U S I N G M E D I C I N E S A F E LY

P N W 3 9 2S E P T E M B E R 1 9 9 3

A P A C I F I C N O R T H W E S T E X T E N S I O N P U B L I C A T I O NO R E G O N • W A S H I N G T O N • I D A H O

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V I C K I S C H M A L L , E X T E N S I O N G E R O N T O L O G Y S P E C I A L I S T A N DJ A N I C E L E N O , E X T E N S I O N A G E N T , J O S E P H I N E C O U N T Y , O R E G O N S T A T E U N I V E R S I T Y

These individuals contributed significantly to this publication: GeorgeConstantine, professor of pharmacy, Oregon State University; William J.Falbe, clinical pharmacy consultant, Veterans Administration MedicalCenter, Nashville, Tennessee; William Simonson, associate professor ofpharmacy practice, and adjunct associate professor of medicine (geriat-rics), Oregon Health Sciences University, Portland, Oregon; and RonThalman, pharmacist, West Linn, Oregon.

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C O N T E N T S

INTRODUCTION

WHAT YOU SHOULD KNOW ABOUT YOUR MEDICINES

HELPING YOUR DOCTOR HELP YOU

WORKING WITH YOUR PHARMACIST

TAKING MEDICINES SAFELY

STORING MEDICINE

KEEPING TRACK OF TAKING MEDICINES

YOUR PRESCRIPTIONS: QUESTIONS TO ANSWER

HOOKED ON A PRESCRIPTION DRUG?MEDICINE CHART

WEEKLY CHECK-OFF CHART

CONCLUSION

If you would like additional copies of this publication, PNW 392, UsingMedicine Safely, send $1.50 per copy to: Publications Orders, AgriculturalCommunications, Oregon State University, Administrative Services A422,Corvallis, OR 97331-2119. We offer discounts on orders of 100 or morecopies of a single title. For price quotes, please call (503) 737-2513.

For additional information about the effects of medicines on olderpeople, please read PNW 393, Using Medicine Safely in Later Life.

edicines today are powerfulchemicals that are more ef-fective than ever before.

Used carefully they can work won-ders. However, both prescription andover-the-counter (nonprescription)medicines can create problems, espe-cially if misused or abused. You prob-ably try to find out about movies andrestaurants before going to them, howto use new appliances, and what todo if a product does not work well.It’s even more important to get goodinformation about your medicines.Protect your health—be knowledge-able about the drugs you take.

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W H AT Y O U S H O U L D K N O WA B O U T Y O U R M E D I C I N E S

One of the most effective weaponsagainst problems with medicines is toget all the facts. Here’s what you

should know about each medicine you take.

Name. Know either the brand name or thegeneric name.

Purpose. Find out what the drug is for andhow it is supposed to help. Should it reducepain or fever? Should it lower blood pressureor cure infection?

How and when to take it. Find out whenand how often you should take the medication.Should you take it before, with, or after meals?Should you take it at bedtime? If it is prescribed“as needed” what does that mean? What shouldyou do if you miss a dose?

How long to take it. Many medicines needto be finished completely or continued forseveral days even though you feel better. Stop-ping a medicine too soon may not allow it towork completely, resulting in a relapse or flare-up of the original problem. Other medicine isintended only for a short time and should notbe continually refilled unless necessary.

What to expect. Know what results toexpect from the medicine and what to do ifthese results do not occur.

How quickly it will work. Find out howlong it should take for the medicine to work.Some medicines act quickly, for example, nitro-glycerin for angina (chest pain). Other medi-cines take time to work; for example, antide-

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pressants may take four weeks or longer to beeffective and some drugs for arthritis may takeseveral weeks to ease pain.

Possible side effects. Any medicine canhave side effects. Side effects may be of noclinical significance, for example, a change inthe color of urine or loose bowel movements;or they may be serious, for example, dizziness,sexual dysfunction, memory problems, or de-pression. Ask your doctor:• What are possible side effects I should be

aware of?• What should I do if side effects or unexpected

reactions occur?• When should I call you about side effects?

Cautions and warnings. Know any cau-tions you should observe while taking themedicine. Ask your doctor:• What foods, beverages, or other medicines

should I avoid while taking this medicine?• Should I avoid drinking alcohol?• Are there activities I should avoid? For ex-

ample, should I avoid driving a vehicle,operating machinery, or exposure to the sun?

