BY JAMIE LOBER
Two out of every three patients who visit a doctor leave with at least one prescription for medication, and those numbers are increasing. Medications can save a life and improve the quality of life, but they also may do serious harm if not taken correctly. Pharmacists who know their patients and have their medication profiles on file can make all the difference.
If you have ever left the pharmacy and wondered why you were administered a certain drug and what it is supposed to accomplish, you are not alone. You may make light of leaving the doctor or pharmacist without asking a few questions because you feel embarrassed, but sometimes being unclear about your prescription can compromise your health. In fact, prescription overdoses are one of the top causes of drug deaths in Georgia. According to the American Pharmacists Associations, the most common misuse of medications are:
• Taking the incorrect dose
• Taking a dose at the wrong time
• Forgetting to take a dose
• Stopping medicine too soon
Whether filling a prescription for your child, picking out an over-the-counter (OTC) product, or asking general healthcare questions, your pharmacist can be invaluable to you! Pharmacists go through rigorous schooling to become experts in medications and can provide much-needed health information. Your pharmacist can help you understand your prescription and even how to dispose of the drug properly. His or her guidance can significantly decrease the chances of a preventable accident happening to you. We’ve asked Bob Moody, pharmacist at Coliseum Park Professional Pharmacy; Jim Kennedy, pharmacist at Kennedy Drugs; and West Wells, pharmacist at Graves Pharmacy, all of Macon, as well as Sean Clarkin, director of strategy at Partnership for a Drug-Free America key questions about prescriptions that might be helpful to you.
Q: What is the role of a pharmacist?
BOB MOODY: The pharmacist explains how to use a drug when the patient comes to pick up their prescription. He checks for any drug interactions. The pharmacist is also available to answer questions about over-the-counter and prescription medicines.
Q: Why should folks get in the habit of using the same pharmacy?
BOB MOODY: It is important that the pharmacist gets to know you over time and becomes familiar with the main aspects of your health history. If you regularly visit the same pharmacy, the pharmacist will be able to determine if there could be a drug interaction.
Q: What should you know in order to be an advocate for your health when it comes to knowing your prescriptions?
WEST WELLS: There has to be communication with the doctor and patient and also the patient and pharmacist in order for things to be clear and to avoid confusion. The patient should try to get information from the doctor. Because doctors like to talk in medical terms, the doctor needs to explain himself so when the patient comes to the pharmacy, the pharmacist can ask the patient what the doctor told him. From that information, the pharmacist can help the patient better. There has to be an overall understanding of what is going on with their body and if the patient has high blood pressure or diabetes, they need to have a full understanding of it. This way, the pharmacist can use his knowledge of the drugs to help put together what the drug is doing in the patient’s system.
Q: Do you just pick up your prescription and leave?
WEST WELLS: You need to first look at the prescription and make sure it is what you are expecting to get. {Pharmacists are human, and can consequently, make a mistake.} If you have any questions, you should ask the pharmacist. By knowing what your diagnosis or problem is and how the doctor is treating it, you can verify that the pharmacist is giving you the right medicine.
Q: Are there specific questions that you should ask when you pick up your prescription?
JIM KENNEDY: Most of the information you need is given to you when we print out your prescription from our elaborate system. Usually you should ask about side effects and what you can expect other than what it is intended for, such as that Benadryl can cause drowsiness and other things can cause nausea, et cetera.
Q: What is a black box warning?
WEST WELLS: A lot of drugs have serious side effects that have black box warnings that everyone needs to take into consideration. If a doctor prescribes it, the patient still needs to be willing to take a risk if there is a black box warning that the manufacturer of the drug puts out because of a side effect or a condition caused by the drug that could be harmful to the body. In the medical world, it comes down to risk versus benefit or the risk of the patient taking the drug or therapy versus the benefits of it helping in the long-run.
Q: Are there special considerations for children’s prescriptions?
BOB MOODY: If the child cannot swallow pills, you might want to make sure the medicine is mixed before you leave. Do not ask for it to be mixed over the telephone before you pick up the drug because they are only good for a certain amount of time after being mixed. If the doctor calls in an antibiotic today and you do not get around to picking it up until tomorrow, it will sit around degrading.
JIM KENNEDY: Do not let your child give himself the medicine because it could be {an unintentional suicide}. Parents should be very aware of that and keep it out of the child’s reach.
Q: What should you ask the pharmacist about OTC drugs?
