Common Medicine Prescription Mistakes

Common Medicine Mistakes
Doctor writing prescription

Common Medicine mistakes and how to prevent them

Prescription drugs are biologically active substances that can do good but also harm if used in the wrong way or at the wrong moment. And then we are not yet talking about using the wrong medication or the wrong dosage.

It is estimated that close to 10% of patients in Hospitals are admitted for medication related problems. With the amount of drugs being marketed nowadays, it is increasingly difficult for a doctor and a pharmacist to keep track of everything. Computers do help a lot for the cross checking of  interactions of medications, but then again, if you visit different pharmacies all the time your Rx history may not be up-to-date. And even worse, visiting different doctors within 3 days, because the flu symptoms did not go away within 2 days (Duh- Real flu can last for 3 weeks of misery and the only thing we can do is symptom relieve) may result in prescriptions with mismatching antibiotics or double dosage.

Here are some tips that you can use to safeguard your health.

Mistake #1.

You can not read your doctors handwriting. If you can’t, there is a chance your pharmacist can not either. Some doctors use even abbreviations which may be common in Holland or the US, but your pharmacist may not be familiar with the particular shorthand? A quarter of mistakes is misreading, quickly written names like losec, lasix or lamisil and lamictal can be easily mixed up especially with strengths that might be the same.

Safest Rx: Ask your doctor to spell out the name or even write the intended treatment like water pill or acid reflux (in some countries this is going to be mandatory).

Mistake #2

You have a miserable cold and pop 2 tablets of  a cold medication and some paracetamol every 4-6 hours to keep going. Warning: If that cold medication is one of many containing acetaminophen a.k.a as paracetamol, you might be getting close to a toxic dose by the end of the day. 20 tablets Tylenol extra strength in a day will do damage to your liver, add 3 alcoholic drinks and it will double the damage.

Safest Rx: Stay clear from OTC multidosage products and compare the ingredients with prescribed medication you might be taking as well.

Mistake #3

You leave the pharmacy without confirming that this X drug for Y condition.

2% of pharmacy dispensing contains mistakes according to studies. Provide the pharmacy with the right data to process the prescription as good as possible, including birthdate and full name of the intended recipient. Make sure the pharmacist verifies the medication and explains the use with you, when handing you the medication.

Safest Rx:
choose your pharmacist as careful as you choose your doctor and stick with them. Your history records will give a safety net when the computer checks for interactions or wrong dosages.

Mistake #4

Scared to tell your doctor about herbal products you are taking? In that case you belong to the majority, but do not conceive natural as being without side effects or interactions. St Johns worth (found effective for depression) can interact with the Pill. If you are using bloodthinners, hypertensive or diabetic drugs you should consult with your doctor or pharmacist.

Safest Rx: bring bottles of anything else you use whether natural or not to your doctor when having a check up.

Mistake #5

You self treat with someone else’s medication

You break out in a rash, so you use something the doctor has prescribed for your husband’s skin problem. You commited a big health sin! Even if it looks the same it might be a different problem. If your husbands problem was allergy related and yours viral, chances are you made your problems worse. Your neighbours waterpill that helped her swollen ankles may give you a wrong reaction, especially if you are using a bloodpressure drug like and ACE inhibitor.

Safest Rx: eliminate the temptation, never safe leftover medication and never take something from a good samaritan to try help your problem as well.

Mistake #6

You ignore the warnings on the label.

Does it really matter you take your antibiotic with or without food? Certain antibiotics absorb poorly into the body with food, others give discomfort when taking them on an empty stomach. Taking Cipro or tetracycline with Mylanta? You might as well take a sugarpill because little will be absorbed. How about taking your medication after dinner or before breakfast? Fosamax absorbs appr for 2% in your body and that is under the condition you take it with plain water at least half a hour before eating anything, if you take it with milk you might as well throw it in the toilet straight away because that is where it will end up. Some drugs really work best at night due to your body’s rhythm.

Safest Rx: Ask for a patient leaflet at the pharmacy or take the 10 seconds to read the labeling on your packaging. And if you are not sure if a milkshake is a dairy product, ask the pharmacist.

Mistake #7

Take your medication only when you feel sick.

Are you also one of those people taking diabetic of pressure medication when you need it? Join a circus, it means you are superhuman having sensory abilities not known by medical science. A headache does not mean you pressure is to high, 99% it is unrelated and if so, it means the pressure has been bad for a long period and REALLY bad.

