Avoiding Drug Mistakes

Dr. Mallika Marshall Answers Questions About Prescription And Over-The-Counter Drugs

(CBS)  Miami's medical examiner released startling details this week about the 11 prescription drugs found in Anna Nicole Smith's hotel room after she died from an overdose. There were hundreds of pills — muscle relaxants, sleeping pills and other potent drugs — all authorized by Smith's Beverly Hills psychiatrist.

Smith's death illustrates how dangerous prescription drugs can be if not used carefully, especially for the 32 million Americans who take three or more medications daily.

The Saturday Early Show's Dr. Mallika Marshall has answers to questions about the most common mistakes Americans make with prescription and non-prescription drugs, and how to avoid them.

Q: Do prescription drugs really hurt all that many people?

Yes. A recent report said at least one-and-a-half million Americans are harmed each year by mistakes involving medications. So it doesn't just happen to the rich and famous. It could easily happen to you or me or a loved one.

So what are the main things to watch out for?

Problems can arise from mixing multiple drugs together; mixing drugs and alcohol; not asking for enough information from your doctor about a medication; getting the wrong prescription from the pharmacy; using more than one pharmacy; and failing to take medications as directed.

Okay, let's go through them: First, drug interactions.

This is the most common danger, and it includes over-the-counter as well as prescription drugs. People taking medication for high blood pressure should be careful of decongestants: they can raise blood pressure. Many antibiotics reduce the effectiveness of oral contraceptives so you may wish to use back-up birth control. If you take a blood thinner like Coumadin, don't take aspirin — it can cause internal bleeding. There are many other examples, so ask your doctor or pharmacist about the risks of drug combinations.

What about drug interactions with alcohol?

Alcohol can interfere with a number of medications. First of all, anti-anxiety drugs like Valium and Xanax, narcotic painkillers such as Percocet, Vicodin and Codeine, and antihistamines in common cold and allergy preparations can all be very sedating. Add alcohol — which is also a sedative on top of them — and you have a real recipe for disaster. Alcohol can also interfere with certain antibiotics, so ask your doctor or your pharmacist if it's safe to drink with certain medications; even if it's just a glass of wine, make sure it's OK.

Okay, what about getting enough information from your doctor?

Studies show that most people remember only about a third of what their doctors tell them. So be sure you know the name of the medication prescribed, what it's for, how often you should take it, and how you might react. And don't hesitate to write it all down.

Next is getting the wrong prescription from the pharmacy.

Pharmacies can make mistakes. So when you pick up your prescriptions, make sure you know the names (including the generic names) of the medications you take, and check the prescription bottles to make sure they match. Also, check the pills — if they look different than the ones you're used to taking, go back to the pharmacy and ask why. The pills may be just from a different supplier, but they could be wrong, too.

What about not using more than one pharmacy?

If you use multiple pharmacies, they can't screen for drug interactions because they may not know all the drugs you're taking. If you MUST use more than one, show the pharmacists a list of whatever you're taking.

Finally, what about failing to take medications as directed?

It's a bigger problem than most people realize. In fact, studies show that up to one-third of older people don't follow instructions about taking prescription drugs. Sometimes they cut back to save money, sometimes they forget, and some folks just don't like schedules. It can go the other way, too: taking more of a drug than prescribed is at least as dangerous as not taking enough. So follow doctor's orders and help the older people in your life do the same.

[wayjan107]

As a pharmacist in community practice, nothing would be worse for me than to make a dispensing error that would cause harm to one of my patients.

However, there has been a real sea change in the practice of pharmacy. The major impact has been the immense increase in the volume of prescriptions being dispensed. As a result of this higher volume, the work flow has been reorganized in most, if not all, community pharmacies (chains and independents).

Prescriptions are verified by a pharmacist at the end of the dispensing process. This involves a computer assisted check for interactions, allergies, and correct drug. Because of this system errors are kept to a minimum.

Unfortunately, there is one step in the dispensing process that is often left out--personal counseling from the pharmacist. The law mandates that patients must be counseled; but ONLY when the patient replies "yes" when asked if they would like to be.

When the patient is not counseled errors and potentially harmful issues may be overlooked. Studies have shown that when patients are counseled on each of their prescriptions errors are reduced.

