Prevent Common Prescription Mistakes

Common Medicine Mistakes
Doctor writing prescription

Common Medicine Prescription 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.

Tip #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).

Tip #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.

Tip #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 to 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.

Tip #4

Scared to tell your doctor about natural herbal products you are taking? In that case you belong to the majority, but do not interpret 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.

Tip #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.

Tip #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.

Tip #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)

Tip #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.

Male Menopause, Does Testosterone Replacement Benefit?

Male Menopause, Does Testosterone Replacement Benefit?

For decades, older women have taken hormone replacements to replenish estrogen and progesterone levels lost to aging, called Menopause. We have learned during the years that hormone replacement can be beneficial but not without risk for the stimulating effects of the hormones. Long term use (>5 yrs) is therefore advised in general for women. More recently, testosterone (the most important male hormone) supplements have been used by aging men to improve their quality of life, Male Menopause or Andropause has been described as the male decline in testosterone levels. In 2003, the number of elderly American men taking testosterone replacement therapy was already 1 million, and the number has been growing faster in recent years. Lets have a look at the current studies on effect and safety.

Testosterone and its Effects


It’s not clear that naturally falling testosterone levels cause any signs and symptoms in men. Studies of men who have very low levels of testosterone due to diseases and treatments may offer some clues to the role testosterone plays in a man’s body as he ages. According to those studies, testosterone deficiency can have several effects on the body, including: Decreased sexual function , Loss of bone density, Loss of muscle mass, Increase in fat mass, Reduced muscle strength, Memory loss, Mood changes and depression.

Potential benefits Potential risks
Improve muscle mass and strengthCause skin reactions
Increase bone mineral densityCause fluid retention
Thicken body hair and skinCause baldness
Improve sexual desireStimulate noncancerous growth
of the prostate and cause urinary symptoms
Boost energyCause testicle shrinkage
Decrease irritability and depressionCause acne
Improve cognitive functionStimulate growth of prostate cancer that’s already present
Stimulate blood productionEnlarge breasts
table: pro's and cons of using testosterone supplement

Some men experience these signs and symptoms, but don’t have unusually low levels of testosterone. Others may have low levels of testosterone, but don’t experience any signs and symptoms that would prompt them to seek treatment.

Testosterone replacement therapy can help older men deficient in the hormone reduce their risks of heart disease, diabetes, and death, according to new research presented at the annual meeting of The Endocrine Society.

The goal of testosterone treatment is to keep the levels within normal range. Low levels of testosterone are common with age, occurring in about 20% of 70-year-olds. Low levels of testosterone are associated with the metabolic syndrome — a cluster of risk factors such as abnormal cholesterol and high blood pressure that boost risk of heart disease, stroke, and type 2 diabetes as well as other risks to health.

The Studies found that testosterone replacement therapy reduced the metabolic syndrome risk factors and did so in a similar way in all the age ranges studied.

Testosterone Replacement Therapy and Heart Disease Risks

In the first study 95 men, aged 34 to 69, with low levels of testosterone were included.
All had metabolic syndrome. Those who have this diagnosis must have three of five risk factors: increased waist circumference, low “good” cholesterol or HDL, high triglycerides, elevated blood pressure, and elevated blood sugar.

They were treated for at least a year. Every three months, they measured cholesterol, waist circumference, and other parameters.

The testosterone replacement was given as a long-acting injection (Nebido), every three months. The men were not given a special diet or exercise program.

The supplemental testosterone reduced total cholesterol, “bad” LDL cholesterol, triglycerides, and body mass index while improving “good” HDL cholesterol. The men lost their pot bellies, appr. three or four inches off the waist, and a reduction by one-fourth to one-third of their total cholesterol. No adverse effects were reported.

Testosterone Replacement Therapy: No Age Effects?

In a second study, the same 95 men were divided into three groups, based on age: less than 57, 57 to 63, and older than 63.

They found the older men and the younger men had similar improvement in their risk factors.

Precautions with testosterone supplementation

It is well known that with prostate cancer, the cancer is usually dependent on testosterone. Prostate cancer is a slow-growing tumor. Cancer must be ruled out before starting supplements, and routine prostate checkups are advised.

A test to monitor red blood cell formation, called a hematocrit, is needed, too. The potential increase in red blood cells, can theoretically boost heart attack or stroke risk.

Testosterone and Death Risk

Low testosterone levels are associated with an increased risk of death, according to Robin Haring, a researcher from Germany.He evaluated data on nearly 2,000 men, aged 20 to 79, following them for seven years until August 2007. He noted testosterone levels, age, weight, smoking habits, and physical activity. During the follow-up, 226 men died. Men with low testosterone have a more than twofold higher risk of death during the follow-up period.

They were more likely to die of cardiovascular disease and cancer, but not of other causes.

Testosterone Replacement Therapy: Long-Term Effects Unknown

The problem area  about supplemental testosterone is the lack of knowledge on long-terms effects. Testosterone [in excess] can increase blood pressure and compromise kidney function. These problems can be seen with bodybuilders using large doses of testoterone or an equivalent derivative. If health risks with the low supplementation to “natural” levels can induce similar problems has not be seen yet in studies, sideeffects were not significant but patients were also filtered on possible prostate problems. With influx of new ways of taking TRT we wonder how this market will develop. Low testosterone levels are not [yet] indicated as a disease so reimbursement by insurance is nill. Dermal patches and gels and (long acting) injections range in price between $20 – 200 monthly excluding the tests and consultation fees.  Allthough the studies show that restoring testosterone when it is low improves metabolic syndrome factors and could help prevent type 2 diabetes and cardiovascular risks as with other therapies lifestyle changes can also have a significant effect on the hormone levels and the mentioned risk factors, especially the good old watch what you eat (and how much) and exercise !