Unfortunately these chronic diseases are called chronic because they will not go away anymore. True, drastic changes in lifestyle can improve your condition but you only “sense” being ill from ie diabetes if your numbers are way off. Regular testing and your daily tablet will keep your long term risk on sudden death or illness low. It is very important that the balance created by the medication stays as constant as possible. Even worse; suddenly withdrawing the medication might give a worsening of the disease ie with antidepressants or bloodpressure medication.

Safest Rx: Take your medication as prescribed, if you feel there is a reason to stop discuss it with your doctor first. If you have difficulty remembering to take the medication try using pillboxes and leave your medication in places where you have a daily routine like with the toothbrush (make sure the environment is suitable)

Mistake #8

Take alcohol with your medication, or worse not taking the medication because you want to consume alcohol.

First you have the old time believe that alcohol and antibiotics do not mix. The only one that gives problems is Flagyl and its relatives. For most antibiotics the interference is linked with the fact that your immunesystem might suffer from taking alcohol while fighting an infection, so you do not help the antibiotic doing its work optimal.

SSRI antidepressants (Zoloft, Paxil, Prozac) are more stimulating than sedating so they shouldn’t interact with alcohol. However alcohol is a depressant so confer with your doctor before drinking. Alcohol and the common antihistamines like benadryl and chlorpheniramin are a sure recipe for sedation, the reason why Nyquil works so good at night and should be taken cautiously. Non sedating antihistamines like Allegra, Claritine and Zyrtec are not likely to cause sleepiness.

Get Your Flu Shot

Getting the flu shot can reduce the risk that you will get the flu. Getting the flu shot may ease the symptoms, too, if you catch this nasty virus.

There is a wide variety of vaccines:

-The nasal spray is quick, easy and better yet, painless. You sniff and you’re done.
-There is a flu shot that covers four versions of the flu, and one that will protect you from three strains of the flu.
-You can even choose a flu vaccine that uses a shorter needle Continue reading “Get Your Flu Shot”

Stop Spreading the Superbugs

For nearly a century, bacteria-fighting drugs known as antibiotics have helped to control and destroy many of the harmful bacteria that can make us sick. But in recent decades, antibiotics have been losing their punch against some types of bacteria. In fact, certain bacteria are now unbeatable with today’s medicines. Sadly, the way we’ve been using antibiotics is helping to create new drug-resistant superbugs.” Continue reading “Stop Spreading the Superbugs”

Caribbean Pharmacy is the Best Place to Shop

Affordable prescriptions

Our Caribbean pharmacy is the best place to shop because the cost of prescription drugs and medications is very high when you purchase in the United States. If you are vacationing and lose or have forgotten your medications at home, you want to purchase your refills from a pharmacy that will fill your prescriptions with safe and reliable drugs.

While the changes to health insurance and prescription coverages will see huge changes in the United States, if you suddenly become a self-pay patient it is nice to know you have a trusted source where you can get those prescriptions filled, and at great prices, too.

Having an illness or condition that requires medications is stressful enough. Let Philipsburg Pharmacy help ease the financial stress your written prescriptions can cause. You do not have to use the mail order prescriptions your insurance is pushing! This not only runs small, community pharmacies out of business, but you are at risk of losing the face to face interaction with the healthcare professional you trust, your local pharmacist.

Antibiotics

Antibiotics

Viral and bacterial infections are by far the most common causes of illness for most people. They cause things like colds, pneumonia, measles, mumps, malaria, AIDS and so on. The job of your immune system is to protect your body from these infections. The immune system protects you in three different ways:

  1. It creates a barrier that prevents bacteria and viruses from entering your body.
  2. If a bacteria or virus does get into the body, the immune system tries to detect and eliminate it before it can make itself at home and reproduce.
  3. If the virus or bacteria is able to reproduce and start causing problems, your immune system is in charge of eliminating it.

Sometimes your immune system is not able to activate itself quickly enough to outpace the reproductive rate of a certain bacteria, or the bacteria is producing a toxin so quickly that it will cause permanent damage before the immune system can eliminate the bacteria. In these cases it would be nice to help the immune system by killing the offending bacteria directly.
Antibiotics work on bacterial infections. Antibiotics are chemicals that kill the bacteria cells but do not affect the cells that make up your body. For example, many antibiotics interrupt the machinery inside bacterial cells that builds the cell wall. Human cells do not contain this machinery, so they are unaffected. Different antibiotics work on different parts of bacterial machinery, so each one is more or less effective on specific types of bacteria.

