings on the label. Up to 40% of Americans are using alternative therapies whose side effects and drug interactions are, in many cases, unknown.

So here are some suggestions to ensure that those medications are doing the good they are meant to:

AT HOME

  1. Keep a list of the medications you are taking including the dose and how often you take the medication. Do not forget meds you take occasionally, herbals etc. Noting the imprint and color of the pill can help you identify the drug when you get refills. Also include your food and drug allergies. Present a copy of this list to each new physician you go to and keep a copy in your wallet.
  2. Change the list when you change what you are taking or after having an unusual reaction.
  3. REPORT ANY UNUSUAL SYMPTOMS THAT MAY BE SIDE EFFECTS OF YOUR MEDICATION.
  4. Keep medications in their original containers and store as directed (refrigerate, keep out of sunlight etc.)
  5. Never take someone else's medication.
  6. Read the label when you take the medication or place it in the weekly pill containers that simplify many of our lives.
  7. Keep your medications separate from those of other family members.
  8. Store all medications where children can't reach them. DO NOT CARRY THEM IN YOUR POCKETBOOK WHERE TODDLERS LOVE TO EXPLORE.
  9. Don't chew, crush of break any capsules or tablets unless instructed.
  10. Use accurate measuring device when taking liquids.
11. THROW AWAY UNUSED MEDICATIONS PROMPTLY AND CAREFULLY!

AT THE DOCTOR'S OFFICE

  1. Take your medication list with you to each appointment. If you have started taking anything new, including over the counter meds or herbals, or prescription drugs from a specialist, add these to the list.
  2. Make sure you understand why you are taking a new medication, how it is taken, for how long you will be needing it, and what the known side effects are. CONSIDER, DO YOU REALLY NEED THIS?
  3. Have the doctor write the reason for the medication on the prescription so the pharmacist will transcribe it onto the pill label.
  4. If your doctor gives you samples, make sure that they are clearly labeled and will not interact with the drugs you are taking. Your pharmacist has a computer to check interactions, but you are bypassing him with samples.

AT THE PHARMACY

  1. If possible use one pharmacy. That pharmacy should have all your medications listed in their records. Most pharmacies have a program in their computer to check for drug interactions. If you also use a mail in company, be sure they have all your medications in their computer. Neither will be able to enter herbals and other supplements.
  2. If your represcription pills do not match the old, check with the pharmacy and then, if necessary, your doctor.
  3. Go to the pharmacy when it is not busy. Many pharmacists are trained to counsel patients and enjoy this if they are not overworked.

IN THE HOSPITAL

  1. Take your medications and your list with you to the hospital. After the hospital staff has seen them send them home with your family.
  2. You or your surrogate should know what meds you are getting in the hospital and why they are being given. Check medications before you take them and be firm about checking with the doctor if you do not know what they are.
  3. Be sure the nurse checks your ID bracelet before giving you medication.
  4. If you have allergies to any dyes or medications that might be given before a test, remind the staff.
  5. In the hospital, you have the least control. Hospitals are adopting many new systems to protect you, but still many medication errors are made. If possible, have a friend or family member with you as much as possible if you are too ill to control your own treatment.

Adapted from guidelines of The Institute for Safe Medication Practices

Some helpful websites:

  1. medlineplus.gov
  2. ismp.org

Most public libraries have Physicians Desk References with pictures of many commonly prescribed drugs life sized. The PDR includes drug interactions and atypical responses in the older patients. Beware: entries in the PDR can be alarming every possible side effect ever reported in trials is listed important or not.

Rinda Kelley Schwartz

Suggested format for one page summary of health history for your wallet

  1. Top line: name, date of birth, social security #; date you compiled this document (i.e. 07/06/09); insurance company and group #
  2. Chief Complaint: 3-10 word summary of current problems (example: a=pain in chest; b=asthma)
  3. Brief History of Present Illness (onset; severity, what makes it better or worse, progression)
  4. Other medical problems: list them
  5. Current medications: dose and type of medication and how taken; include all over the counter meds
  6. Allergies: drugs, contact and environmental; (if you are allergic to drugs, or taken steroids within the past year, consider a “med-alert” type bracelet)
  7. Previous Operations: dates and complications
  8. Previous infections/immunizations
  9. Pets and travel (domestic and international)
  10. Family history (abbreviated) of cardiac, cancer, lipids (type), mental illness, autoimmune diseases (diabetes, GI problems, arthritis, thyroid), etc
  11. Contacts for emergency (cell phone number); should include name of person with your power of attorney if a “Do Not Resuscitate (DNR)” decision is needed.
  12. Name and phone number of your primary care MD
  13. Other contact information you want to include

Anything else you think is helpful and important

This one page summary is very useful for Emergency room visits, where time is of the essence

Keeping it to one page makes it both portable and readable. If you keep a notebook for your doctor visits, it can serve to update this single page summary.

Updates should be as needed, or at least on an annual basis.

Best wishes for good health to all.

Lauren Pachman