Prudent Use of Medications

October 25, 1999

Safe, effective drug use depends upon the patient’s understanding of the drug regimen, its risks and benefits, and the necessary precautions associated with each medication. In many cases, the key to safe and effective use of medication is open communication with the prescriber. The following items should concern you.

The name of the drug. Knowing the name will not only enable you to look up information about the drug, it will also enable you to discuss it with your doctor (or another doctor) should this be necessary.

The drug’s purpose. This information will help you understand your treatment and whether or not it is working.

How and when should it be taken? This basic information will be on the product’s label. Some medications are best taken on an empty stomach (before meals) for maximum absorption. Some are best taken on a full stomach to prevent the medications from irritating the stomach. Some are inactivated by food and must be taken on an empty stomach. Some have to be taken on an exact schedule, while others do not. It may be helpful to keep a written record of what you are doing-particularly when several medications are being taken on different schedules.

Are there any special instructions? Sometimes specific foods, alcoholic beverages, or other medicines will react unfavorably with the medicine just prescribed. Be sure that your doctor is aware of other drug products, dietary supplements or herbs that you are using.

What side effects might occur? All drugs have possible side effects. If they occur, in some cases nothing need be done and the medication can be continued. In others, a change of dosage or a different medication will be advised. The occurrence of certain side effects would be a reason to stop using the drug. It can help to be aware of the common side effects and what to do if they occur. One of the most important side effects is drowsiness — a common characteristic of antihistamines, sedatives, and drugs for mental and emotional problems. People taking any of these drugs should not drive a car until they have determined that the drugs will not interfere with their ability to do so safely. Information about side effects can be obtained by asking your physician or pharmacist or consulting a reliable reference.

How long should the drug be taken? Some drugs need be taken only until symptoms stop, while others should be taken for a period specified in advance. For example, pain relievers can be stopped when your pain goes away, but antibiotics are typically prescribed for 7 to 14 days to eradicate germs that remain even though symptoms of the infection have disappeared.

What should I do if I miss a dose? In some cases it will be advisable to make up the dose to maintain an adequate blood level of a medication. In other cases it will not matter, and doubling the dose will increase the likelihood of side effects.

Is written information about the drug available? Some doctors provide instruction sheets on common prescription drugs. A package insert may be available from the pharmacist who fills the prescription, but these tend to be overly technical. Excellent reference books are available, and comprehensive information will soon be available on the Web sites of online pharmacies.

Is a generic form available? Generic drugs usually cost less and are just as potent as name brands. Some doctors routinely prescribe them, but others either think they are inferior or simply do not bother. With a few medicines for serious diseases there may be a medical reason to avoid a generic drug. But in most cases there is no reason they cannot be used.

It should not be necessary to question your doctor about all of these things each time you receive a prescription. A good doctor will communicate most of this information when the medicine is prescribed. But don’t expect or demand a lengthy discussion on the uncommon side effects and complications of common drugs. If you think your doctor is not communicating enough, a tactful question may lead to clarification.

Various types of aids can help people take their medications properly. These include medication calendars, individual instruction sheets, color-coded bottles, blister cards, calendar trays, self-sealing plastic bags on which the dates and times for medicating are written, special bottlecaps t hat record when bottles are opened, and bottlecaps and boxes that beep or buzz when it is time to take a dose.

When traveling, try to take along enough medicine to meet your needs. Carrying an extra prescription may be wise in case your luggage is lost or your supply runs out. If a childproof container is hard to handle, ask the pharmacist for one that is easy to open.

Safety Precautions

  • If you go to more than one doctor, tell each about any prescription and OTC medications you are taking. It is a good idea to keep a record with you. Also tell the doctor about any adverse drug reaction you have had.
  • Stick to the prescribed dosage. Taking extra may increase the chances of adverse reactions without increasing the chances of benefit. And don’t stop a medicine because you don’t think it is working. Some drugs have to be taken for several days or even weeks before their effect is apparent. Instead, contact your doctor for instructions. Keep a daily record of all drugs being taken, especially if treatment schedules are complicated.
  • Remember that alcohol and sedatives can multiply each other’s effect on the brain. Don’t mix alcohol and sleeping pills, antianxiety agents, or any other drugs that have sedative effects. If you drink regularly, make sure your doctor knows about it.
  • Keep your drugs in their original containers so no mix-up occurs about which drug is which.
  • Remember that it may be risky to share medicines with others. When prescribing medications, doctors take into account the patient’s age, weight, sex, other medications being taken, and other factors. What is good for one person may not be good for someone else.
  • Clean out your medicine cabinet periodically. Throw away any drugs that have reached their expiration date or changed in color, odor, or texture. Flush them down the toilet so that no one else can use them. Drugs prescribed for a previous illness or for another person should not be taken without first checking with the physician. The drug may have lost its strength or changed its composition, or a more appropriate drug may be available for the illness.
  • Call the doctor promptly if an unusual drug reaction occurs.
  • Consider purchasing all of your prescription products at a pharmacy with a computer that tracks them and alerts the pharmacist to possible adverse drug interactions. This might have protective value if your physician overlooks a significant interaction. However, this potential benefit should be weighed against the advantage of comparison shopping to save money.

Questions and Answers about Generic Drugs

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This article was posted on October 25, 1999.