Ask your doctor or pharmacist questions. Ifyou don’t understand how or why to take yourmedicine, you could make a serious mistake. Ifyou’re not sure about directions, ask yourpharmacist or doctor rather than guessing. Ifyou have difficulty hearing or rememberinginstructions, ask your doctor or pharmacist towrite them down. Many prescription drugscome with printed information. Ask your phar-macist if an information sheet is available foryour medication.

H E L P I N G Y O U R D O C T O R H E L P Y O U

You and your doctor are partners whoshare a common goal—your good health.Using your medications wisely and

safely requires good communication betweenyou and your doctor. Follow these guidelinesto ensure you’re getting complete instructionsfrom your doctor.

Be prepared to provide your doctorwith complete and accurate information.Before your appointment, make a list of thefollowing:• Your symptoms. Describe the symptoms you

have experienced—for example, changes insleep or bowel habits, headaches, pain, orfatigue. Be clear, specific, and concise. Thishelps the doctor make a proper diagnosisand determine the best treatment.

• Allergies. List any allergies and reactions youhave to foods and other substances.

• Adverse medication reactions. List all medi-cine you have had a negative reaction to,describe the specific reaction, and when itoccurred.

• All medicines you are taking. Write down thenames of all medicines you take, includingthose you bought without a prescription—such as aspirin, cold remedies, antacids, andlaxatives—and those prescribed by otherdoctors. Doctors need to know about over-the-counter medicines you take becausesome can significantly impact the effective-ness of prescription medicines. Every doctoryou see needs to know all of the medicinesyou are taking. Without this information, adoctor may prescribe a medicine that issimilar to one you are already taking—andyou could end up with a double dose—or a

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medicine that may interact dangerously orcancel the effects of another medicine.

• Other medicinal preparations. Share informa-tion about substances such as herbs, vitaminor mineral supplements, extracts, and beepollen that you are taking. Tell your doctorthe amount and frequency with which youtake such preparations.

• Caffeine and alcohol consumption. List theamount of coffee, tea, soft drinks, and alco-hol you drink in an average day.

• Smoking habits. Write down the number ofcigarettes, cigars, or pipes you smoke daily(or the amount of tobacco you chew).

Make a list of questions to ask yourdoctor. If the doctor does not have time toanswer your questions, ask who in the officecan. Answering your questions is part of thedoctor’s responsibility.

Be sure you understand what your doc-tor tells you. Tell the doctor if you do notunderstand any terms used or instructionsgiven. No question that you have is a “dumb”question. You have a right to information aboutyour health and prescription drugs in languageyou can understand. If you have difficultyhearing, or if language is a barrier, arrange forsomeone to go with you or have the doctor putexplanations and instructions in writing.

Keep a medicine chart. (See page 15.)Take the chart with you when you visit yourdoctor. Ask questions about the medication’spurpose, side effects, dosage, description, andspecial instructions so that you can fill in infor-mation about each medicine.

Tell the doctor if you think you mayhave problems taking a medicine. If youthink you will not be able to take a medicineas directed, say so and be specific about thereason it will be difficult.• Is cost of medicine a problem? Ask if a less

expensive and equally effective generic drugis available.

• Is the schedule for taking the medicine toocomplicated? If so, perhaps your doctor canprescribe an equally effective medicine thatcan be taken once a day instead of threetimes a day.

• Do you feel you should be able to solveyour health problem, for example, depres-sion, without taking drugs? If so, explain this

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so the doctor can explain the advantages ordisadvantages of the medicine.

• Do you think you will have difficulty actuallytaking the medicine—swallowing the pills,giving yourself an injection (for example,insulin), putting drops in your eyes, or in-serting a suppository?

The better the information you share, themore it can help your doctor prescribe medi-cine that will work for you and the conditionbeing treated.

Once you leave the doctor’s office, you areresponsible for obtaining your medicines andtaking them as instructed. You have a need—and a right—to know how to do this properly.

W O R K I N G W I T H Y O U RP H A R M A C I S T

our pharmacist is the best person to talkto about all of your medications. A phar-macist can do the following:

Provide reliable information on allmedicines. The pharmacist is an expert onboth prescription and over-the-counter medi-cines. The pharmacist is knowledgeable aboutpossible side effects, drug interactions, andhow to properly use medicines.

Verify what your doctor said. Perhapsyou did not get enough information or are notcompletely clear about what the doctor toldyou about a medicine. Your pharmacist canverify what your doctor said and answer yourquestions.

Monitor the medicines you take. It isimportant to always use the same pharmacy. Ifyou are a regular customer, the pharmacy maykeep a record of the medicines you purchaseor a complete patient medication profile.