Antibiotic Resistance

Bacteria aren’t particularly intelligent. However, it is possible, and unfortunately all too common, for bacteria to “learn” how to survive even with antibiotics around.

There are several ways that bacteria can become resistant. All of them involve changes in the bacteria’s genes.

  • Bacterial genes mutate (change), just like the genes of larger organisms mutate. Some of these changes happen because of chemical or radiation exposure; some just happen randomly, and no one’s sure quite why. If bacteria with a changed gene is less susceptible to an antibiotic, and that antibiotic is around, the less susceptible (and more resistant) version of the bacteria is more likely to survive the antibiotic and continue to multiply. This is particularly likely to happen if the amount of antibiotic around isn’t quite enough to kill all of the bacteria quickly — as can happen if you don’t take enough of the antibiotic to keep its level in your body high, or if you stop taking the antibiotic too early. This is why when you are prescribed an antibiotic you MUST take it exactly as prescribed, and for as long as it was prescribed. It’s also why we don’t (or shouldn’t) give you an antibiotic for an illness like a cold that isn’t likely to be bacterial: the antibiotic will kill off the susceptible bacteria, leaving bacteria that are resistant to that antibiotic.
  • Although there are many different species of bacteria, some bacteria can “trade” genes with other bacteria. If you have a relatively harmless bacteria in you — say, in your mouth or your intestines (both places are chock full of bacteria) — and you’ve used (or overused or misused) antibiotics some of those harmless bacteria will become resistant to the antibiotics you’ve  used. They can then give the resistance genes they have developed to other, harmful bacteria.
  • There are viruses around that attack bacteria rather than plants, animals, or people. Most of these viruses just kill the bacteria, but sometimes the viruses can copy genes, like the antibiotic resistance genes, from one kind of bacteria to another.

Kinds of Antibiotics

There are now so many different antibiotics on the market that it’s hard to keep track of them all.

Penicillins and Cephalosporins

In the early 20th century, Alexander Fleming discovered that a mold called Penicillium (the cells are pencil-shaped when you look at them under a microscope) produces chemicals which kills most of the bacteria nearby. (The mold is green when it grows in large amounts, and is often found on bread. This, however, does not mean that eating moldy bread will cure your ear ache… or anything else. There are other things produced by molds, too.) Sometime later, another mold was found which produced a bacteria-killing chemical; this chemical and its cousins were called “cephalosporins” after the mold it came from.

The vast majority of antibiotics are either penicillins or cephalosporins; chemical changes have been made to the molecules over the years to improve their bacteria-fighting abilities and to help them overcome breakdown and “immunity” of resistant bacteria. Most bacterial cells have double layers on their outside. The outermost layer, the “cell wall”, is similar to the outer layer of plant cells, but is missing in human and animal cells. This wall must grow along with the cell, or the growing cell will eventually become too big for the wall and burst and die. Penicillins and cephalosporins kill bacteria by messing up the wall-building system. Since we don’t have cell walls, and plants have a different wall-building system, neither we, nor animals, nor plants are affected by the medicine.

Penicillins and cephalosporins usually don’t cause many problems for a patient. Like all antibiotics, they can cause mild side effects like diarrhea. Less common side effects include rashes (which may or may not imply a true allergy) and hives (which usually means you’re allergic to the medicine). The rarest — and scariest — side effect is “anaphylactic” allergy, in which your airway swells up when you take a dose of the medicine, sometimes to the point where you can’t breathe.

Macrolides (Erythromycin, Klaricid, Azithromycin)

Erythromycin is another antibacterial produced by a mold. There are a couple of new relatives of erythromycin (azithromycin and clarithromycin) that work the same way, but kill more bugs and have slightly fewer side effects. The erythromycin-like antibiotics are also known as macrolides.

Macrolides works by blocking the bacterial cell’s machinery for making new proteins. Since proteins both make up much of the cell’s structure and make the enzymes that direct all the cell’s chemical reactions, blocking protein manufacturing makes the cell unable to function. Macrolides in low doses will stop bacteria from growing and multiplying, but you need a higher concentration to kill the bacteria. However, if you can stop growth until your immune system kicks in, that will help you get rid of the infection.

