Chances are you take a medication regularly — about 80 percent of us take a pre scri ption or over-the-counter (OTC) medication, dietary or herbal supplement at any time. A third of us take five or more at a time, and more than half of older Americans take at least three medications. So let’s talk about your pre scri ptions – or rather, your medications since some of what you take may not require a physician to prescribe it.
Even if the only medications you use are prescribed by a physician, seeing more than one physician increases the chance that one or all of them are not fully aware of your current medications. Without a universal standard for an electronic medical record, each of your physicians relies on written communication to update the others with changes.
If you are seen in a hospital or out of town at an urgent care clinic, telling the doctors you take a blue pill for your blood pressure and a red pill for your heart is like traveling to someplace just by driving in the general direction without a route plan. It might work but only with a lot of luck.
The great thing about 21st-century medicine is that there are many treatments for conditions that physicians could not treat or perhaps did not realize needed treatment in the 20th century. The major killers, high blood pressure, diabetes and high cholesterol, now can be effectively treated in most people. Even smoking addiction can be treated with very effective medication.
Medications are helping us prevent disease and remain productive well into old age, but they must be used properly. Physicians must understand the drugs completely in order to prescribe them properly, but the average patient probably does not have the background to fully understand prescribed and OTC meds. However, every person on a medication must understand some basic information in order to get the best results and reduce the risk of harm from the medications.
Every patient or his/her caregiver must know the name of the medication and why it is prescribed. Some medications can be used for many different problems; Misunderstanding that a medication typically used for blood pressure is now being prescribed for a kidney problem could cause serious issues if a doctor makes a change in the blood pressure medication and the patient instead applies the directions to the kidney medicine.
Drug names can be intimidating, particularly generic names. Remembering drug names need not be scary; repetition increases familiarity. If we can remember the names of celebrities such as Charlize Theron or countries like Azerbaijan, surely we can remember the words hydrochlorothiazide or lisinopril.
Maintaining a current list of all pre scri ption and OTC meds by trade and generic names and reason for use can help us remember our medications and to maintain an accurate and up to date record. Carry the list with you in a wallet or purse. If any medications are changed, have the list updated immediately. An accurate list avoids confusion and guessing.
Understand whether the medication is to be continued indefinitely or stopped at some point or used just for a particular symptom. Some medications are meant to be continuous and others just as needed. It’s important to know this for every medication used.
All medications, even OTC and nutritional supplements could have side effects. The list of side effects that often accompanies a pre scri ption does not indicate what will happen but what might happen. Most of the time, side effects never occur. Your physician is the best source for what side effects would be most likely to occur and what to do about them.
Find out if there is something you should be noticing to determine the medication is working. Often there is nothing the patient can measure, but if there is, you should know it.
With the wide variety of medications available, there is a possibility of interactions among them. The risk increases as the number of medications prescribed increases although it is possible to take several medications that are completely compatible one with the other. Your physician is in the best position to advise you about this. That is why it is essential that your primary physician be aware of all medications you are taking.
While your pharmacist can tell you about potential interactions, not all interactions are a problem and some are used therapeutically. For example, blood pressure medications that increase potassium levels are often used with blood pressure medications that lower potassium to balance the effect. Your primary physician can interpret for you how important an interaction is.
Modern medical care is the result of teamwork among the primary physician the patient, and other medical personnel involved in your care. When you ask your physician questions about your OTC and pre scri ption medications, you are not questioning your physician’s judgment. Rather you are increasing your understanding and the likelihood that the desired result will be achieved. So, next visit, talk about your pre scri ptions.
John Messmer is associate professor of family and community medicine at Penn State College of Medicine and a staff physician at Penn State Hershey Medical Center.
