Medication Safety

Monitoring your loved one’s medications is one of the most important aspects of medical caregiving.

As a caregiver, you may help someone with medications. You may be there when the doctor prescribes the medication. It may be your job to pick up prescriptions at the pharmacy and make sure she takes the right medicine at the right time. You may need to watch for side effects, signs of overmedication or drug interactions.

This article will help you supervise medications more safely.

Over-The-Counter Medicines

Common over-the-counter medications include pain relievers (such as Tylenol and aspirin), anti-inflammatory drugs (such as ibuprofen and Advil), cough syrups, antacids (such as Tums and Pepto-Bismol), allergy relief medicines, and laxatives. You can buy these drugs without a doctor’s prescription.

Although these medicines are considered safe, they can interact (cause reactions) with other medications. It’s also possible that an excess of an over-the-counter medication can be toxic. It is very important to tell the doctor or pharmacist about all the medicines, both prescription and nonprescription, the person takes, the amount taken, and to ask if there are any possible drug interactions between them.

When You Buy Nonprescription Medicines:

  • Read the list of ingredients carefully. They may include alcohol, aspirin, caffeine, salt (sodium) or sugar.
  • Ask the pharmacist to explain anything you don’t understand.
  • Typical aspirin tablets contain 325 milligrams (mg) of aspirin. Some over-the-counter extra-strength pain medicines contain a combination of aspirin and acetaminophen (the ingredient in Tylenol).
  • Look at the list of warnings or precautions.
  • Never take ibuprofen and aspirin together; they counteract each other.

Again, these medications can interact with other prescription and nonprescription drugs. Some should not be taken by people with certain medical conditions. Read labels carefully!

Drug Interactions And Overmedication
 
Many older people and people with chronic illnesses take several medications and they may see more than one doctor. It’s possible for one doctor to prescribe a medicine and not know the patient is already taking a drug that does the same thing. The person may over-medicate herself. If the doctor doesn’t know all the medicines the person takes, the doctor may prescribe a new drug that causes a bad reaction with another drug. Drug interactions can make someone sick and the symptoms can be mistaken for a new illness.

Review prescription dosages at least once a year. Over time, a person’s need for a medication can change. A chronic illness can improve or get worse. Older people often need a smaller dose of a drug because drugs stay in the system longer. People who are small-sized or who lose weight may also need smaller doses.

  • Important Questions To Ask:
  • What is the medicine for?
  • ill the medicine interact with other drugs she takes?
  • Is there a generic (not a brand name) form available?
  • How often should she take it?
  • How much should she take?
  • How long should she take it?
  • Should she take it with food or on an empty stomach?
  • Are there other special instructions? Should she avoid alcohol, sunlight or certain foods?
  • Are there any side effects and should we report them?
  • Can we prevent side effects?
  • What should we do if she misses a dose?
  • Do blood levels need to be checked for this medication? If so, how often?

Your pharmacist can answer many of these questions for you. Use the same pharmacy and get to know your pharmacist. Many pharmacies keep a record of all prescriptions. That way they can be on the alert for possible medication problems.

Keep A Record

It is essential that you keep a record of all the medications the person takes, including over-the-counter medicines like aspirin as well as prescription medicines.

Keep the list current and take it with you to all doctor appointments. (You can also post this list in a visible location, so that anyone else who provides care is also aware of medications.) Take the list when you go to the pharmacy for any new prescriptions. That way, both your doctor and your pharmacist will know exactly what medicines the person takes.

Set Up A Schedule

  • Write down the times that each medicine should be given.
  • Use a pill container to organize pills. That way, you will know right away if a dose was missed. Several types of containers are available at pharmacies. Some hold pills for one day and others hold up to one week’s worth of pills. You can even use an empty egg carton to organize pills.

Mail-Order Medicine

It’s possible to purchase many drugs by mail. Ordering by mail is usually cheaper, and it’s a real convenience for people who have a hard time getting to the pharmacy.

But mail-order may not be the best solution when you buy a new drug. You may not be able to talk to the pharmacist about possible drug interactions or the best way to take the medicine. If you have questions, you can always contact a local pharmacist; they will be able to help you.

Also, mail-order companies usually require that you buy large amounts of the drug. With a new prescription, you won’t be sure that the drug works well and that it doesn’t have serious side effects.

General Rules

  • Never increase or decrease the medication dosage without checking with your doctor.
  • Only give someone a medication if it was prescribed for her.
  • Keep all drugs in their original containers.
  • Unless your doctor tells you otherwise, give the entire prescription even if symptoms are gone. Many antibiotics need to be taken for a full 5–7 days or longer, even though the symptoms are gone within the first couple of days.
  • Give medications with a full glass of water unless instructions say to do otherwise.
  • Don’t crush pills or capsules unless you check with your pharmacist. Many medications have a coating to protect the throat or stomach lining. A crushed pill could release all the medicine at once instead of the way it’s intended. For this same reason, don’t allow someone to chew pills or capsules unless you’ve checked with the pharmacist that this is okay.
  • Don’t cut pills in half unless they have a line across the middle to show they can be broken and you have checked first with the pharmacist. Ask the pharmacist if the pills come in smaller doses or ask the pharmacist to break them for you.
  • Throw away all medications that are past the expiration date.

Managing medications is no easy task. But careful management will save money, prevent medication problems, and make sure that necessary medications can do the job they’re supposed to do.

Originally written and published by the Aging and Adult Services Administration Department of Social and Health Services, State of Washington. Reprinted with permission.

Washington State Department of Social and Health Services

Caregivers Handbook

This 80+ page guide provides resources, checklists and worksheets - all in one place.