Just as patients are encouraged to have one primary care physician, they should also have only one pharmacy.
“It is important to use one pharmacy so the pharmacist can have a complete medication profile and keep you informed,” said Alison Irwin, clinical pharmacy coordinator at Baptist Health System’s (BHS) Princeton Baptist Medical Center.
Irwin emphasized the importance of providing a list of all medications, including over-the-counter medications, to the physician.
“A number of over-the-counter medications can interact with prescription medications,” she said. “That includes herbal supplements.”
For instance, the blood thinner Coumadin (generic name, warfarin) interacts with some herbal products, she noted. Because of the potential for drug interactions, patients should ask their pharmacist or physician before taking any over-the-counter medications.
“We like to emphasize that, used properly, medications can be life savers, but not used correctly, they can be dangerous,” Irwin said. “The more medications the patient takes, the greater the potential for side effects or drug interactions. This is why it is so important that both physicians and pharmacists be made aware of all the medications taken by their patients.”
Along with keeping the health care providers informed, the patient should also be informed and be compliant with what is prescribed, Irwin noted.
“It is important to know what medications you are taking and what they are for and to be aware of potential side effects, particularly what symptoms you will need to report to a physician,” she said.
“It is important to never take another person’s medication and to always take your medication exactly as prescribed,” Irwin explained. Also, do not take expired medication.
“Patients should not stop taking a medication or change the dosage without asking their physicians,” she said. “If a patient misses a dosage, the next dose should not be doubled. Skip that dose. If the patient misses two or more doses, he or she should consult the physician to find out what to do.”
Antibiotics are sometimes not used properly. Some patients stop taking antibiotics before the prescription is completed, but this could cause further problems, Irwin pointed out. “Antibiotics sometimes have the infection suppressed, and it can recur if it is not completely treated. It could also cause a resistance to the antibiotic,” she said. (For more information about antibiotics, see story below).
“Being informed is the key,” Irwin said. “The more a patient is informed, the more compliant he or she will be, (which will result in a more successful treatment).”
Americans will spend an estimated $5 billion this year on herbal supplements such as ginseng, ginkgo biloba and St. John’s wort. These and countless other over-the-counter medications are often used by people to self-treat everything from headaches and depression to high cholesterol and poor concentration. But be aware: Natural does not mean safe.
“Many patients assume that because a product is labeled ‘natural,’ it is perfectly safe,” said Jack Carter, M.D., anesthesiologist at Montclair Baptist Medical Center. “However, these substances can interact with prescription medications or anesthesia in unexpected or adverse ways.”
In fact, the American Society of Anesthesiologists cautions those who use herbal medications to stop taking these “natural” products prior to having surgery. Patients are advised to stop taking herbal medicines at least two to three weeks before surgery, since this is the amount of time it takes for most medications to clear out of the body.
“What we’re seeing as anesthesiologists is that patients who do not inform their doctors of their use of these supplements may be putting themselves at risk. Although all the information is not in on the dangers associated with the use of herbal products, we do not want our patients to take any unnecessary risks,” Dr. Carter said.
Researchers have noted serious health risks with herbal products including St. John’s wort, ginkgo biloba, and ginseng. St. John’s wort, which is often taken to treat anxiety, depression and sleep disorders, may intensify or prolong the effects of some narcotic drugs and anesthetic agents. Ginkgo biloba acts as an anticoagulant and may lead to excessive blood loss during surgery. Ginseng, a popular herbal supplement believed to increase vitality, may lead to episodes of high blood pressure and rapid beating of the heart.
If you are currently taking or are considering the use of herbal medications, here are some safety steps.
- Before trying a supplement, take a look at your diet and lifestyle and determine if changes in these areas could accomplish your health goals instead.
- Talk with your healthcare professional.
- Look for products with the words “standardized” for consistency. Check for warnings on packages.
- Stick to single-herb products, not combinations. The more herbs are combined, the more difficult it is to determine an individual herb’s effects.
- Stop taking supplements if there is a problem and see a physician.
If there is not enough time to stop your herbal medication before a surgery, bring the product, in its original container, to the hospital. This allows the anesthesiologist to see exactly what you are taking.(BHS)
Has your medicine cabinet had its annual check-up? Health professionals recommend you inventory your medicine cabinet once a year. If it’s been a while since your medicine cabinet had its check-up, Baptist Health System (BHS) offers these tips to help you get started:
- Take everything out of your medicine cabinet and examine each item carefully.
