Medication Safety: raise awareness, empower yourself by UofL Health Louisville KY

Medications are used for a number of reasons – with the primary use of improving our health. If not properly taken, medication could cause harm.

Kentucky leads the country (tied with West Virginia) in scripts per capita utilization, and Kentucky is always in the top four in state rankings on prescription drug burden. The average script per capita use in the U.S. is 12.1, but Kentucky stands at 19.3. If you add over the counter medication use plus herbs and supplements, it becomes clear that the use of these products is a part of life we all have to pay more attention to whether it be in regards to ourselves or friends and family.

There are 400,000 deaths per year which are considered premature and preventable, of which 18 percent were lethal medication related adverse events.

We know that adherence to medication regimen contributes to adverse events, but monitoring and prescribing are more significant contributors to medication misadventure. These statistics mean that the consumer has to advocate for their own safety in the use of medications.  The presumption that because a product is on the market it is safe, either through FDA approval as in prescription and OTC products, or with little FDA regulation (as in supplements and herbals) is a false assumption.

Keep records and information about your medications (“medications” here means prescription, OTC, herbals and supplements.)

o   Always bring a list of your medications to every doctor’s appointment, don’t assume they have an up to date list.

o   Update your list every time you add or stop using a product.

o   This is especially important when you have multiple doctors.

o   Bring a copy for each doctor’s office, hospital, or any health care encounter you go to; the average office visit is from 15-20 minutes long and you can help them get the information by leaving an updated copy of your medication list.

o   Use online medication information services such as or rxlist.

o   Obtain written information about your medications from internet or live sources like your pharmacy.

  • What to do if you miss a dose?
  • Can it be taken with food?
  • How long should you take this medication?

Keep records on how your medications are or are not working.

o   The idea is that it’s important not to take anything that’s not working, or if what you’re taking is almost working or too strong, it’s important to adjust, and adjustment requires reporting on various aspects of medication use such as effect, how taken, when taken.

o   Consider keeping a log (on a calendar for example) of when you take your medication with respect to meals, bedtimes, waking time, and with other daily information related to medication use such as blood sugar readings, or blood pressures.

o   There are many free online templates available, or you can create your own, for logging (tracking) blood pressure and other conditions.

This is a great way to know whether your medication use is working or needs adjusting to get the outcomes you are aiming for.  This information is useful for your doctor, so don’t forget to bring that as well to your appointments (a copy of, or they can copy it).

Create a medication chart to clarify how, why and when to take your medications

o   Sometimes due to the number of medications we have, it becomes difficult to keep informed of what to take when and what they are all for, you can find many free templates for medication charts or create your own.

o   Don’t be afraid to ask your pharmacist, or nurse to help you fill the medication chart out to ensure the instructions are translated as accurately as possible.

o   When unsure about how to take a medication, ask your pharmacist or doctor, then repeat what you understand back to them to ensure you both are in agreement.

  • Learn the names of your medications and what they are for.
  • Know the dosage and strengths of your medications.
  • Don’t split or crush medications that are not intended to be altered.

o   Many once daily drugs are designed for 24 hours’ worth of dose to be released throughout the day, and sometimes when crushing or splitting occurs, a 24 hour amount of drug is released at once, which can be harmful or even deadly.

o   This type of medication usually has an identifier in its name such as XR, XL, CR, LA.

o   Some medications which are long acting can be split if they have a score or line in the middle for the purpose of splitting.

o   Capsules which are sealed at the seam are not meant to be split

o   Some medications are not crushable or split able for another reason: they are encased in a protective shield because the contents are toxic or harmful when they are exposed to breathing or touch the mouth, esophagus or stomach.

Know the top adverse reactions for each of your medications and monitor for their presence.

Know what should be monitored when using each drug.

o   For example: if you take a water pill, you usually have to get blood work done periodically to make sure you are not losing to much sodium or potassium or having other imbalances.

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Article by: Demetra Antmisiaris, PharmD

Dr. Demetra Antimisiaris earned her doctor of Pharmacy degree at the University of the Pacific (California) in 1989, and completed a Geriatric Clinical pharmacy residency at VAMC West Los Angeles-UCLA. She is a Certified Geriatric Pharmacist and Fellow of the American Society of Consultant Pharmacists. After working as a geriatric pharmacy long term care consultant, she joined the UofL Family Medicine & Geriatrics faculty to lead the “Polypharmacy Initiative” which is an innovative and unique program amongst medical schools in the United States, dedicated exclusively to fighting the problem of polypharmacy through education, research and outreach.

All posts by Demetra Antmisiaris, PharmD
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