Avoiding Medication Errors
Coordinating appointments, dealing with people unfamiliar with BP, the education system, the mood swings of our beloved bipolar children, and life’s things that are thrown at us are all a challenging balancing act to say the least. But there is another challenge where we should be on guard, medication errors. There are many things that can lead to medication errors from pharmacy mistakes to difficult to read written prescription orders, misreading label directions, to confusing one medication for another when taking them. So, because this can be such a serious situation with possibly dire consequences, here are some tips to help us remember how to stay med smart and med safe.
What ‘counts’ as medication?
Herbs and vitamins
Supplement
Over-the-counter medication (OTC)
Medications requiring a prescription
Home or natural remedies
Responsible reporting
Bring an updated list of all your child’s medications to every doctor, every time. Whether it is the dentist, pharmacist, psychiatrist or ENT - everyone treating your child needs to know about all of the medications being taken.
Include a complete list of allergies (medications, food or other) with the list of medications.
It is always good practice to use the same pharmacy for all medications so your pharmacist is aware of all medications and can serve as another check on interactions or allergies.
Also, with one pharmacist knowing all the conditions that are being treated can help identify potential problems the prescribing physician may have missed or may not be aware.
Subscribe to and have your child wear a MedicAlert bracelet or necklace and keep the information up to date wtih the company.
Is this a new medication?
If this is a new medication, ask the doctor to show you a picture of it so you will recognize it at the pharmacy. A Physician’s Desk Reference, or PDR to many of us, will have pictures of the pills.
Ask the doctor to tell you exactly how much is to be taken, when, and how often/long then repeat it back to him or her for clarification. If the doctor’s handwriting is questionable, be sure to take your own notes on the dosing information to compare with the pharmacy label.
Know the name(s) of your medications
All drugs have a brand name and a generic name, know both of them.
Some drugs have names that are very similar to other drugs, either the generic or brand name. Be aware of this and watch for prescription fill errors. It can be important to know the physical aspects of the drug that has a similar name as well as ‘your’ medication.
Some medications are known by more than one brand name. Example, Wellbutrin, an antidepressant, is marketed as Zyban for smoking cessation.
Is this a combination medication? Be sure you know what all of the ingredients are that it contains to ensure there is not an allergy or other problem with one of its components.
Medication Identification
What color is it?
What numbers or letters are imprinted or stamped on the pill?
Is it partially scored, scored on one or both sides or not at all?
Open the bottle and look at the pills while standing at the pharmacy counter. Once you leave, it is usually state policy that the pharmacy cannot exchange or otherwise accept a medication back from a patient.
Don’t be afraid to question the pharmacist if you feel you’ve been given the wrong medication or dose. You are perfectly within your rights as a consumer to request to see the bottle from which the prescription was filled.
Special Dosing Instructions
Does this medication require dosing with food or on an empty stomach?
With specific foods such as milk?
Are there any stringent requirements for dosing times such as three times a day – does that mean at meals or every 8 hours? Sometimes this can make a HUGE difference in the efficacy.
What should you do if you miss a dose?
What if you are queasy and become ill shortly after taking the medication?
Should you change the way you take your medication if you are sick?
Do you need to avoid certain foods or medications for any period of time before or after taking it? For example, some medications can’t be taken less than 2 hours, before or after, an antacid or milk.
Should you avoid certain activities such as driving heavy equipment while taking this medication?
If this is a liquid medication, use a calibrated cup or other measuring device from the pharmacy department, not a household spoon as overmedication often occurs when using a spoon from the kitchen drawer.
What are the side effects of this medication?
What are the common side effects?
Are there side effects that you may get but go away in time?
What side effects require medical attention?
What side effects are not an emergency but should be reported to the doctor?
What degree of side effects are acceptable and where should you draw the line? For example, tremor can be a common side effect but at some point it can be severe enough to make it difficult to write legibly or walk a straight line.
Does this medication interfere or interact adversely with food or another medication you are already taking?
Some drug interactions are not severe; others are life threatening so know what you are dealing with.
Another possibility is a desired or helpful drug interaction where one medication combined with another produces a synergistic effect - enhancing the results of one or both medications equaling a sum effect that is greater than what could be achieved on either medication dosed without the other. Or, when one medication can reduce the required dose of another such as when Depakote and Lamictal are dosed together, Depakote increases Lamictal levels so a much lower Lamictal dose is required.
There are some medications that interact negatively with certain foods. For example, many medications are not to be taken with grapefruit or grapefruit juice.
What exactly does this medication treat?
Is this treating psychosis or mood?
What should be the desired results and how soon should they be seen?
Does this medication treat the same thing as another medication you’re taking?
Is this replacing another medication?
If replacing another medication, does the old medication have a specific discontinuation method or can it be stopped cold turkey?
Can the new medication be given while the old one is still being taken or must the old one be completely discontinued before starting the new one?
Are there special storage instructions?
Does it require refrigeration?
Most medications have some degree of chemical alteration when exposed to high heat or moderate heat over a period of time.
Many medications are affected by humidity and require storage in some place other than the medicine cabinet in the bathroom. This is a very common place where medications are stored for many people and usually the worst place to keep any medication.
Copyright © Crackerjack 2005