Keep a patient medication profile. Apatient medication profile tracks your medicineand allergy history, medical conditions thatneed to be considered, and all the medications(prescription and over-the-counter) you take. Itoffers these advantages:• Serves as a check against taking medicines

that you might be allergic to.• Reduces the possibility of taking a medicine

which your medical history indicates is notappropriate.

• Helps prevent undesirable drug interactions,especially when you are taking medicinesprescribed by more than one doctor.

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• Enables the pharmacist to alert you and yourdoctor to potential problems with your medi-cines.

• Enables the pharmacist to better monitorwhether you are taking your medicinesproperly, and remind you when you need aprescription refill.

• Enables the pharmacist to better advise youabout over-the-counter medicine.

Buying all of your medicines from onepharmacy that maintains a patient profile forcustomers can help prevent medication prob-lems. Choose one pharmacy that you like andstick with it. To select a pharmacy, ask thesequestions:• Do you keep patient profiles?• How is the patient profile used? Some phar-

macies keep records primarily for paymentand tax purposes; others keep records whichare more complete. Choose a pharmacy thatuses the profile to screen for possible druginteractions and allergies.

• When is the patient profile checked? Choose apharmacy that checks your record for poten-tial drug interactions each time you fill aprescription.

In addition, choose a pharmacy where thepharmacists take time to explain your medicineto you and answer your questions. Some phar-macies have designed a special area where youcan privately discuss questions or concerns youhave about your medicines.

If you move and change pharmacies, re-quest a copy of your profile. This could behelpful to the new pharmacist—and a newdoctor.

T A K I N G M E D I C I N E S S A F E LY

he federal government takes precautionsto ensure that the medicine available to usis safe and effective. Doctors and pharma-

cists can help. But ultimately, each one of us isresponsible for how we take our medicines.Here’s what you can do to ensure you aretaking your medicines safely:

Take medicine in its original form.Never crush pills or open capsules to makethem easier to swallow, unless approved by ahealth care professional. Changing the form ofmedicine may alter its stability and absorption.Some medications are coated to protect themfrom gastric enzymes or to protect the stomachfrom drug irritation; if crushed or broken, theymay not work as intended.

Drug overdose can result from changingthe form of medicines. Some medicines aredesigned with multiple coatings of time-releasebeads that permit slow absorption of the medi-cine. When time release capsules are crushed,a greater than normal amount of the medicineis released, and overdose or intense side effectscan occur.

Take medicines with water. Water is thebest beverage for taking medicines. Drink a fullglass.• Do not mix medicines into hot drinks. Hot

temperatures can destroy the effectiveness ofcertain drugs.

• Do not swallow medicine with alcohol. Alco-hol can dissolve coatings on time-releasedtablets and capsules, causing too much medi-cation to be released too soon. Drinking evena small amount of alcohol with certain medi-cines can greatly increase the depressant

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effect on the brain. Mixing alcohol and medi-cine may cause excessive drowsiness, coma,or death. Drinking alcohol is particularlydangerous with the following medicines:• Antihistamines• Tranquilizers, sedatives, or barbiturates• Antidepressants• Pain medication

Do not mix medicines with food. Forexample, do not crush a pill and put it in yourapplesauce, unless your doctor or pharmacistapproves. Although it may be easier to take amedicine mixed with food, it may alter amedication’s effectiveness. If you are givenapproval to mix a medicine with food, mixonly one dose at a time just before you take it.

Read the label before taking medicine.Make sure you are taking the right medicinebefore you take it. Get into the habit of verify-ing the name on the label, not just the shape orcolor of the container.• Never take medicine in the dark, no matter

how sure you are about its location. Turn onthe light and read the label.

• If you wear glasses, make sure you havethem on when you take your medicine.

• If the print on labels is too small, ask thepharmacist to write instructions in large print.

Discard medicines that are old or havechanged. Don’t take any medicine that isexpired, decayed or changed, in an unlabeledcontainer, or no longer needed. Throw it out.

Medicines do not last indefinitely. Manufac-turers conduct tests to determine the length oftime a given drug stays active and can be stored

safely. The expiration date is valid only if amedicine has been stored properly. Medicinewhich has changed in color or odor, is crumbly,or appears different in any way may be toxic orhave lost its effectiveness. An expiration date ison all prescription and over-the-counter labels.

