Taking Medications

Posted by Nurse Linda in Life After Paralysis on November 05, 2021 # Health

Doctor holding a stethoscopeMany individuals take medications for all sorts of issues. Medication is a term that can be used to define any substance that alters something in your body, most often for preventing or treating a problem but sometimes for enjoyment. Medications can include prescription, over-the-counter, supplements, alternatives, complimentary or as needed. Also, included in the 'general medication' category should be inhalants, alcohol, and nicotine because these also affect body processes.

Almost everyone has taken medication at some point in their lives, others have continuous medications to maintain their health, some take supplements, and a few do not take medications regularly. However, there are some general guidelines for taking helpful medications.

In nursing, there are eight rights of medication. Even though these are used for nurses to administer medications, it is critical that you think about these when taking your medication at home or in any setting. These rights have been adapted to the viewpoint of individuals taking medications.

Eight Rights of Medication

1. Right, person-medication should be taken specifically for treatment for you as an individual and your healthcare needs. Medication should not be borrowed or taken because someone else had success with it. Do not use someone else's left-over medication. Never share medications.

Using medication is just half of the responsibility of taking it. As a consumer of any type of medication, it is important to know and understand what you are taking, why, and how you should take your medicine. Understanding what you are taking is critical to ensuring a medication error has not been made. If you take your medication on your own or someone gives it to you, knowing what the medications are, what they look like, the dose and the time you take them is your responsibility.

2. Right medication-a specific medication, supplement or alternative medication should be discussed with your healthcare professional or prescribed by them. Most medications can be taken in generic form, but a few others cannot. For example, some individuals who take thyroid medication cannot substitute the generic because of their unique needs. Generics are great alternatives but be sure you are taking the correct medication, not something similar.

If you take a red pill at 8 am but are given a green pill, a question about your medication should be made before you ingest, insert, or rub the substance on your body. Sometimes, the manufacturer at the pharmacy is changed. A notice will typically be on the pill bottle and being told it is different by the pharmacist. If you are in a healthcare setting like the hospital, their supplier may use a different manufacturer. These reasons are all justified, but on rare occasions, medication errors are made. It is never wrong to question when something different appears in your medication supply.

3. Right dose-take medication only as prescribed or indicated on the packaging. Sometimes people think a little does good; a lot might do better, but people can overmedicate themselves easily with damaging effects. Medication doses are calculated specifically. For instance, antibiotics must be taken for the full prescription to effectively treat an infection. In addition, some vitamins can build up in your system, creating toxicity.

Reading the package insert for prescription medications is a responsibility. There is a wealth of information that is helpful. A list of precautions about interactions with other medications, foods, or other substances will be specified. The time of day the medication should be taken, including spacing between doses, is also a helpful direction so as not to over or under Medicare yourself and not to counteract the drug from working to the maximum benefit. A list of side effects is provided to know if you are reacting to the medication. Warnings help protect your safety.

4. Right route administration of medication should be as indicated by prescription or packaging. Similar to taking the right dose, how you take medication is critically important for effectiveness.

If something should be taken by mouth, inhaled, rubbed on the body, or inserted into a body cavity, it should be administered that way. Some pills in tablet form can be crushed. Pills with enteric coatings should not be crushed because that protects the stomach from erosion by the medication. Capsules, gels, or time-released oral medication generally should not be altered. This is because they may be formulated to dissolve in the bowel instead of the stomach.

5. Be sure to notice the right time needed between each dose of medication and the time of day to take the medication. Taking the medication with food to coat the stomach or on an empty stomach is a good example. These instructions will be on the pill bottle or package insert. Medications may work better when taken at a certain time of day.

Some common but often ignored medication specifics are overlooked. Many individuals do not read the package insert, so they take their cholesterol medication in the morning. Taking it at bedtime is more effective as most cholesterol is made in the body at night. Some antibiotics work best when taken with water, others with milk or after eating to control stomach upset. Some heart medications should only be taken if your pulse is over 65 beats per minute, so you need to assess your pulse first. Some anticoagulants (blood thinning medication) cannot be taken with leafy green vegetables in your diet. There are many more specific directions for medications that are learned through the package insert.

6. Right documentation- if you take medication that requires a specific time between doses, note the time you take it. Especially with pain medication, it can become easy to lose track of your last dose. If an antibiotic is specified as taken every six hours, you need to take it around the clock, which is a six-hour space between doses. Dosing four times a day can mean taking four doses when awake.