JIM KENNEDY: You should ask if it will interfere with any medicine you are taking or if there are contraindications. Other questions you may want to ask include what the medicine is supposed to do, when and how you take it, how long you should take it, if it contains anything that causes an allergic reaction, and if it can be taken with food or other medications. You may also want to find out if it is safe to become pregnant or breastfeed while taking the medication.
Q: What is the biggest concern with OTC drugs as well as prescription drugs?
BOB MOODY: The main thing is to make sure that you do not take too much of the medicine because many of them have limits on how much you can take each day. If you miss a dose, usually you can take it when you remember but you do not want to double up. For example, if you miss a dose today and remember tomorrow that you missed yesterday’s dose, you do not want to take two at that point. You can overdose even on something that may seem minor like Tylenol. Some prescription pain medicines have Tylenol in it and people may take Tylenol over-the-counter without realizing that they are already getting the maximum dose which causes them to get too much and leads to liver damage.
JIM KENNEDY: If you have an accidental overdose, you should call the doctor or pharmacist immediately. Sometimes people will take something and forget they already took it—which happens often with elderly people who get confused.
Q: What is the proper way to store a medication?
JIM KENNEDY: Nobody should take the medicine except the person for whom it is prescribed, and it should be kept out of the reach of children. Pay attention to the temperature as prescribed on the bottle. Usually room temperature is recommended, but there are exceptions. Some things like insulin require refrigeration. Medications can lose their effectiveness if they are not stored correctly, and a bathroom medicine cabinet is the worst place to store drugs because of the moisture and heat.
Q: How can you know if you are having an adverse reaction to a medication?
JIM KENNEDY: If you experience adverse side effects like dizziness, break out in a rash, or have your lips swell; you should notify the doctor, so he can tell you whether to keep taking it or prescribe something in place of it. Children can experience adult reactions like becoming extremely drowsy, nauseated, vomiting, hives, and itching.
Q: What is the best way to dispose of medications?
BOB MOODY: If you had a prescription and the doctor changed you to something else, the best way to dispose of the medication is to put it in cat litter and mix it with water. {Flushing it creates a potential health hazard by allowing it to get into the water supply.} You can also bring it the pharmacy and they will get rid of it for you, but it cannot be reused.
Q: Can kids and adolescents get into trouble with prescription and over-the-counter drugs?
SEAN CLARKIN: Teen abuse of prescription drugs like pain relievers and over-the-counter medicines like cough medicines remains at a surprisingly high level. Data shows that nearly twenty percent of teens in grades nine through twelve report that at some point in their lives they have used prescription drugs without having a prescription for it themselves.
Q: What medicines are kids abusing, why, and from where do they get them?
SEAN CLARKIN: The biggest class of prescription drugs that are abused are pain relievers like Vicodin and Oxycotin because there is a high when you do not have an injury that warrants it. Kids use it to party. Stimulants like Adderall and Ritalin are being abused to help kids focus better, stay up late, and study. Roughly three-quarters of the abuse is sourced from somebody’s medicine cabinet or from somebody who has been prescribed the medicines and is reselling them. Many kids abuse prescription medicines, believing it will help them manage their lives, deal with stress, perform better on the athletic field, and lose weight. Often, abuse of prescription drugs co-occurs with a mental health issue like depression or ADHD. So it is important, in those cases, to get to a family physician or psychiatrist who can give your child an assessment and make a treatment plan.
Q: What can parents do to prevent kids from abusing drugs?
SEAN CLARKIN: Parents should be clued in as to where their child gets the drugs and how available it is. They need to manage their own medicine cabinets and properly dispose of unused pain relievers and other prescription medicines that may be lying around. If you suspect your child is using and find over a period of a month or two that something is not right, e.g., there is a sustained downturn in grades and your child is less interested in doing things he used to like, then trust your instinct. Sit down with your child and have a frank conversation. You may also want to talk to a teacher, coach, or other family member to get another point of view on what is going on.
Q: Should you talk to your child about prescriptions?
SEAN CLARKIN: It does not have to be a serious two hour-long lecture but parents are encouraged to have spontaneous conversations and to take advantage of little teachable moments—like seeing a story on television about drugs. Evidence shows that kids who learn about the risks from parents are less likely to use drugs.
Q: We know that in many ways the pharmacist and the doctor are a team, but between the pharmacist and the doctor, who are we most apt to call with medication questions?
BOB MOODY: Most people call their pharmacist first, because frankly, pharmacist come for free, and they usually cannot talk to the doctor for free. Sometimes the pharmacist is able to help and sometimes he is not.