Keep an up-to-date medication record.This should include all prescription and over-the-counter medicines, their dosages, and howlong you’ve taken them. Share this record withyour doctors. This is particularly important ifyou see more than one doctor. This recordhelps your doctors prescribe medicine thatwon’t interact badly with another. You can usethis record to occasionally review your needfor medication with the doctor.

PRESCRIPTION MEDICINEThe use of some medicines must be closelymonitored and controlled. You should keepyour doctor informed about your health condi-

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tion and follow prescription instructions care-fully.

Take medicines as directed. If you do notfollow the instructions exactly, your medicinesmay not work properly.• Don’t change the dosage or schedule with-

out checking with your doctor. Increasing ordecreasing a dosage or taking a medicinemore or less often than prescribed can seri-ously reduce its effectiveness. “More is bet-ter” does not apply to medicine.

• If you miss a dose, don’t take a double doseto make up for it.

• Don’t try to save your medicine. Take medi-cine as prescribed to protect your health; it isfar less expensive than hospitalization.

Tell the doctor if you didn’t have a pre-scription filled or didn’t take the pre-scribed dosage. Otherwise, the doctor maythink the treatment is not working and prescribeanother medicine—which may be less effective

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or have more side effects than the original medi-cine—when the problem is that the medicinewas not taken as directed. Keep a record of anydoses you miss and share this with your doctor.

Take medicine until the doctor tells youto stop. Even if the symptoms have disap-peared and you feel better, continue taking yourmedicine as directed until it is gone. If you stoptaking it too soon, the symptoms may return orworsen. If you feel a medicine is not doing whatthe doctor said it would do, or if it seems to becausing more harm than good, call your doctor.

Take medicines prescribed only foryou. Sharing prescription medicines is danger-ous. Never take medicines prescribed for some-one else or lend medicines to others. Eventhough your symptoms appear to be the same,you may be suffering from an entirely differentproblem.

Prescriptions are written based on aperson’s health problem, physical condition,age, and weight. What is safe and effective forone person may produce side effects, no relief,or a severe reaction for another person.

Know what the prescription label infor-mation means. Labels provide informationabout how to use medicine. But, sometimesinstructions may not be clear or correctly un-derstood. For example, do you know whatthese instructions mean?• Take as directed. What were the directions?• Take three times a day. Around the clock or

during waking hours? Do you take at specifictimes evenly spaced, such as 7 A.M., 3 P.M.,and 11 P.M., or do you just take three dosesany time during the day?

• Take as needed. As needed for what? Whatdetermines need? Headache, back pain, or...?Does “as needed for pain” mean severe painor should you take it for minor discomfort?

• Take two tablets daily. When? Morning orafternoon, or one in the morning and one inthe afternoon?

• Take before bedtime. Immediately before bed

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or 1-2 hours before?• Take before meals. Immediately before meals

or 1-2 hours before?

If instructions seem vague, ask your pharma-cist to advise you about when and how to takeyour medicine so you get the most benefit.

Carry a medication record card in yourwallet. The card should list important factsabout your health, such as health problems,medications you take, and drugs to which youare allergic. It could save your life! The infor-mation is helpful if you are involved in anaccident, if you faint, black out, or you areaway from home and require medication.Emergency staff can give you better treatment ifthey have this information.

Wear an emergency medical identificationbracelet or chain if you are allergic to a medi-cine or other substances (for example, beevenom), or if you have a medical condition,such as diabetes, that affects how you should be

Prescription NumberPatient’s NameMedication Dosage InstructionsName of DrugRefill InformationDate Prescription Filled

➀➁➂➃➄➅➆➇➈➉

Doctor’s NameQuantityDrug ManufacturerPotency Expiration Date/Pharmacist’s Initials

Ron Thalman’s

R o b i n w o o d P h a r m a c y19137 Willamette Dr. • West Linn, OR 97068635-3516

No. 215231Ronald BakerTake one tablet daily

LANOXIN 0.25MG

Dr. Morita, L.

# 100Refills 8 of 9 Burroughs Well11/12/91 Discard After 12/93 RT

➀➁

➂

➃➄

➅

➆

➇➈➉

treated in an emergency. Contact your pharma-cist or MedicAlert (1-800-432-5378) for an emer-gency medical identification to keep with youat all times.