Since all protein making is affected, erythromycin can slow down or kill any bacteria, even those without cell walls. Because of this, we use the erythromycins for several diseases, including bacterial bronchitis, chlamydia, and whooping cough, that penicillins and cephalosporins can’t touch.

The biggest problem with these medicines is that they can irritate the stomach. Always take erythromycin with food or milk. The same goes for clarithromycin. Azithromycin doesn’t irritate the stomach nearly as much as the others and should be taken on an empty stomach.

Sulfas

The sulfas (more properly “sulfanilamides” or “sulfonamides”) were the first man-made antibiotics to be developed. They interfere with certain “manufacturing” systems in the bacterial cell, including ones that bacteria use to produce new DNA for new bacteria. Sulfas can stop bacteria from growing, but they cannot actually kill the bacteria.

Sulfas also have a tendency to produce allergic reactions. We use sulfas nowadays mainly in combination with another drug which attacks a different part of the bacteria. The drugs we usually combine with sulfas are either erythromycin or trimethoprim

Trimethoprim-Sulfamethoxazole (Septra, Bactrim)

Trimethoprim (TMP) is another man-made antibiotic. Like the sulfas, trimethoprim blocks an important step in the bacteria’s system for making new DNA — but it’s a different step. By itself, TMP can kill bacteria, but very slowly. Usually, though, we use TMP in combination with sulfamethoxazole (SMX), and the combination of TMP and a sulfa kills bugs better. In fact, bacteria that are partly resistant to either TMP or SMX can still be killed by the combination of the two. The combination is widely used for urinary tract infections, airway and skin infections.

Nitrofurantoin

Nitrofurantoin is another synthetic antibiotic, used mainly for urinary tract infections.(Since it is excreted in the urine, it concentrates in the bladder very nicely.) Nitrofurantoin stops bacteria from growing, and can kill bacteria with a high enough level, by blocking the bacteria’s ability to use energy it makes by “digesting” nutrients like sugar, and by blocking other chemical reactions that use the same system. It should be taken with food ie yoghurt to prevent upset stomach. Resistance is limited and it can be taken safely during pregnancy

Aminoglycosides (Gentamycin, Tobramycin)

The aminoglycosides are drugs which stop bacteria from making proteins; they work by attaching permanently to the protein machinery. Since they attach permanently, the bacterial cell will die if it gets enough of the drug. They can be used by themselves, or along with penicillins or cephalosporins to give a two-pronged attack on the bacteria.

Since aminoglycosides are broken down easily in the stomach, they can’t be given by mouth and must be injected or given IV When injected, their side effects include possible damage (temporary or permanent) to the ears and to the kidneys; this can be minimized by checking the amount of the drug in the blood and adjusting the dose so that there is enough drug to kill bacteria but not too much of it. Generally, aminoglycosides are given for short time periods, and in hospital settings.

Chinolones

The chinolones or quinolones, of which the best known is ciprofloxacin (Cipro®:), interfere with an enzyme called DNA gyrase that is essential for duplication of bacterial DNA. (Bacteria have only one long chromosome (DNA molecule); the chromosome gets twisted during replication, like a telephone cord, and, again like the telephone cord, the chromosome can become so twisted that nothing more can be done with it. DNA gyrase is the “untwisting” enzyme.) This interference is completely different from the interference of other antibiotics with bacterial “machinery”, and so bacteria that are resistant to other antibiotics may be sensitive to the chinolones.

However, bacteria can develop resistance to the chinolones, too.

Chinolones should not be taken together with calcium or antacids since it reduce the absorption.

Tetracyclines (Doxycyline)

Tetracycline kills bacteria and protozoa by inhibiting the manufacture of specific proteins needed by the organisms to survive.
Tetracycline Antibiotics is a group of antibiotics produced by certain sepcies of the fungus Streptomyces. Tetracycline drugs (also known as broad-spectrum antibiotics) are effective against many different types of bacteria.

Doxycycline is used in the treatment of infections of the skin, bone, stomach, respiratory tract, sinus, ear, and urinary tract. Lyme disease and certain sexually transmitted diseases (gonorrhea and chlamydia) can also be treated with Doxycycline. Doxycycline is also recommended for the treatment of Anthrax.

Tetracyclines enhance sensitivity for sunlight and are preferably taken on empty stomach.