Prevent adverse drug interactions by managing medicine

Open the top of the far left square of a plastic case labeled “S” for Sunday, and a handful of pills are ready to be taken. They are all different shapes and sizes, prescribed by different doctors. Some are supplements recommended by a friend. Taking them will help a patient reach their maximum health. 

 Or will it?

   Adverse drug interactions are common and can be quite serious, according to Carma Hanson of Safe Kids Coalition and pharmacist Erin Navarro of Altru retail pharmacy.

   Mixing or overdosing on medications can lead to unpleasant symptoms including upset stomach and cause damage to major organs such as the liver and kidneys.

  Common mistakes

   When a sick person staggers to the medicine cabinet, sometimes it’s difficult to judge what should be taken.

   Navarro says this often leads to overlapping medications. For instance, if a person witha cold takes Tylenol for fever and Nyquil for cough, they could be damaging their liver. Nyquil has Tylenol in it, so even taking the appropriate amount of each medicine is still too much.

   Navarro says overlapping Tylenol is the most common toxicity issue she sees.

   Carefully reading labels and taking note of the active ingredients in overthe-counter medications is an important step in avoiding overlapping medications.

   Navarro also says athletes often take pain medicine before competing in sporting events to prevent pain and play through injuries.

   Combining pain medication and strenuous activity or dehydration can cause kidney failure, leading the athlete to need dialysis or a kidney transplant.

   It’s better, she says, to only take over-the-counter medications when they are absolutely necessary.

   Rash or nausea that develops while taking medications can bea sign of an adverse interaction. Hanson recommends discontinuing the medication and talking to a doctor or pharmacist immediately.

   Hanson says prescription medications are also commonly misused. She says it’s important for people to take prescriptions only according to their doctor’s directions.

   “There’s a reason for those directions,” she says.

   Taking expired medicine is another common mistake people make.

   Navarro says, just don’t do it.

   When shopping for overthe-counter medicines to keep on hand, she says buy small quantities, so all the pills will be taken before the expiration date.

   She also suggests “spring cleaning” to eliminate any expired medications.

  Disposal

  When it comes to getting rid of expired medications, many people choose to flush or trash pills. Navarro says this is impacting water supplies, creating health risks for people and animals.

   Instead, medicines should be placed in a drop box at the Grand Forks police station (122 S. 5th Street) where they will be removed and incinerated appropriately.

   Hanson says that is the best way to dispose of medications.

   Navarro adds that some pharmacies will take back unused medication, as well.

  Storage

   Just because the cabinet in the bathroom is called a medicine cabinet doesn’t make it the best place to store medication, Navarro says.

   She says one of the first things she learned in pharmacy school is that medicine breaks down in steam and heat, making the bathroom one of the worst places to keep medication.

   She suggests finding a cabinet in the kitchen to store medication. She also encourages patients to store all medication in one place, where it’s easy to keep organized.

   Hanson adds that medicine should be stored out of children’s reach and locked up.

   She says people often don’t think of medication as a poison, but it’s the most common substance children accidentally poison themselves with.

   Colorful, gummy vitamins that look like candy are especially tempting to children, Hanson says. While one of these supplements each day can be beneficial, much more than that can cause serious health problems.

   Likewise, adult medications can be extremely dangerous even in small quantities when a child takes them because of the difference in body size and metabolism. Topical medications such as diaper ointment or eye drops can also lead to serious health problems if ingested.

  Talk to your doctor

   It’s important to consult a primary care physician about any medications being taken.

   Navarro and Hanson both say this should include any homeopathic remedies, herbal supplements or vitamins. Often prescription medications can interact with these supplements and cause health problems.

   “Just because it’s a supplement doesn’t mean it’s for everyone,” Navarro says.

   If the physician isn’t told about over-thecounter medications and supplements, they won’t be able to anticipate any adverse interactions.

   Hanson says often people don’t think of alternative remedies or supplements as medication, but they can impact how the body processes prescribed medication.

   They suggest bringing all medications and supplements to doctor visits and regularly going through each one with the primary doctor to determine what should be eliminated.

   Keeping the primary care physician updated on what is being taken is essential to make sure medicines are benefitting and not harming the patient.

   Navarro says, for patients with chronic conditions, this is especially important because their bodies might not react to medications in the same way a healthy body would.

   If a chronic condition exists, it’s important to consult a doctor about which over-the-counter medications are safe.

   Navarro also suggests using the same pharmacy for all medications, so a pharmacist can help identify any adverse drug interactions and monitor use.