PERSONAL MEDICATION INFORMATION

ALLERGY:ALLERGY:ALLERGY:

CURRENT MEDICATIONS:

MY DOCTOR IS:

MY PHARMACY IS:

PH:

PH:

PH:

Do not ask the pharmacist forunprescribed refills. Refrain from asking yourpharmacist to refill a prescription without con-sulting with your doctor first. A pharmacist islegally obligated to only dispense medicineprescribed by a medical doctor. Some medi-cines are habit forming; others should not betaken for extended periods of time. Generally,automatic refills should be avoided. Your medi-cation should be reevaluated at regular intervals.

OVER-THE-COUNTER MEDICINEGive as much care to taking over-the-countermedicine as you give to taking prescriptionmedicines. Over-the-counter medicine differsfrom prescribed medicine in that the activeingredients, mix of ingredients, and recom-mended dose are considered relatively safe.

If taken in large dosages, some over-the-counter medicines are equal in strength toprescription medicines. Some medicine thatformerly required a prescription is now avail-able over-the-counter. For example, the painreliever ibuprofen is now a common ingredientin many over-the-counter medications.

Don’t use any over-the-counter drug longerthan recommended on the label without firstchecking with your doctor or pharmacist.

Just because a medicine can be purchased

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without a prescription does not mean it is 100percent safe. Over-the-counter medicines cancreate problems in these ways:• Change the effect of prescribed medicines.

Over-the-counter medicine may make aprescribed medicine either stronger or lesseffective. As a result, the doctor, unawarethat you are taking over-the-counter medica-tion, may mistakenly decrease or increasethe dosage of the prescribed medicine.

• Mask symptoms of disease. Antacids, forexample, taken for an upset stomach maycover up warning symptoms of ulcers anddelay diagnosis and treatment.

• Lead to overdose. An over-the-counter medi-cine can have effects similar to a prescribedmedicine. Combined, the medications maylead to drug overdose.

• Alter normal body function. Habitual use oflaxatives and enemas, for example, candecrease normal bowel function.

• Aggravate existing health problems. Forexample, antacids may produce magnesiumtoxicity in some patients with kidney prob-lems. Some antacids contain large amountsof sodium (for example, Alka Seltzer andBromo Seltzer), and should not be taken bypeople on low-sodium diets because it mayalter their blood pressure.

Read the label on the package. Labels forover-the-counter medicines have detailed infor-mation. Reading and understanding productlabels is critical to using over-the-counter medi-cines safely. It’s especially important to readlabels carefully if you have a special healthproblem or are on a special diet. For instance:• If you have high blood pressure or diabetes,

you should not take decongestants unlessprescribed by a doctor.

• If you have high blood pressure, or are on alow sodium or salt-free diet, you shouldavoid products containing sodium bicarbon-ate (a common antacid) or other forms ofsodium. Labels provide ingredient informa-tion and may indicate whether a product isconsidered salt-free or low in sodium.

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Read the label before purchasing an over-the-counter medicine so you are sure it is safefor you. Read the label even if you have pur-chased the product before because ingredientschange. New warnings are sometimes added.Watch for label banners or flags indicating asignificant product change. Be sure you under-stand the following:• Indications for use. Is the drug meant to be

used in the way you plan to use it?• Ingredients. Does the product contain any-

thing you should avoid?• What are the active and inactive ingredi-

ents? What do they do?• Are you allergic to any of the ingredients?• Are you sensitive to any ingredients

because of a chronic health condition?• If you are on a low-salt diet, what is the

sodium content?• If you are on a low-sugar diet, what is

the sugar content?• Warnings. What are the product warnings?

• Who should not take the medicine?• Should you use it for a short time only?• Are you currently taking any medicine that

the medication should not be taken with?• Are there any foods or beverages you

should avoid while taking the medication?• Are there any circumstances under which

a person should see a doctor beforetaking the medicine?

• What are the symptoms that indicate themedication should be discontinued?

• When should a doctor be consulted ifsymptoms persist?

• Directions. What are the directions for takingthe medicine?• What is the appropriate dose?• How often should it be taken?• How long should it be taken?• How should it be taken?

• Cautions. What should you be cautiousabout with this product?• Are there any activities you should avoid

while taking the medicine (for example,driving, drinking alcoholic beverages)?

• Can you follow the cautions?

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• What should you do in the case of anoverdose?

• What are possible side effects? What sideeffects might you expect?

• When does the medicine expire? After whatdate should you no longer use the medicine?

Most over-the-counter medicines havetamper-resistant packaging and carry informa-tion about how to check for evidence of tam-pering. Do not take the medicine if packagingor contents are not intact or look questionable.

