Medication Safety

Posted by Nurse Linda in Life After Paralysis on December 09, 2020 # Health

Taking medication is necessary to maintain your health. Some individuals take medication daily while others take medication intermittently or only as needed. Supplements are medications, but often people do not think of them in that way. Medications can interact with over the counter supplements and foods. Understanding your medications is important for your health and to ensure you are getting the maximum benefit from them.medicine

Know what your medications are and why you take them. Many people take prescribed medication without really knowing what it is treating. You could be taking a medication for a problem that has been resolved. Sometimes people take medicine that is not working for the issue that they have. When you have a basic understanding of what you are taking and why, not only will you be helping yourself, but you also will be better able to communicate with your healthcare provider about the status of your condition. Remember that you may no longer be experiencing your healthcare condition because the medication is controlling the issue. In other words, the medication is treating your problem, so you do not want to stop taking it. Knowing that the medication is working is good information.

Read the information that comes along with your prescription. These pages of information can be daunting. There is a lot of scientific information that might not be understandable, but the sections to really highlight are the parts about how to take the medication, what the side effects are, and interactions with other medications, supplements, and foods.

There are many interactions between drugs, food, unprescribed drugs, and supplements. Many people think of their prescribed drugs as being separate from interactions with other substances. It is critical to begin to think about drugs as potential interactions with a variety of substances in our lives.

The route of medications needs to be considered with interactions as well. Medication comes in oral form or taken by mouth. However, drugs come in a variety of forms. Any medication or supplement can be oral, rectal, vaginal, injectable, inhalants, applied to the skin or through the vein. Changing the route of administration does not affect drug interactions. They occur no matter how the drug is taken.

Understanding when the best time to take medication will allow the medicine to work at its most effective rate. An example is cholesterol medication, which works best when taken at bedtime. Since it is a once a day medication, I find people generally just take it in the morning. But our bodies produce the most cholesterol at night while we are sleeping. Therefore, taking cholesterol medicine at bedtime is the best time for it to be the most effective. This information is in the instructions included in the paperwork with your prescription but typically not on the medicine bottle.

Different medications are taken specifically with or without foods. Some foods or supplements reduce or heighten the effects of the medication. For instance, coumadin should not be taken with vitamin K supplements or foods that contain a high level of vitamin K, such as leafy green vegetables. Vitamin K counteracts the blood-thinning action of the coumadin. Other blood-thinning drugs may not have this interaction.

We are fortunate to live in a time of computers. This is a benefit because there are computer programs that can check drug interactions. Your healthcare provider probably has one on their computer that will pop up an alert about interactions when they prescribe medication. The pharmacist that fills the prescription will have a program for interactions as well. That creates a double-check of your prescribed medication for potential interactions as well as any allergies that you have reported. If you use multiple healthcare providers from different systems, their computers may not all coordinate. Be sure you check all medications and not just those from a single provider.

The critical issue is that for the drug interaction programs to work, you need to report all allergies that you have, including allergies to prescribed medication, supplements, over the counter medications, street drugs, foods, dust, even fragrances. If you are not taking the allergy-producing medication currently or if you have changed formulations, it is still critical for your health that you report any allergy. Lingering side effects can still be possible. Also, you might be allergic to just one ingredient in medications, so a completely different medication with that same ingredient can trigger an allergic reaction. Some drugs and medications alter the physiology of your body. Stopping a medication even years ago can lead to a re-trigger of an old allergy or physiologic change that will affect your wellbeing.

If you are concerned about the interactions of medications, supplements, and foods, you have several ways to find out about interactions. Reading the prescribed medication information sheet is one way. You can look up the drug and the interaction of concern on your own computer. There are programs that will inform you about drug interactions in general. You can use these to check drug with other drug interactions, drug and supplement interaction, drug and food interaction. You can check one drug with a second drug or three drugs or three drugs and two supplements. The combinations are endless. These are just two available programs to check for interactions:

https://www.webmd.com/interaction-checker/default.htm This site also has a place to see what your medication should look like if you drop a pill and are not sure what it is.

https://www.drugs.com/drug_interactions.html You can save your work on this site if you want to refer to it in the future.

There are also a variety of interaction charts that can be printed for you if you do not have access to a computer.

https://www.drugs.com/drug_interactions.html

https://www.aafp.org/afp/2017/0715/p101.html

https://www.aafp.org/afp/2008/0101/p73.html

Don’t forget our four-legged friends. There are medication interactions program for dog’s medications.

https://www.drugs.com/vet/

Polypharmacy is when someone takes many medications. Taking a number of medications is important if they are needed for active health issues. However, often people start taking medications and supplements that are not stopped after the issue resolves. These can end up working well so they are continued, often past the time of need. This can happen quite accidentally and usually without intention. As we go through life, we seem to collect healthcare issues and the medications used to treat them.

Individuals at most risks of polypharmacy are generally older or those with issues with thinking. However, polypharmacy can creep up on anyone. When you see your healthcare professional at your annual visit, you should have a medication checkup where all of the prescribed medication, supplements, over-the-counter medications, lotions, ointments, etc. and other drugs you might be taking are evaluated for need and interaction. Typically, at each visit, you will be asked by a support person what you are taking. These will be entered into the computer. It is best to bring up the medication review as a question to your healthcare provider to ensure you are taking only what you need and that there are no interactions.

Many people use daily medication organizers that are sorted weekly, so you have convivence in taking your medications at the right times. These dispensers cut down on the amount of time to organize your medications, but also, they are excellent in reducing medication errors. Weekly medication dispensers are often given away at the pharmacy or at health fairs. The larger organizers that are arranged for the day of the week and time are typically not given away. There are also prescription services at most pharmacies that will put your medications into packets by day and time of dose rather than receiving a bottle of all one type of medicine. These are very convenient but also come with an extra price.

One last point for medications is how you store them in your home. Leaving the medications in their original bottle (unless the pill is in your dispenser) is important, so you have the basic information at hand as how to take it. The number of the prescription is on the bottle for an easier refill. There will be a sticker on your medication bottle or package if the medication should be stored in a dark place or at room temperature or in the refrigerator. Never store medications in your bathroom or medicine cabinet. The steam from the shower or warmth in the bathroom is too humid for medication. Their potency can be affected.

Care for the preservation of your medication is critical to your health. Once you get a routine for your medication, it all falls into place quickly. Planning helps maintain your health. Nurse Linda

Pediatric Consideration: Children’s medications are often in liquid form until the child is old enough to swallow pills. Special measuring spoons might come with the liquid medication, so the correct amount is given. The medication is then taken by the child from the spoon end. Be sure to carefully wash, rinse and dry this measuring spoon so medications are not mixed, the right amount is measured, and the medication spoon is not contaminated. Once something touches the mouth, bacteria is on the device. Clean with hot, soapy water and rinse well.

Some children need to require many types of medication. Children’s medication can become polypharmacy as well. As parent’s, we only want the best for our child. Following the healthcare provider’s orders are what every parent does. Be sure to have your child’s medications checked especially if you use multiple providers from different healthcare systems. The computers may not all interact with each other. Checking is always a good step in the right direction. Nurse Linda

Linda Schultz, Ph.D., CRRN, a leader and provider of rehabilitation nursing for over 30 years, and a friend of the Christopher & Dana Reeve Foundation for close to two decades. Within our online community, she writes about and answers your SCI-related healthcare questions in our Heath & Wellness discussion.