Guidelines for Taking Medications

1. Guidelines for Taking Medications Skills for Independent Living: Volume III Health

2. Medication: Step 1 • Before taking any medication, please tell your doctor any of the following: • Report all allergies, to medications as well as to non-medicines. • Mention reactions even to substances considered unrelated, since chemicals can cross-react. • Substances that are often not even regarded as medicines, such as birth control pills, can cause severe allergic reactions. • Make certain the doctor is aware of all medicines taken for other conditions, even non-prescription substances. • Seemingly-harmless medicines like an aspirin can cause harmful interactions with other medications. • Tell the doctor if pregnant (or pregnancy is a possibility) or if nursing. • Numerous medications increase the risk of birth defects. Skills for Independent Living: Volume III Health

3. Medications: Step 2 • Update this information each time visiting the doctor.  Be sure to inform primary care physicians of any medications that a specialist may have prescribed. • Always read the label.  Pay careful attention to the precautions and directions for usage for ANY MEDICATION.   Skills for Independent Living: Volume III Health

4. Medications: How to Take Them • Do not exceed the prescribed amount.   • In dosing, distinguish between TBSP (tablespoon) and TSP (teaspoon).  • Understand that giving more medicine is by no means better, and that taking a larger dose will not necessarily result in the drug beginning to work any faster. • It is possible to overdose even on vitamins. • For liquids, use a specially-marked measuring spoon to measure the dose accurately.   • Silverware teaspoons and tablespoons often do not contain accurate quantities.  With ordinary utensils, one teaspoon can hold just half of the volume that a teaspoon of another shape contains. • For accuracy, measure at eye level. • Do not take the medicine too often. Skills for Independent Living: Volume III Health

5. Medications: How to Take Them • On the other hand, do not take too little of the medicine. • Do not skip doses. • If one tends to be forgetful, use an alarm as a reminder. • Particularly if a person must take more than one medicine, s/he may find it easiest to use a dated pill box.  • Or make up a simple schedule of dose times, and then whenever a medication has been taken, mark the calendar to indicate that the dose has been taken. • Remember to take the medicine along when traveling away from home. Skills for Independent Living: Volume III Health

6. Medications: Safety First! • Check the potential side-effects so one can keep an eye out for them, including signs buildup of the drug to toxic levels (for instance jaundice). • Many medicines may cause dizziness.  Make sure to know how you react to a medicine before driving, operating machines, or doing anything else that could endanger oneself if not fully alert. • Adhere to precautions about harmful drug interactions. • Taking two drugs together can elevate side-effects, or have other unintended effects. • Also, occasionally a medication will list  precautions concerning certain foods.  For instance, heart/blood pressure medications and the immunosuppressant cyclosporine warn patients not to take them with grapefruit juice.  Skills for Independent Living: Volume III Health

7. Medications: More Safety Tips • Do not use outdated medicines.  The drug can break down into dangerous compounds. • Swallow pills whole unless they are designated as "chewable". • Do not crush tablets or remove the contents from capsules.  To do so may raise toxicity. • One should not share medication with family members for whom it has not been prescribed, even if they appear to have the same illness. Skills for Independent Living: Volume III Health

8. Medication: Take As Directed! • The pharmacist should issue an information sheet detailing how to take the medicine correctly for any medication dispensed.  If necessary, request these written instructions. • Make sure to ask for an explanation of any terms or instructions that were not understood. • It may help to bring along a family member or friend who can take down what the doctor says and ask for clarification, especially if one is feeling too ill to pay attention or ask questions. Skills for Independent Living: Volume III Health

9. Medication: Take As Directed! • For maximize absorption of the drug: • Take the medicine with food if directed to do so (also aids in preventing irritation of the stomach), or take it on an empty stomach if that is what is advised.  • For instance, while some antibiotics (such as Macrodantin) should be taken with food, tetracyclines and penicillins are best taken on an empty stomach. •  Even milk can keep a medicine from working effectively. • Swallow pills whole unless they are designated as "chewable" tablets. • Chewing tablets or emptying capsules may prevent the drug from working properly, by altering timing of absorption, thereby influencing blood levels. Skills for Independent Living: Volume III Health