GENERIC MEDICINEA generic name is the name given when a newmedicine is invented. It’s the medicine’s officialname. A brand name is the name a companygives a drug for marketing purposes. Examplesof generic and brand name medicines are:

G E N E R I C B R A N D

aspirin Bayer, Bufferin, Anacindiazepam Valiumacetaminophen Tylenol

A generically equivalent medicine is usuallyless expensive. Because of the costs that drugcompanies incur in developing, advertising,and promoting their products, brand namemedicines are generally higher in price thanproducts sold under the generic name.

Both brand name and generic medicinesmust meet standards and be approved by theUnited States Food and Drug Administration. Agenerically equivalent drug has the same activeingredients, strength, and dosage as its brandname counterpart. Before switching to a genericmedicine, check with your doctor or pharmacist.

Not all drugs are available in generic form.After developing a new medicine, a companyreceives a patent on it that lasts for 17 years.During this time, no other company can manu-facture it and it is not available in generic form.Ask your doctor or pharmacist to see if a ge-neric drug is available.

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S T O R I N G M E D I C I N E

ow you store your medicines is impor-tant. Improper storage can cause medi-cines to lose their strength, disintegrate,

or even become dangerous because of chemicalchanges. Three common mistakes are:• Putting medicine on windowsills• Keeping medicine in the bathroom• Mixing medications together in one container

Here’s how to safely store your medicines:

Store medicines in a cool, dark, dryplace (unless otherwise instructed). Mostmedicines should be stored between 50-68°F.Higher or lower temperatures, as well as lightand humidity, can alter the effectiveness ofmedicines. Store medicines on a shelf in a hallor bedroom closet, or in a kitchen cabinet thatis not close to the oven or stove, and is out ofthe reach of children, in a locked container.

Do not store medicine on windowsills, inthe bathroom, near heat-producing surfaces orappliances, or in the car. Despite its name, thebathroom medicine cabinet is one of the worstplaces for medicine because of heat and mois-ture. Do not store medicine in the refrigeratorunless instructed to do so. Auxiliary labels tellyou if refrigeration or other special storage is re-quired. If you are not sure about how or whereto keep a medication, ask your pharmacist.

Keep medicines in original labeledcontainers. Medicines are dispensed in con-tainers designed to protect the drug. For ex-ample, brown containers are used for light-sensitive medicines, and glass containers areused for medicines which can be absorbed byplastics (for example, nitroglycerin tablets).

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The label on the original container providesimportant information. Intact labels ensure youknow which medicine is in which containerand in an emergency medical personnel canquickly identify your medicines.

Use the rule of “keeping medicines in origi-nal containers” when you travel. Ask your phar-macist for smaller containers, with labels, foryour medicines. A decorative plastic or metal pillbox or travel case may be unsuitable or may bedangerous because it is unlabeled. Before usinga commercial pill container, talk with the phar-macist about the best type of container.

Store medicine out of the reach of chil-dren and pets. A major cause of accidentalpoisoning is young children taking a parent’sor grandparent’s medicine. All medicinesshould be stored out of children’s reach.Childproof safety caps on medicine and alocked cabinet are best. A locking tackle ortool box works well.

Keep medicine containers tightlyclosed. Caps on medicine containers are de-signed to protect against moisture.

• Check your medicine storage area regu-larly. Flush medicines down the toilet thatare expired, altered in some way, in con-tainers without labels, or no longerneeded. Throw empty containers, notmedicines, into the garbage.

• Store medicines in their original, labeledcontainers, in a place protected from light,humidity, and heat.

K E E P I N G T R A C KO F TA K I N G M E D I C I N E S

o get the most benefit and reduce risksfrom your medicine you must take it asdirected. Sometimes this is difficult, par-

ticularly if you are taking several medicinesdaily, at different times, and with differentinstructions.

An organizer system can make keepingtrack of medicines easier and ensure that youtake the right medicine at the right time. Thereare a variety of organizer systems that you canmake or buy. Having a system that works foryou is what counts.

MEDICINE CHARTA medicine chart is a basic guide to your medi-cine use. It usually includes the following infor-mation:• Drug Name (what it is called)• Purpose (what it is for)• Description (color, shape, other identifying

features)• Directions (when and how it should be

taken)• Special instructions (other pertinent informa-

tion, possible side effects, or precautions)

A large sheet of paper may be used to makea poster-sized chart and a smaller sheet to makea chart you can carry with you when you visitthe doctor or pharmacist, or are away fromhome. If the shape, size, color, or when andhow you should take your medicine changes,correct the description on your medicine chart.

