HERSHEY – Pharmacology is part of our lives. Humans have attempted to treat disease, relieve pain, and prevent illness with nostrums and potions since the beginning of civilization. In the last half century, however, our use of medications has expanded. Today, about 80 percent of us take a prescription or over-the-counter (OTC) medication or dietary or herbal supplement at any given time. A third of us take five or more at a time, and more than half of older Americans take at least three medications.
This is not necessarily bad. Much of our increased longevity and better functional capacity in later years is due to medications that lower blood pressure, control cholesterol, manage diabetes, improve heart function and so on. However, these benefits can be costly in ways beyond the financial investment. With increased numbers of medications, the possibility of an interaction increases, and as we age, the expected effects of some medication changes.
The risk of interaction increases if multiple doctors are treating a patient. Unless there is excellent communication among the physicians and patient, one physician may prescribe a medication that interferes with another drug.
Many people consider OTC medications perfectly safe since they do not require a physician to prescribe them. Some are not, particularly in higher than acceptable doses, plus many OTC medications and herbal products do interact with prescription drugs, sometimes with significant consequences. Some OTC medicines that are generally safe for most people can pose significant risks for the very young and very old.
Patients may misunderstand the purpose of a medication or how it is to be used. Sometimes, low literacy prevents the reading and understanding of directions. Other times, patients may not accept the need for treatment or may believe a “natural” remedy is better and avoid an appropriate therapy.
October is Talk About Prescriptions month — a time to encourage people to discuss their medications with their primary physicians and their pharmacists. The emphasis is on seniors who make up 13 percent of the population but consume a third of prescription and OTC medications and present the greatest risk of potential problems from medications. Visit here for more information.
Several recommendations are designed to improve safety and maximize benefit that everyone should consider when taking a medication. The person taking the medication or his/her caregiver should know:
— The medication name, why it is prescribed and what it does;
— When and how should it be taken;
— Whether it is compatible with other medications, both prescription and OTC, being used;
— If it is to be continued or stopped and why;
— Any adverse effect that might be common or expected and what to do about it;
— How to tell if the medication is working; and
— The type and likelihood of serious adverse effects.
It is very important that every person know the name and dosage of the medication and what it is for. Some medications can be used for many different problems; misunderstanding that a medication typically used for blood pressure is now being prescribed for a kidney problem could cause serious issues if a doctor makes a change in the blood pressure medication and the patient instead applies the directions to the kidney medicine.
Drug names can be intimidating, particularly generic names. Maintaining a current list of all prescription and OTC medications by trade and generic names and reason for use can help. Remembering drug names need not be scary; repetition increases familiarity.
Take notes during doctor visits and consider bringing a friend or family member as “second set of ears” to be sure important points are heard and remembered. The person taking the medication is as important a part of the team as the physician and pharmacist. Full participation in understanding the use of medications can reduce the risk of problems and increase the benefit.