10. Medications: Take As Directed! • Shake liquid medicines to mix fully. • Read and comply with the drug interactions; do not take the drug along with (or within the dictated time interval of) other medications that interfere with its effects. • Taking two drugs together can either interfere with their action. • Do not take outdated products, since drugs are apt to lose potency as they age. • If the medicine has changed in color or taste, discard it. • Store medicines correctly to preserve them optimally, or they may lose potency. • Store away from heat and direct light. • Do not store the capsule or tablet form of antibiotics in the medicine cabinet.  (The moisture in bathrooms breaks down the medicine.) • Check whether it should be refrigerated (not the same as frozen). • Take medications on the recommended schedule, which is designed to maintain the proper blood level of the drug. Skills for Independent Living: Volume III Health

11. Medications: Take As Directed! • Keep taking the medication for the full prescribed regimen, even if feeling better. • Not finishing the entire prescription may jeopardize treatment. • In the case of antibiotics, taking only a partial prescription can lead to harmful antibiotic resistance. Skills for Independent Living: Volume III Health

12. Medication: Know Why You Are Taking Medication • Find out how long it should be before symptoms start to subside.  (If applicable, also find out when symptoms can be expected to be gone completely.) • Check if the person should keep taking the medicine after s/he feels better.  Do not discontinue the medication without first checking with the physician.  • If the doctor has indicated that the medication can be discontinued after a certain period of time, or once symptoms have resolved, ask whether it ought to be tapered off, rather than stopped abruptly.  • Again, often the drug must continue to be taken, regardless of improvement in the patient's condition. Skills for Independent Living: Volume III Health

13. Medication: Know Why You Are Taking Medication • Know whether the medicine can be refilled, and if so, whether it should be refilled. • Inquire about other, non-medicinal aspects of therapy, including diet and exercise. Skills for Independent Living: Volume III Health

14. Medication: Know What Side-Effects May Happen • Ask the doctor how to handle any bothersome side-effects such as dry mouth or diarrhea. • Would any particular unintended effects warrant getting in touch with the doctor immediately or, after hours, going to the emergency room? • If unable to tolerate the medication issued, discuss alternatives with the healthcare provider.  If possible, treatment can be revised to a plan that the patient can stick with, via substitution of: • Equally-effective medicine without the intolerable side-effect or of • Medicine which is taken on a schedule that better accommodates one's lifestyle. • Ask about what tests, such as blood tests, will be done to monitor the effects of the medication, and how often assessments should take place. Skills for Independent Living: Volume III Health

15. Medication: Missing Doses • If a dose is missed, refer to the instructions provided.     • Depending upon when it is remembered, sometimes that dose is supposed to be taken, but other times it is supposed to be skipped. Skills for Independent Living: Volume III Health

16. Medication: Affordability • Let the doctor know if a medication is not affordable.  • It may be possible to substitute a generic equivalent of an expensive name-brand medicine.  • A subsidy may be available for low-income patients. Skills for Independent Living: Volume III Health

17. Medication: Asking Questions • It is important to understand one's treatment, so it can be followed properly.  If there are still unanswered questions after leaving the doctor's office and the patient is reluctant to bother the doctor, s/he can contact his or her nurse about prescribed treatment.   • A pharmacist can also help answer basic questions about how to take medication safely and effectively. Skills for Independent Living: Volume III Health

18. Medication: Non-Prescription • If taking over-the-counter medicine for a cold or injury, call the doctor if: • The medicine does not bring a fever down within a few days. • After a couple of weeks, the medicine still has not relieved pain. Skills for Independent Living: Volume III Health

19. Medication: Off-Label • Off-label" refers to when a medication is prescribed for a use other than its intended use.  This could be: • For treatment of a different disease • In a different dose. • Administration in a different way (such as intravenously rather than by injection into a muscle). • Another off-label situation would be when a medicine, particularly a new drug, has not yet been approved in a particular age group. Frequently medicines, although demonstrated to be safe and effective in teenagers and/or adults, have not been systematically studied in children, the elderly, or pregnant women, in order to be certain of the drug’s effects on those groups. • A good example is medications for mental illnesses, which usually have not undergone clinical trials in youngsters.  Accordingly, when dispensed off-label to a child, the product must be accompanied by a notification that "safety and efficacy have not been established in pediatric patients". • Important: There are special considerations for giving children medicine. Skills for Independent Living: Volume III Health