Mind Your Meds

By Chandra Orr

November 20, 2008 6 min read


Keep track of your medications in order to use them effectively

Chandra Orr

Creators News Service

What's that hiding in your medicine cabinet?

Behind the collection of hotel soaps, half-empty bottles of Lysol and stray Q-tips sits a half used bottle of penicillin from 1983, medications with indecipherable names prescribed for who-knows-what and a slew of long-expired supplements.

Maybe it's time to weed through all those little brown bottles.

Ideally, your medicine cabinet should always be in order, but at the very least you should tackle the task once a year.

"Generally medications expire on a yearly basis -- and medications do go bad," said Carla Mills, an advanced registered nurse practitioner in private practice in Naples, Fla., and author of "A Nurse Practitioner's Guide to Smart Health Choices" ($17, Maverick Health).

Many pharmaceuticals lose their potency over time, which can mean big problems for patients that keep taking them, Mills said. For example, nitroglycerin, taken to prevent heart attacks, goes stale once opened. Continue taking it once it expires and you have a recipe for disaster.

Dispose of unused and expired medications in a safe, responsible manner. Due to the potential environmental impact on waterways and aquatic life, the American Pharmaceutical Association (APhA) advises patients to never flush medications or pour them down the drain unless the label or patient information specifically states to do so.

Instead, take advantage of community-based household hazardous waste collection programs or ask your local pharmacy if they accept unused medication for disposal.

If no such programs exist in your area, crush unused pills and mix them with used coffee grounds or cat litter in a sealable plastic bag, then dispose of them in the trash. Doing so makes pills less appealing to pets and children and prevents medications from being diverted or transformed into illegal substances, according to the APhA.

Be sure to remove and destroy the prescription label and all personal information before recycling the empty containers.

Unless you're filling a pill organizer, never take pills out of the pharmacists' bottle. The label includes essential information that patients and doctors may need in the future, including the expiration date, the prescribing physician's name, exact dosage instructions and the name of the medication -- which is especially important considering so many medications have similar names.

"Never separate pills from the bottle they came in," Mills said. "Once they leave that bottle, no one can identify them. Even if the information on the label isn't particularly helpful to you, it may be essential to your primary care physician."

If multiple family members use pill boxes or pill organizers, make sure each container is distinct to avoid an inadvertent mix-up. Look for pill organizers in different colors or write each person's name in large print on the box.

After sorting through your medicine chest, make an appointment to see your primary care physician. Take your current prescriptions, over-the-counter medications, vitamins and supplements to the appointment so your doctor can review your regimen, check for harmful drug interactions and detect any duplicate prescriptions.

"It's so important to have a primary care provider -- someone who can look at what all the specialists are prescribing and make sure there is no conflict," Mills said. "Some medications shouldn't be mixed, and only a health professional would know that, but more commonly what we see are people on two medications that do the same thing but have different names, things like Nexium and Prevacid."

It helps to get to know your pharmacist as well. Filling multiple prescriptions at multiple pharmacies leaves more room for mistakes, so choose one location and make a point to check in regularly.

"Pharmacists are on the front lines of helping patients get the most out of their medications," said John A. Gans, vice president and chief executive officer of the APhA. "As our population ages and more people become dependent on medications than ever before, pharmacists will play an increasingly prevalent role on the healthcare team and in improving medication use and advancing patient care."

Consult with your pharmacist before taking any type of medication, prescription or otherwise. Ask about proper dosage instructions, side effects, what to do if you miss a dose and possible interactions.

"Pharmacists are very well-trained," Mills said. "They will pick up on potential drug interactions and notice if you've been prescribed two medications of the same class, which is a recipe for disaster."

The APhA also recommends keeping an up-to-date list of all medications, herbal products and vitamins, including the time and dosage and the conditions the medications treat. Keep the list handy for emergency situations -- it could be a lifesaver.

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