- Check expiration dates and throw away all outdated medicines, over-the-counter drugs, ointments and medicated creams. “It’s important to realize the chemical content of drugs can change as they pass their expiration dates,” said Arthur Mueller, a registered pharmacist and director of pharmacy services at Montclair Baptist Medical Center, one of the 11 hospitals in BHS.
- If medications are not in their original containers and labeled clearly, throw them away.
- Discard old tubes of cream that have become hardened or cracked and any liquid medications that appear cloudy or filmy.
- Dispose of any unused antibiotics. “It’s important that patients complete all of their antibiotics as prescribed by the physician to make sure that the infection is gone,” Mueller said. People who self-medicate using left-over medications run the risk of building up an immunity to the antibiotic or masking a more serious problem.”
- Never share prescription antibiotics with a family member.
- Re-evaluate where you keep your medicines.
Every medication is a potential poison, Mueller cautioned. “If you have children in your home, — and this can apply to visiting grandchildren as well — keep medications locked in a high cabinet.
Bathrooms are actually one of the worst places to store medications. Since the heat and humidity in a bathroom can cause medicines to decay rapidly, the American Medical Association recommends keeping them in a cool, dry place like a bedroom closet.”
While each family’s needs will vary, the following medicine cabinet staples can help you cope with minor emergencies and illness until you can reach your physician: •Acetaminophen, aspirin and/or non-aspirin pain reliever.
Be sure to check with your doctor or pharmacist before taking any over-the-counter medications.
Mueller also recommended another task related to medications — make a list of all the medications you take. It’s easy and costs nothing, but is important, especially for seniors. Include personal information such as your name, all telephone numbers, address, city, state and zip code, emergency contact, physician names and phone numbers. Keep this list in your wallet or purse — close to your health care cards.
“Be sure to include everything you take — vitamins, cough syrup, pain relievers, eye drops, blood pressure medication,” Mueller advised. “You may also want to make a list for each member of your family.” (BHS)
Taking all of antibiotics important routine
In 1928 Alexander Fleming, a Scottish scientist discovered the first antibiotic, revolutionizing the way physicians treat disease. Today, people consume more than 230 million doses of antibiotics each year.
“While antibiotics can mean the difference between life and death,” said Alison Irwin, clinical pharmacy coordinator at Baptist Health System’s Princeton Baptist Medical Center, “serious problems can also arise if these medications are not used appropriately.”
Physicians and pharmacists caution that overuse of antibiotics can lead to antibiotic resistance and an increased risk of prolonged illness or death. Noncompliance — that is, failing to take antibiotics exactly as directed — can also promote the development of resistant bacteria.
“Resistance can occur when bacteria that cause infection are not killed by the antibiotic,” she said.
“When an antibiotic attacks a group of bacteria, those more susceptible to the medication are killed; but some more resistant bacteria may survive and multiply rapidly, passing that resistance on to new generations of bacteria,” she said.
Penicillin is a well-known example. At one time, Irwin noted, penicillin could be used to treat many bacterial infections, but its use is now very limited because of resistance that has developed. “Now we are seeing infections that are resistant even to the newer antibiotics.”
Antibiotic resistance is an increasingly widespread problem, according to Irwin. “Many patients just don’t feel that they’ve been treated unless they receive a prescription for an antibiotic, even for colds and other viral infections,” she said. Antibiotics can help fight infections caused by bacteria, but not viruses, such as the one that is the culprit for “the common cold.”
To choose the most appropriate antibiotic, physician may order cultures (tests with various antibiotics and samples of the bacteria) to determine what kind of bacteria are causing an infection and to which antibiotics the bacteria is sensitive. “By targeting a specific bacterial infection with the most appropriate antibiotic, we reduce the likelihood of increasing resistance to antibiotics.”
What role can a patient play in preventing the development of drug-resistant bacteria? Irwin offers these tips:
- Talk with a doctor to determine what treatment is best.
- Take antibiotics exactly as prescribed.
- Don’t take antibiotics prescribed for other people.
- Even if feeling better, take all of the antibiotic prescribed.
- Check the expiration date and don’t take out-of-date medications.
- Recognize that while antibiotics are useful drugs, they are not useful for viral infections such as colds or the flu.
“Pulling last year’s antibiotics from the medicine cabinet to self-treat this year’s flu-bug is definitely not a good idea,” Irwin said. (BHS)
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