How to be Drug Smart
35 Easy-To-Take Tips
BY RUSSELL WILD
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Ladies’ Choice
Few drugs are one-size-fits-all—a
problem that’s magnified when women take man-size doses. “Women have
different metabolisms and tend to be smaller,” says University of California,
San Diego professor Jay Cohen. “A 105-pound woman taking the same dosage
as a 200-pound man might be taking too much.” Women also tend to be
more sensitive to drugs than men, adds Cohen, noting that the 1997 withdrawal
of Seldane, an antihistamine, occurred because of heart problems that
primarily struck women. Women should ask their doctors about medical
literature that addresses gender issues (as opposed to the often oversimplified
advice on the package).
Just Say No
Some drugs are so unpredictable
when taken by older people that experts suggest you avoid them altogether,
or take them in carefully calculated and monitored doses. Examples include
the analgesic propoxyphene, the anti-inflammatory indomethacin, the
antidepressant amitriptyline, and over-the-counter drugs containing
diphenhydramine (Benadryl), chorpheniramine (Chlor-Trimeton), and most
other nonprescription antihistamines. Ask your doctor and pharmacist
whether a lower-than-standard starting dosage might be appropriate,
given your age. For a list of high-risk medicines, check out The Merck
Manual of Geriatrics, available at many libraries.
Act Your Age
As you grow older, your metabolism
changes. The liver and kidneys may work more slowly. Body composition
changes. The result is that your doctor may prescribe less medication
to treat a problem when you’re 70 than if you were 27. In fact, the
dosages for an elderly person are often half of what a younger person
might need (most drugs are not clinically tested on a large number of
older people). And taking standard doses when you’re older can lead
to side effects. Some age-sensitive drugs, according to Cohen, author
of Over Dose (Putnam, 2001):
|
• |
Antidepressants: citalopram (Celexa), bupropion (Wellbutrin), sertraline
(Zoloft) |
| • |
Anti-Inflammatories: naproxen (Anaprox), celecoxib (Celebrex), ibuprofen
(Motrin) |
| • |
Antihypertensives: diltiazem (Cardizem), propranolol (Inderal), moexipril
(Univasc) |
| • |
Cholesterol-Lowering Meds: atorvastatin (Lipitor), lovastatin (Mevacor) |
| • |
Ulcer and Gastritis Meds: omeprazole (Prilosec) |
Beware of the Crush
Some people pulverize
their pills and put them in liquid. “Certain drugs will degrade and
become less effective when crushed and put into a solution,” says Abdelmacksoud.
Some pills release medicine slowly. When these drugs are crushed, your
body can absorb them too quickly. Drugs that should never be crushed:
extended-release products (such as Procardia XL), enteric-coated pills
(aspirin), and sublingual medications (nitroglycerin). If your doctor
tells you to split pills, and they aren’t scored, buy a pill splitter.
But split your pills on the day you take them. (Doing it earlier may
affect the medication.)
Use the Right Bottle
Don’t make the common
mistake of putting your pills in a different bottle. You could easily
underdose on one medication, overdose on another, and forget which pill
is for what. You could mistake a painkiller for a diuretic. The original
bottle is also tinted or opaque to keep out light, which can degrade
many meds. Storage instructions should be on the bottle and the package
insert.
Don’t Drug and Drive
Many medicines can
cause fatigue and a slowing of reflexes. For example, a University of
Iowa study found that the antihistamine diphenhydramine (Benadryl) caused
more driving impairment than being legally drunk.
Leave Yourself Reminders
Keep forgetting
to take your pills? A bevy of high-tech devices can provide you with
reminders, from beeping chains and pagers to electronic pill containers
and telephone or computer services. Low-tech methods include sticking
notes to the bathroom mirror or refrigerator and other creative tricks.
A lot of pharmacies will be happy to call and remind you that your prescription
refill is due. So explore these and other options with your health care
provider and your pharmacist.
Take ‘em All
Only the hardiest bacteria
survive the first few days of an antibiotic treatment. But if you quit
before the infection is completely eliminated, those surviving bacteria
will be fruitful and multiply. Not only that, but you’ll be contributing
to a serious public health hazard—the rise of antibiotic-resistant strains
of bacteria. One other way to be part of the solution: Don’t push your
doctor to give you unnecessary antibiotics. Half of the antibiotics
given to humans are prescribed for colds, coughs, and other viral infections,
which aren’t helped by antibiotics.
Send old Drugs Packing
You should always
throw out your medications once they’ve passed their expiration dates.
Try thinking of expired medicines as old car tires: They may still be
functional, but the manufacturer can no longer guarantee their effectiveness.
In some cases chemical decomposition can even turn a once-beneficial
medicine into a poison. Use of outdated tetracycline (an antibiotic)
has been linked to Fanconi’s syndrome, a serious disease that can affect
the kidneys and cause bones to soften. So review your medicines at least
once a year and get rid of oldies that are no longer goodies.
Get Medicine out of the
Cabinet
Drugs should
be stored in a cool, dry place. Ironically, one of the worst places
to keep medicines is in the medicine cabinet. “Bathrooms and kitchens
tend to be the moistest spots in the house,” says Diana J. Mason, RN,
Ph.D., and editor-in-chief of The American Journal of Nursing. “A better
place for medicines is inside a dresser drawer.” If you have young grandchildren
who visit, make sure you pick the top dresser drawer and that the child-safety
cap is always secure. A chilling one-third of all accidental prescription
drug poisonings in children involve a grandparent’s medication. Red
stickers with the nationwide poison control hotline number—800-222-1222—are
available free by sending a SASE to Council on Family Health, Emergency
Stickers, 1150 Connecticut Avenue, NW, Suite 1200-B, Washington, DC
20036.
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