As a patient you can better protect yourself by saying "Yes, I would like to speak to the pharmacist" when asked. At that time you and your pharmacist can review your medications and discuss any new ones being added. This conversation can serve as a last front in preventing medication errors.

R. Wayne Bowen,RPh,B.S.in Pharmacy

[leidhold]

STOP DISPENSING EVIL MEDS!!!

DR's JUST DUMP MORE MEDS IN YOUR HANDS

THAT'S ALL THEY DO!!!

YOU LEAVE THEIR OFFICE, YOU HAVE A BAG OF MEDS!!!

EVEN WHEN YOU DON'T NEED THEM, THEY SAY TRY THESE.

THEY DON'T EVEN KNOW THE SIDE EFFECTS OF THE MEDS THEY ARE MAKING US TAKE.

YES, MAKING!!!

IF YOU DON'T DO WHAT THEY WANT, YOU ARE NOT COMPLIANT!!!! THEY THEN TREAT YOU TERRIBLE!!!

DR's DON'T READ THE LITERATURE!!!


IN MY OPINION, DR's AND MEDS ARE EVIL....

THROW DR's IN JAIL!!!


NOW!!!

LEIDHOLD

[leidhold]

EVERYONE HAS TO RECHECK EVERYTHING THESE DAYS.....

SOMETHING IS WRONG IN OUR SOCIETY WHEN YOU GOTTA JUDGE DR'S, PHARMACISTs, FOOD, & MEDS, etc.

NO ONE IS DOINNG THEIR JOB!!!

GIVE THE DR's AND PHARMACISTS SOME MEDS TO HELP THEM FOCUS!!!

MAYBE SOME RITALIN!!


HAHAHHAHAH.....

LEIDHOLD...

ALWAYS MY OPINION!!!!!!!!

[annd2302]

Posted by leidhold at 04:35 PM : Apr 07, 2007

Postings by this person is difficult to read, and becomes boring after just a few words. Please use proper written English when commenting, and most of all, lose the "ALL CAP mentality.''

[gordon.couger]

As a patient we need to do our job as well as the doctors and pharmacist. Don't lie to the doctor about what you take, drink etc, it can kill you.

Just because it is natural or/and doesn't need a prescription doesn't mean it's safe or you can be take all you want.

Always take a list of the all the drugs you take with you to every doctor you visit and tell them about the illegal stuff you take and how much you drink. Doing anything else is playing Russian Roulette.

Don't buy drugs from multiple pharmacies if you can help it. Make sure you understand how every drug you take fits in with the rest. Ask the pharmacist that's what they do. Doctors use what ever works & what ever comes to mind. That's what drug companies pay rep's $100K+ to tout drugs to doctors. It may not be a perfect system but it's the one we have. Disregard it at your own risk.

Don't insist the doctor have an answer for every problem. I don't know is the answer a lot more of the the time than any of us like & we don't need a drug for every thing we think is wrong. One reason we get so many drugs is that is what we expect when we go to the doctor. If they don't give use what we want we go to another doctor until we no longer have a problem or think we are getting the treatment we need.

Every one in the chain is human & humans make mistakes. Do your part & make sure that You know what is going on. If things don't seem right call your doctor or pharmacist.

I am patient wit more than 1 drug error.

gc

[sueneely]

Very good, Mr. Bowen. I was a pharmacist for many years, also. The dispensing of medication has been reduced to "harmacy". Anna Nicole Smith's death can not be construed as accidental.
It was poisoning. If the vehicle had been arsenic, there is no doubt that would be the nomenclature used.
My big question is about the origin of the acutal medications. Who dispensed them? Did they come from a third world country? No one has used chloral hydrate for years. I won't go on, but it should be clear that pharmacists must wake up to the hundreds of patients to whom they dispense lethal combinations. What happens to 120 hydrocodone in 30 days every 30 days? Obviously, the source of pain is not being addressed. Obviously,other sources of comfort or cure are not being sought.

The patient is ultimately responsible for everything that goes into his/her own body. Legal drug, illegal drug,alcohol, or supposedly innocuous OTC medication all work on similar receptors,inundate the poor enzyme systems to death and upsets the digestive system to a terminal point.

Panacea is nowhere and danger lurks everywhere.