Managing Your Medications

If you're like many Americans, your medicine cabinet is stocked like a pharmacy with prescription drugs, over-the-counter medications and nutritional supplements. But mixing and matching could be dangerous.

Dr. Robert Michocki of the University of Maryland's School of Pharmacy tells The Early Show co-anchor Rene Syler that dietary supplements, herbal products and drugs not approved by the Food and Drug Administration can interact with prescription medication.

Another assumption is that there is really no need to read the labels for over-the-counter medication or herbal products. Dr. Michocki stresses, "It's important to talk to a physician, health-care specialist or pharmacist and make sure it doesn't interact with the prescription medicines."

Food also can interact with medication you may be taking. Dr. Michocki explains, "If it upsets your stomach, maybe you should take it with milk or food but that could be the wrong thing to do. There are a number of medicines out there that, when taken with dairy products rich in calcium, actually can decrease the absorption of the drugs. The class of medicines like Cipro when taken with aspirin or dairy products can quickly reduce the absorption of these medicines and give you a syrup concentration. Another big area is grapefruit juice. A lot of drugs interact with grapefruit juice that people aren't aware of."

As for keeping your medicines in the bathroom medicine cabinet, he says, "You really shouldn't keep your medicines in the bathroom. That's probably the worst place to keep it. The high humidity and the changes in temperature can affect the tablets and (cause) loss of potency. It should be kept in a secure, child-proof area out of the light and at room temperature."

The following is an excerpt from his article: Ten Steps To Effectively Manage Medications By Robert J. Michocki, PharmD, BCPS, Chair, Department of Pharmacy Practice & Science University of Maryland School of Pharmacy

Ten Steps to Effectively Manage Your Medications:

1. Herbal & Dietary Supplements Are 'Medications' Too. In recent years, the use of vitamins, herbal and dietary supplements have grown significantly. Although these supplements are taken with positive intentions in mind, some of the remedies can interact with both prescription and OTC drugs, potentially causing harmful effects. Cosumers MUST always inform their physician and pharmacists of any supplements being taken. The herbal remedy Ginkgo, which is consumed to enhance mental sharpness, may cause problems if taken with anticoagulants or blood-thinners as the herb impedes blood clotting.
2. Can't Swallow Pills? Ask About Alternatives. If a child or an elderly person experiences difficulties swallowing pills, attempting to ease this problem by dissolving or crushing the medication may change how the pill works and could be less effective. Always talk to your pharmacist before taking this action. Today, many medications are available in liquid, sprinkle or chewable forms and some pills can be dissolved in certain specific liquids. If a child dislikes the taste of a particular drug, pharmacists can often add flavoring without diminishing the effectiveness of the medication.
3. Ask Which Foods & Beverages Can Adversely Interact with Your Medication. Certain foods and beverages can interact with medicines, potentially making them less effective. Calcium-rich dairy products, such as milk and cheese, can reduce the effectiveness of antibiotics. Grapefruit juice should not be consumed if a consumer is taking certain blood pressure-lowering medications Likewise, ask your pharmacist or doctor if your medication should be taken with food or on an empty stomach.
4. Medications Should Be Stored in a Medicine Cabinet Outside of the Bathroom. Leaving your medication in the front seat of your car for a few days during the summer months or storing your drugs within a medicine cabinet in a steamy bathroom may affect the drugs' potency and effectiveness. If your pills are moist and powdery, it is a positive sign that the drugs have been affected by humidity and/or changing temperatures. Sek advice from your pharmacist immediately.
5. Parents Should Know the Weight of Their Child. The majority of pediatricians and pharmacists advise parents to regularly weigh their child and maintain an accurate record of the weight. A child's weight is the best way for pharmacists to determine the correct dose of prescription medications and for parents to ascertain the appropriate dosage for OTC drugs. Guessing your child's weight to determine the appropriate dose to give when administering an OTC drug is not good enough. Giving your child less than the required dosage prevents the drug from treating your child's symptoms and giving your child too much of the medicine can potentially be very harmful to his or her health.
6. Brand-name vs. Generic Drugs: What Is the Difference? Brand-name drugs and generic drugs are technically the same prescription drug, but sold at different price levels. Generic drugs are manufactured using the same Food and Drug Administration (FDA) regulations as brand-name drugs, and in most cases there is little evidence of any difference in the therapy the medication provides. Because of some unique properties of the drug or its manufacturing process, some brand-name medications are preferred to generics.
7. Ask About the Active Ingredients in Your Prescription Medications. It is vital that consumers do not mix the active ingredient of prescription medication inadvertently with an OTC drug containing the same active ingredient, which could result in overdosing. For example, taking over-the-counter Tylenol® along with the prescription pain reliever, Percocet® can potentially result in an overdosage of acetaminophen. The label on OTC drugs provides consumers with information on the medication's active ingredient.
8. Drugs the Elderly Should Not Take. As people age and experience physiological changes, drugs react differently in the body. Therefore, the elderly should avoid certain medications, particularly if they have cardiac, psychiatric, respiratory or gastrointestinal disorders. Drugs like beta blockers or aspirins, as well as some OTC antihistamines such as diphenhydramine (Benadryl®) and chlorpheniramne (Chlor-Trimeton®), may cause dizziness, urinary retention or affect the central nervous system and should be used with extreme caution.
9. Invest in Medication Compliance Products. Pill timers, organizers, pillboxes, and specialized pill packaging are available in pharmacies to help consumers manage their medications more successfully. The elderly typically use these tools and they can be beneficial for consumers taking more than one drug daily. These simple devices can ensure that patients adhere to their medication regime, helping to enhance their quality of life and prevent incidences of medication misuse.
10. If You Are Not Sure, Consult Your Pharmacist. Pharmacists are the medication experts in the health-care team and understand how drugs interact in the human body. They are readily available to answer any question about the medication you are taking and how to maximize its effectiveness. Don't just rely on your pharmacist to fill your prescription -- use him or her as a resource to better control your medications and improve your health.

About Dr. Michocki
Robert J. Michocki, PharmD, BCPS, Chair, Department of Pharmacy Practice and Science, has been educating students at the University of Maryland School of Pharmacy since 1971. He is a board-certified pharmacotherapy specialist whose research interests include the role of the pharmacists in geriatric care, and drug therapy for Alzheimer's and asthma patients. Dr. Michocki serves as a consultant to the Veterans Administration Hospital and the University of Maryland Medical System. He has published more than 50 papers in the scientific and professional literature and has presented the results of his work in many forums.