Your doctor or pharmacist may also be ableto help you obtain a personal medicationrecord booklet to help organize your medica-tion information. (See example on page 20).

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WEEKLY CHECK-OFF FOR MEDICATIONSA check-off chart can be used to guide anddocument your medicine schedule. To makeone, use 8 1/2 x 11-inch ruled paper. Startingfrom the right side, mark off seven 3/4-inchcolumns. Label these columns for days of theweek, starting with Sunday. In the column tothe left of the day columns, list the name anddosage for each medicine, and the time to betaken (see example on page 21). Each time youtake a medicine, check it off on the chart. Youmay want to make photocopies of the chart.

COLOR-CODED SYSTEMA coding system, used in combination with amedicine chart or check-off chart, can be par-ticularly useful if you have difficulty readingprescription labels. Use colored self-adhesivelabels or colored markers to code the labels ofthe medicine containers. Put a color mark bythe name of the medicine on your chart thatmatches the color mark on the label of thatmedicine’s container. (If you take more thanfive or six medicines, you may want to useletters of the alphabet instead of colors). Con-sider these suggestions:• Use colors that are distinctly different from

one another. (To some older people, darkgreen, navy blue, and black look the same.)

• Make sure you can see the color clearly, butdo not obscure label information.

• Be sure to mark the medication containers,not the caps. Caps may be returned to thewrong containers.

• When refilling a prescription, be sure to givethe new medicine container it’s proper colorcode.

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CALENDARS Calendars can help remind you to take medi-cation. If you take medicine only once a day,consider using a daily tear-off calendar. Tearoff the dated page after the medicine is taken.

If you take multiple medicines, a calendarwith large squares may be helpful. Mark on eachday when medicine is to be taken. Each timeyou take a medication, check it off in the square.

ENVELOPE SYSTEMSAn envelope system can be particularly usefulif it is difficult for you to open bottles or readmedication labels. There are two types of enve-lope systems:• System One. Put each medicine in a separate

envelope. Write the name of the medication,dosage, and times to take it on the envelope.

• System Two. Put a day’s worth of pills intoone envelope. Label each envelope with theday of the week, the dosage of each medi-cine, and when to take it.

MONDAY

• 1 red pill with breakfast• 1 blue pill one hour

before breakfast and dinner• 1 green capsule at bedtime

SY

ST

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NAME OF MEDICINE

• Dosage (e.g., 2 pills)• Take one hour before meals• Take at bedtimeS

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CONTAINER SYSTEMSA container system works best if you take thesame pills in the same dosages every day and ifit is easy to tell the difference between yourpills. An egg carton works well to make a dailysystem. For example:

1. Label each of the 12 slots for hours of theday.

2. Put the pills into the appropriate slotseach morning.3. Take pills that are in the 8 A.M. slot at that

time, and so on.

E G G S

8 am 9 am 10 am 11 am 12 pm 1 pm

2 pm 3 pm 4 pm 5 pm 6 pm 7 pm

An egg carton also can be used to make aweekly system:

1. Label 7 of the slots according to the day thepill is to be taken.

2. Put the medicine for one day in each of theslots.

3. Write on the inside of the carton lid thetime when each pill is to be taken.

E G G S

Su M T W Th F

Sa

• One pink pill with breakfast• Blue capsule at noon• White pill at bedtime

Commercial medication containers are avail-able for multiple and single dosages by the day

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C O M M E R C I A L C O N T A I N E R S

or the week. You, or a friend or relative, canfill the container for a week and then take yourmedicines at the specified times.

Ask your pharmacist about the differenttypes of systems available. Also, be sure asystem is right for you and that it is easy to use.

Check with your doctor or pharmacistbefore using an envelope or container systemto verify it is suitable for your medicines. Somemedicines must be kept in tightly covered,light-proof containers.

THE CALENDAR (OR BLISTER) CARDThe calendar card is a day-by-day dosage cardfor people who take several medications atdifferent times.

Each card contains 31 separate sections(called blisters) large enough to hold several

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B L I S T E R C A R D

pills or capsules. Each blister has the day of themonth next to it (from 1 to 31), with corre-sponding stickers indicating the day.

A card is prepared by the pharmacist foreach time of day a person takes medicine. If aperson takes medicine four times during theday, four cards are prepared. All doses aresealed into the card. Cards are customized foreach person and repackaged to accommodatechanges in prescriptions.

Ask your pharmacist if your medication canbe packaged and dispensed in a calendar card.You may have to pay a little more for the ser-vice, but if it helps you to take your medicinesproperly, it’s worth it.

