Safe Medication Use

I’m sure many of us see medications as a necessary evil…we don’t like taking them, but we appreciate how beneficial they can be to our health.  Unfortunately, medication use comes with some risks.  All medications have potential side effects.  And errors in prescribing, dispensing, and administering medications lead to thousands of injuries each year.

So what can we do to prevent medication errors from affecting ourselves and our loved ones?  We can start by increasing our awareness of the medications we are already taking, and then also learn what questions we should ask our doctor and/or pharmacist prior to starting any new medications in the future.

To start, for each medication you are already prescribed, I encourage you to learn the following:

• Medication name.  I know, I know…some names can be difficult to pronounce.  Even medical professionals struggle with names like “eszopiclone,” “ustekinumab,” and “levetiracetam.”  If you have difficulty with the generic name, the brand name is usually easier to say.  I’m sure we can all agree “Cresemba” rolls of the tongue a lot easier than “isavuconazonium sulfate”!  If even the brand name is difficult for you, at a minimum, you can refer to the medication by its indication (i.e. my blood pressure pill, my diabetes medication, etc.).  As a pharmacist, one thing I absolutely beg you not to do is refer to your medication as “the pink pill” or the “blue tablet.”  The reason why I ask this is because the pharmacy may acquire medication from a different manufacturer between your refills, and as a result, your medication may not look the same from month to month.
• Indication.  The indication is simply what the medication is used for.  Are you taking it for depression?  Allergies?  Pain?  That would be your indication.
• Dosing.  For each medication you are prescribed, you want to know what dose to take (how many tablets, capsules, puffs, drops, etc); when and how often you  should take it (morning or evening, twice daily, as needed, etc.); and route of administration (orally, via inhaler, topically, or by injection).
• Side effects.  Every medication has potential side effects.  And while no one expects you to memorize all of them, I encourage you to try to learn the most common ones like sedation and GI upset.
• Interactions.  Many medications have drug/drug or drug/food interactions.  It’s important to know what medications or foods to avoid.  Some common foods that may interact with medications are dairy, alcohol, and citrus fruits/juices.

After enhancing our knowledge of our medications, the next potential challenge may be remembering to take our medications as directed.  We often consider the dangers of taking too much medications due to risk of overdose.  But taking too little medication, or taking it too infrequently, carries its own dangers.

Missing doses of medications for chronic diseases makes them less effective.  Our provider may end up adding another medication to our regimen because s/he thinks the one we are already on isn’t working adequately, when in reality it may work sufficiently on its own if we were to take it everyday.  Missing doses of medications like antibiotics may lead to drug resistance.  According to the CDC, antibiotic resistance is “the ability of microbes (bacteria, viruses, fungi, etc.) to resist the effects of drugs – that is, the germs are not killed, and their growth is not stopped.”  This may mean a new antibiotic will have to be prescribed, sometimes requiring hospitalization if IV medications are needed.

These are some tips and tricks we can use to remind ourselves to take our medications daily:

• Take your medications at the same time each day.  You are much more likely to remember to take your medications if you build them into your daily routine.  Take your morning meds as soon as you wake up, or with breakfast each morning.  Place evening meds on your nightstand as a reminder to take them each night before you go to bed.
• Pill boxes can be especially helpful if you take a lot of medications.  One pillbox stores one week’s worth of all of your medications, with each column representing a different day of the week.  They are available just about anywhere you do your shopping–pharmacies, big box stores, and even dollar stores.  Some also have multiple rows for morning, noon, evening, and/or bedtime doses.  Fill your pillbox the same day each week.
• Those of us into technology can use things like alarms or apps on our cellphones.  Set an alarm for the same time each day as a reminder to take your meds.  Available FREE apps include Medisafe, Med Helper, My Pillbox,  and Mediware. (Note: this is not an endorsement, I’m simply letting you know there are many options available).

To avoid interruptions in your medications, you also want to make sure you order medication refills in a timely manner.  Whenever you receive a medication from the pharmacy, be sure to pay attention to both the number of remaining refills, and the expiration date.  If you find that you are running out of refills, or the medication is about to expire, go ahead and call your doctor’s office to request a new prescription.  S/he may require that you have another office visit before authorizing more refills.

You can also consider using resources like automatic refills and mail order pharmacies to have one less thing on your brain.  Most major retail pharmacies have automatic refill services which refill your prescription on the same day of each month.  They will even call and/or email you once your prescription is ready for pick-up.  This service is ideal for medications that you take every day.

Many retail pharmacies also have cellphone apps, so you can order refills from your phone without having to call the store.  Consider using these types of services for medications that you don’t take regularly, and so therefore, may not be appropriate for automatic refills.

Mail-order pharmacies are convenient in that they deliver medications right to your door.  They also often provide 90-day supplies of your medications, so you can go 3 months between each refill.

Other helpful ways to minimize the incidence of medication errors and harmful medication-related events include:

• Keeping an up-to-date list of ALL of your medications.  This includes over-the-counter products and natural supplements.
• Using one pharmacy for all of your medications.  Pharmacy software looks for dangerous doses and drug interactions, but it can’t identify potential risks if it isn’t aware of everything that you’re taking.
• Keeping both your doctor and pharmacist informed of all of your medication allergies and intolerances.  Allergies are unpredictable, potentially life-threating reactions to a medication such as wheezing or other difficulty breathing, swelling of the throat, hives, and rash.  Side effects are undesired secondary effects resulting from the way the medication works in your body.  Common side effects are nausea/vomiting, diarrhea, sedation, etc.  If you’ve had a bad reaction to a certain medication in the past, your providers will want to avoid prescribing it to you again.
• Storing your medication in a cool dry place.  Kitchens and bathrooms are generally not the best rooms to store your meds due to heat and moisture, both of which can affect the integrity of your medications.  Some medications require special storing, like refrigeration.  Others are light sensitive and must be stored in a dark area.  Again, this information should be printed on your medication bottle, so make sure you read it carefully.
• Keeping medications out of the reach of both children and pets.  Also try to avoid telling children that their medication is “candy.”  While it may decrease the stress of fighting with them to take their meds, it increases the risk of them ingesting them without your supervision, which may lead to accidental overdose.
• Avoiding mixing medications and alcohol.  This can be a potentially fatal combination in some instances.  Read your medication bottles carefully…I can’t say this enough 🙂

1. Mark out all identifying information on your prescription bottle with a black marker.  Odds are your bottle contains your name, address, and phone number.
2. Mix the medication with some type of neutralizing substance like baking soda, cat liter, or used coffee grounds.
3. Place the mixture in a sturdy plastic container like an old laundry detergent or milk bottle.  Seal the bottle tightly with the cap, and possibly even duct tape.
4. Throw both the sealed bottle and the original medication bottle in the trash.

If you are prescribed any controlled medications like opioids or benzodiazepines, I encourage you to utilize National Prescription Drug Take-Back events hosted by local law-enforcement agencies, waste management companies, and /or pharmacies.   These medications in particular have a high risk of misuse and abuse, so proper disposal ensures that they don’t get into the wrong hands.

Your doctors and pharmacists take every effort to keep you safe when prescribing and dispensing your medications.  But although some of us may hate to admit it, we’re still human and are capable of making mistakes.  This is why it’s so important for you to be an active participant in the process.  Together, as a team, we can work to decrease the occurrence of medication errors and potentially harmful medication-related injuries.

I would love to hear you ladies’ tips and tricks for managing you and your loved ones medications.  Please feel free to share any new ideas in the comments section.  And stay tuned for our next post on questions to ask prior to starting new medications…