Take Care When Taking Medication

By Mary Clarkin, CNP

Are you the kind of person who pops a pill with every ache or sniffle; or do you wait until you feel like you’re going to die before you reach for medication? Living at either extreme can be dangerous for your health. When it comes to taking medication, follow your doctor’s orders: prescription and over-the-counter (OTC) drugs should be used as directed, both to achieve their full benefit and lessen their possible side effects.

CHECK THE LABEL

Before you take any medication, read the label carefully. Some medications need to be taken with food, while others should be taken on an empty stomach. Don’t break, crush or chew pills before swallowing them, unless you have been instructed to do so by a medical professional. If you are taking medication with water, drink a full 8 oz. glass rather than sipping just enough to choke down the pill. This will ensure that the pill doesn’t break up before reaching the stomach, which can lead to throat irritation. In most cases, you should not take any medications with alcoholic beverages. Check with your doctor for specific medication interactions or ask your pharmacist for more information.

TWO IS NOT BETTER THAN ONE

Just because your back hurts more today than usual doesn’t mean you should take extra pain medication. The dose prescribed by your physician or listed on the back of the OTC medication is the appropriate dose. Dosing has been studied exhaustively to ensure safety and effectiveness. If you miss a dose of your medication at the scheduled time, don’t panic. Take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and return to your regular medication schedule.

When in doubt

Skip the guesswork with prescription and OTC medications. Tell your doctor:

• If you are allergic to any medications or have had an usual reaction to any medication, food or other substance.
• If you are currently taking any other medications (including over-the-counter medications) or dietary supplements such as herbal preparations, vitamins and minerals
• If you are pregnant, think you might be pregnant, or plan to become pregnant
• If you are breastfeeding
• If you are following a special diet, such as low-sodium or low-sugar diet
• If you have any other medical problems other than the one(s) for which your medication is being prescribed
• If you have problems taking medication

“NATURAL” ISN’T ALWAYS BETTER

While many people believe that natural supplements are safer, they actually are not regulated by the FDA and therefore do not adhere to the same standards as “regular” medications. Some herbal products can have hidden effects that may not be evident on the package labeling, such as thinning of the blood. St. John’s wort and raspberry-leaf tea, both common herbal supplements, may trigger uterine contractions that are dangerous to pregnant women. It’s always best to ask a doctor or pharmacist before adding natural products to your regimen.

AVOID DANGEROUS INTERACTIONS

The way the body absorbs, breaks down, and eliminates medicine from your body is very important to the effect that a medicine has on your system, as well as its effect on other medications. Anytime a person is taking five or more medications (as is frequently the case), the chances that he or she will experience a harmful drug interaction are very high.

You, your pharmacist, and your doctor can work together to lessen the chance of an interaction between medicines. Be sure to tell your doctor and pharmacist about all of the over-the-counter medicines, supplements, vitamins and prescription medications you are taking. It’s also important to discard any outdated medications. Many lose their effectiveness over time. And never share medications with others.

ANTIBIOTIC OVERLOAD

I am frequently asked, “Why didn’t the doctor give me an antibiotic?” Usually, the culprit is a virus, and viruses cannot be treated by anitbiotics. There is only a one in 4000 chance that an antibiotic will help most acute upper respiratory infections. But there’s a one in four chance of diarrhea, a one in 50 chance of skin reaction, and a one in 1000 chance that using an antibiotic will result in an emergency room visit due to some side effect.

Antibiotics can also lead to more resistant infections that are harder to treat. Upper respiratory infections caused by viruses include:

• Head colds
• Sore throats
• Bronchitis
• Sinus infections

The common cold and influenza do not respond to antibiotics. Less than 10 pecent of acute bronchitis cases are caused by bacteria. Most cases of acute ear infections also resolve without antibiotics. Sore throats (pharyngitis) are usually caused by viruses as well. Antibiotics are not recommended unless you have strep throat, and only about 15 to 30 percent of pharyngitis cases in children and up to 10 percent of cases in adults are due to strep throat. Almost all cases of acute bacterial sinusitis resolve without antibiotics.

There are a few situations in which antibiotics are needed, however. See your health care provider if you have a decreased immune system due to cancer, or if you are taking steroids, have HIV, or have had an organ transplant, or if your symptoms worsen or last longer than seven to 10 days.

Most often you should use the over-the-counter symptomatic treatment(s) that your health care provider has recommended. These would include analgesic products such as

• Acetaminophen (Tylenol®)
• Decongestants
• Antihistamines
• Salt water gargles
• Drinking warm tea
• Other methods to help treat symptoms

Also, remember that your best defense against getting the flu is to get a flu shot, but this does not, unfortunately, protect you against the many other viruses out in the environment that cause the other kinds of illnesses other than the actual influenza.

YOU CAN TAKE IT WITH YOU

Keep your medications in their original containers in your carry-on luggage when you travel. Do not pack your medications in checked luggage in case your suitcase is lost. If your medication requires a syringe, ask your physician for a letter describing your medical need, and carry it with you. Take extra medication with you when you travel in case your flight is delayed or you choose to stay away longer than planned.

Mary Clarkin, CNP, is a nurse practitioner in the Cleveland Clinic Ob/Gyn & Women’s Health Institute. She sees patients in the Center for Specialized Women’s Health on the main campus.