Medications can create miracles. When used with care, medications can mean improved quality of life — and sometimes, the difference between life and death. But almost anything with the power to heal also carries the power to harm, when used incorrectly. And Filipinos are using their medications incorrectly. Many studies have found numerous problems with the use of prescription and over-the-counter medications. These included taking a different dose than prescribed, forgetting to take a medication, or taking a medication that was not prescribed. Older age and using multiple medications were major contributing factors. Older people often take many medications, which puts them at risk for dangerous drug interactions. They may have decreased liver and kidney function, slowing the elimination of medications from their system, and have difficulty tolerating the usual adult dosage. Problems related to medications can lead to impaired judgment and coordination, falls, fractures, auto accidents, and other injuries. A 1998 report from the Alliance for Aging Research labeled medication-related problems as a silent epidemic, calling for more research and better education of health professionals, patients, and caregivers on this important topic.
THE KEY: Take An Active Role
One of the most important steps you can take to get the most from your medications and to avoid errors is to take an active role in your healthcare. This means helping create your medication plan, sticking to the plan, sharing information openly, watching for problems, and asking for help.
When your doctor writes a prescription for you, he/she has a definite goal in mind, such as relieving a symptom or managing a disease. Take notes at your medical appointment to help you remember your doctor’s recommendations. If you have personal goals or views about taking medications, write them down and discuss them with your doctor. Your goal might include:
• Learning more about your medications so you take them properly and get maximum symptom relief.
• Taking your medications at fewer times a day, if possible.
• Taking your medications with fewer side effects.
• Spending less on your medications.
To achieve treatment goals, your doctor needs to know exactly how you’re using the medication and what results you’re getting. Carefully observe day-to-day changes in your health and report those changes to your doctor. It’s important that you take your medication exactly as prescribed, or it could be ineffective or even harmful:
• Don’t stop taking medication before your prescription runs out.
• Don’t cut down on your medication without consulting your doctor.
• Don’t take additional medications without your doctor’s knowledge.
If you do depart from your medication plan, tell your doctor. Speaking frankly about all the medications you use — prescriptions, over-the-counter drugs, Chinese medicines, herbs, and other supplements — will help your doctor fine-tune your prescription.
The ‘What, Why, How, and When’ Of Your Medications
To start managing your medications, review their what, why, how, and when:
• WHAT. Find out the exact name of each prescribed medication. Get both the brand name and the generic name in writing. A generic drug may not have the same size, shape or color as that of its brand-name version. However, the generic drug contains the same active ingredients. Keep a personal record of all your medications. Update this record at least once a year, especially if you’re seeing more than one doctor. Keep a list of all the doctors who prescribe your medication. Tell your doctor all the medications you’re currently taking. Take a complete list of your medications to your medical appointments. Include prescription and over-the-counter (OTC) drugs, herbal products, vitamins and other dietary supplements, laxatives and antacids. Tell your doctor about past experiences with medications. Mention whether you’ve ever had an allergic or unusual reaction to any medicine. Most medicines contain more than their active ingredient and some liquid medications contain alcohol. Be sure that none of the ingredients has caused you problems in the past. Ask about possible drug interactions. Make sure that you can safely take a new medication along with your other medications. Tell your doctor if you’re pregnant or if you want to become pregnant. Certain medications may cause birth defects or other problems in an unborn child. For many medications, safe use during pregnancy may not be established yet. If you’re nursing a baby, mention this, too. Some medicines may pass into the breast milk and cause unwanted effects in the baby. Discuss your medications before you have surgery. If you’re planning any kind of surgery (including dental surgery), give your doctor or dentist a complete list of your current medications. Ask about ways to save costs. See if you can save money through buying in larger quantities or by getting generic medications.
• WHY. Know the name of the condition that the medication will treat. If you don’t understand what the condition is, ask for written information or where to find it. Also find out how to tell if the medication is working — or not working. Many medications require periodic monitoring and blood tests to assess their effects. These include, for example, drugs that are used to lower cholesterol or to treat high blood pressure. Find out how each medication fits into your total treatment plan. That plan may call for changes in diet, exercise, and other health habits. Some of these changes may reduce or remove your need for medication. For example, weight reduction and regular exercise may reduce the need for drugs that treat diabetes or high blood pressure. Give your physician the big picture about your health. Tell your doctor about any medical problems — not just those for which your medicine is prescribed.
• HOW. Start with dosage. Find out the exact amount of medicine to take at each scheduled time. Ask if there’s a special procedure involved in taking your medication. You might need to use a nebulizer, inhaler, eye dropper, ear dropper or some other device. If so, ask for a demonstration from your doctor or nurse. Then use the device yourself while one of them observes. Ask for feedback on your technique. Ask for written directions. Ask also about precautions. For example, you may need to avoid your risk of sunburn or other skin discoloration. Ask about possible side effects. Ask your doctor about the major side effects. Report them as soon as possible in case they occur. Your doctor might choose to stop the medicine, lower the dose, or try another drug. Also, report suspected side effects that weren’t described to you originally.
• WHEN. Find out if you must take the medication on a schedule. In some cases, you can take a medication as needed. In other cases, you’ll have to take it at scheduled times. Ask if there are restrictions on what you can eat or drink with medications. For example, some medications shouldn’t be taken within an hour of meals. If you’re on a special diet, mention this to your doctor. Clarify the time period. Ask how many days, weeks, or months you must take your medicines. In the case of chronic diseases, some prescriptions will be renewed on an ongoing basis.
Oral Medications
Here are some practical tips on how to get the most from oral medications:
• Take medicines with a full glass of water — unless your doctor gives different directions.
• Ask if your medicine should be taken with food or on an empty stomach.
• Swallow the whole dose. Don’t break, crush, or chew medication before swallowing unless your doctor tells you to do so.
• Take medications when you can clearly read the labels. Don’t take medicine in the dark.
• If you have trouble swallowing the form of medicine prescribed for you, check with your doctor.
• Take only your own medication. Don’t take medicine prescribed for another person. And never give your medicine to anyone else. Your medicine has been prescribed for your condition and might harm another person. Likewise, another person’s medication could harm you.
• Drugs have expiration dates for a reason. Up until that date, the manufacturer can guarantee the drug’s potency (assuming it’s been properly stored). After that, there’s no guarantee. To get the most value from your medications, store them in a dry place at room temperature and out of direct sunlight — not your bathroom medicine cabinet!
Yes, it’s true that problems can develop with the medications you’re taking. But the good news is that you can take immediate steps to prevent medication errors and get the most from your medications — by simply following the suggestions given in this article!