After using the calendar card, one 82-year-old woman said, “I now feel I can control myown medicines.” Any system that helps youtake your medicines as instructed is helpful.

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Y O U R P R E S C R I P T I O N S :Q U E S T I O N S T O A N S W E R

B

e sure you know the answers to each ofthese questions when a medicine isprescribed for you. Talk to your doctor

and pharmacist to get the facts.• What is the name of the medicine?• What is the medicine supposed to do?• How long is it likely to be before I feel better?• What are the possible side effects I might

experience from the medicine?• What should I do if side effects occur?• Are there any side effects I should report to

the doctor?• How and when do I take this medicine?• Are there any special instructions for taking

this medicine?• How long should I take this medicine?

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• Are there any foods, beverages, medications,or activities I should avoid while taking thismedicine?

• Under what circumstances, should I stoptaking this medicine?

• What should I do if I miss a dose?• How should the medicine be stored?

Other questions you may want to ask are:• Is this medication really needed?• Is the medicine available in a generic form

that costs less? Is the generic form as effec-tive? If so, can the generic drug be substi-tuted for the brand name medicine?

• Can the prescription be refilled? If so, am I tosee the doctor before having it refilled?

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H O O K E D O N A P R E S C R I P T I O N D R U G ?

Anyone can become addicted to prescrip-tion medicines. Drugs that are used torelieve pain, anxiety, depression, insom-

nia, coughs, and suppress appetite are majorculprits.

If you have been using a prescription drugfor some time, take this self-test to determinewhether you might be dependent.

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PRESCRIPTION DRUG SELF-TESTYES NO

Have family members or your doctorever told you they were worriedabout your use of medicines?Do you get annoyed or uncomfort-able when others talk about youruse of pills?Have you been treated previouslyfor alcohol abuse, prescription drugabuse, or other drug abuse?After having been turned down fora refill, have you ever changeddoctors or drug stores in order toget more of the medicine?Have you been taking diet pills,tranquilizers, pain medicine, orsleeping pills for more than twomonths?Are you using your pills more as acrutch than as a solution to a tem-porary medical problem?Do you take your pills on the sly, orhide that you are taking them?Do you feel you might be addictedto your prescription medicine?

If you answered yes to any of these questions,there’s a possibility you are physically orpsychologically addicted to your medicine. Ifyou have concerns, talk to your doctor.

(This test was adapted from: Hooked OnYou, Hope Health Publications, 1990, page16.)

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M E D I C I N E C H A R T

PRESCRIPTION DRUGS

Description How often How long Possible Special instructionsName/Purpose (color,shape) to take to take side effects (e.g. take w/ meals)

OVER-THE-COUNTER DRUGS

Description How often How long Possible Special instructionsName/Purpose (color,shape) to take to take side effects (e.g. take w/ meals)

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W E E K LY C H E C K - O F F C H A R T

DRUG NAME/DIRECTIONS MON TUES WED THU FRI SAT SUN

DRUG A: 8 a.m. 8 a.m. 8 a.m. 8 a.m. 8 a.m. 8 a.m. 8 a.m.

2 pills 1 p.m. 1 p.m. 1 p.m. 1 p.m. 1 p.m. 1 p.m. 1 p.m.3 times a day

7 p.m. 7 p.m. 7 p.m. 7 p.m. 7 p.m. 7 p.m. 7 p.m.

DRUG B:

1 pill 8 a.m. 8 a.m. 8 a.m. 8 a.m. 8 a.m. 8 a.m. 8 a.m.once a day (a.m.)

DRUG C: 8 a.m. 8 a.m. 8 a.m. 8 a.m. 8 a.m. 8 a.m. 8 a.m.

1 pill 1 p.m. 1 p.m. 1 p.m. 1 p.m. 1 p.m. 1 p.m. 1 p.m.following meals

7 p.m. 7 p.m. 7 p.m. 7 p.m. 7 p.m. 7 p.m. 7 p.m.

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he ultimate safety and effectiveness of all medication rests withthe user. Having good informa-

tion about your medicine and takingit as instructed is the best way toavoid problems and receive thegreatest possible benefit.

Medicine is not the solution toevery problem. Talk with your doctorabout alternative treatments or ifyour health problems can be treatedby changes in diet, exercise, or stresslevel.

If you have been taking a medi-cine for a long time, ask your doctorto evaluate how well it is workingand whether you still need to take it.

C O N C L U S I O N

T

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