You can feel some medications working. For example, oral medications may be felt to work in about 20 minutes or as the medication enters your bloodstream. Tone (spasticity) medications might be noticed to be working by your muscles relaxing. The same is for pain medications. However, other medications such as antibiotics and cholesterol medications are not felt but are still working. Lab tests reflect their effectiveness. When you know the purpose of the drug you are taking a medication, you can better assess its effectiveness.

7. Right reason-take medication for the purpose it is to serve. Individuals need to decide if their issue is worth the medication's side effects. In some cases, it very much can be but know your reasonings for taking the medication to make an informed decision.

Knowing why you are taking medication is important to your assessment of the effectiveness of the treatment. Some individuals take a medication for several years, after which they forget why they are taking it. If you do not know why you are taking medication, find out. Then you will be able to assess the continued effectiveness of the treatment.

8. Right, response-assess yourself to see if the medication you are taking is working for you. The side effects might be overpowering. Discuss alternatives with your health professional if you are not having a positive response to your medication.

Polypharmacy or taking five or more medications can lead to interactions. One medication might be used to speed something up, another to slow it down. This is often seen in bowel preparations when someone has constipation, so fiber is added. But then diarrhea develops, so medication to slow the bowel is added. These can conflict with each other. This situation is very common. Keep evaluating your medication to ensure you are not working against yourself.

Alcohol and nicotine are not often thought of in the medication groups. However, each affects the body. These substances can interact by dulling the effectiveness of medication or more likely increasing the effectiveness of your medication, making it toxic. Be sure to read package inserts to see if alcohol or nicotine will affect the action of your medication. Sometimes, alcohol and nicotine are used to dull issues, especially mental health concerns. These may temporarily dull thinking about an issue and may lead to serious complications. Confronting and dealing with the issue is the best method to getting treatment and improving your concerns.

At each office visit with a healthcare professional or trip to the pharmacist, be sure to mention all the medications you take, including prescription, over-the-counter, supplements, alternatives, as needed, inhalants, alcohol, and nicotine. Know the amounts you take, when you take them, and how they enter your body, such as pill form, edibles, inhalants, lotions, insertions, injections. Many other non-prescription substances interact together and affect prescription medication. Drug interactions can occur between drug to drug, drug to food, drug to herb, drug to disease, drug to gene, drug allergy. Alcohol and nicotine can increase or decrease the effectiveness of drugs, both resulting in negative outcomes.

There are a variety of online programs to check your medications for interactions with other medications and foods. This FDA pamphlet is a great start. Information about drugs, food, and alcohol can be found in the FDA pamphlet.

Your healthcare professional and pharmacist can check drug interactions for you. Most have this ability to check prior to prescribing something new. If you take over-the-counter or non-prescription pharmaceuticals, be sure to tell your healthcare professionals so those drugs can be checked as well.

At these websites, you can enter your medication to check for interactions, especially with alcohol:

When you are finished with your medications, or if something changes but you have left-over medication, especially narcotics, dispose of it properly. Take it to a drug disposal location so it can be safely destroyed. Safe drug disposal locations are typically in your local police station lobby. Do not flush medication in the toilet. Nurse Linda

Pediatric Consideration:

Medication for children often comes in liquid form since doses are calculated by weight. The liquid is often the form for medications for neurological conditions. It is also helpful if tube feeding is used for administration.

Be sure to measure the dose carefully. Special measuring 'spoons' are typically given by the pharmacist. The amount should be measured, not given using a kitchen spoon which has a lot of variabilities. For an older child using a liquid medication, flavoring can be purchased at the pharmacy to assist with administration.

Since there is not a large demand for many pediatric medications, specialty pharmacies can make the right medication in the right dose for children. These are called compounding pharmacies. They are often privately operated as opposed to chain pharmacies. There might be one in your local hospital. The medication is made in these facilities by pharmacists that have been educated in the process. Your healthcare provider can direct you to a compounding pharmacy, or you can google a compounding pharmacy near me. If you do not have a compounding pharmacy in your area, one can mail or ship the medications. Nurse Linda

Linda Schultz is a leader, teacher, and provider of rehabilitation nursing for over 30 years. In fact, Nurse Linda worked closely with Christopher Reeve on his recovery and has been advocating for the Reeve Foundation ever since.

In our community, Nurse Linda is a blogger where she focuses on contributing functional advice, providing the "how-to" on integrating various healthcare improvements into daily life, and answering your specific questions. Read her blogs here.

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The National Paralysis Resource Center website is supported by the Administration for Community Living (ACL), U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $8,700,000 with 100 percent funding by ACL/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by ACL/HHS, or the U.S. Government.