25 August 2003

Beware of medication errors

Medications can be miracle workers: They can cure dangerous infections, ease pain and make life with a chronic disease more bearable. But medicines also can - and do - harm and even kill.

Medications can be miracle workers: They can cure dangerous infections, ease pain and make life with a chronic disease more bearable.

But medicines also can - and do - harm and even kill.

One in 20 prescription drugs filled at a pharmacy has an error, according to the Institute for Safe Medication Practices. And a recent study in the New England Journal of Medicine found 25 percent of 661 patients who responded to a survey had an adverse reaction to medications.

Prescribers and patients to blame
The biggest mistakes are made by the prescribers, says Larry Sasich, a pharmacist and research analyst for the Public Citizen Health Research Group.

But that still leaves a substantial number of errors made by consumers.

Many of these adverse reactions are preventable, health experts agree. If consumers would take a few minutes to double-check basic information, they could reduce greatly the chances of errors.

Know what medication you are taking and why you are taking it, says Edgar Arriola, a pharmacist and coordinator of the Drug Information Center at the University of California, Los Angeles Medical Center. Also, know the proper dose.

That way, if your doctor explains it's a 20-milligram tablet but you pick up a bottle of 60-milligram pills from the pharmacist, you can point out the discrepancy.

Confusion with names
Also, pay attention to the name of the drug you're supposed to be taking, experts suggest. Confusion over several drugs with similar- sounding or similarly-spelled names has resulted in serious problems.

For instance, the thyroid medicine Levoxine has been confused in the past with Lanoxin, a heart medicine, and several people were hospitalised and later died, according to US health officials. Levoxine has since been renamed Levoxyl, the US Institute for Safe Medication Practices says.

Lamictal, a drug for epilepsy, has been confused with Lamisil, a drug to treat nail infections. And Celebrex, for arthritis, has been confused with Celexa, for depression.

Pay attention to allergies
Consumers should also know if they are allergic to certain drugs and which ones, says Peggy Han, a pharmacist and clinical coordinator for the University of Southern California Community Pharmacies.

For instance, if you took an aspirin when you were sick and got a rash, remember that and tell the pharmacist and your doctor, she suggests: Be sure it gets written down in the chart. And don't assume if it is written into the chart that it is seen [by your doctor or pharmacist]. Be sure to mention it, Han says.

If you have a chronic condition, such as high blood pressure or diabetes, make sure the doctor who is prescribing any new medicine knows about all your health problems and any medicines you're already taking. The reason: certain drugs, when taken together, can lead to serious side effects.

People on multiple medications who often are treated by several doctors should be doubly sure that each doctor knows their entire list of medicines, experts say.

More precautions
To further protect yourself, carry an index card listing all your medicines and the dose of each, Han suggests. Ideally, your medications should be filled at one pharmacy; if that's impossible, the index card is even more crucial.

Many pharmacies distribute patient information leaflets - the plain English information - in lieu of the package insert from the manufacturer, which is often in highly technical language. Sasich says his group advises consumers to ask for the package insert, since the US Food and Drug Administration (FDA) has approved it.

If the inserts are difficult to read, Sasich recommends paying close attention to four areas listed on the insert: approved uses, contraindications (situations in which the medicine should not be used), drug interactions and dose (to see if your dose is within the acceptable range depending on your weight and problem).

After starting a new drug, assume that any new symptom you develop is the result of the medicine until proven otherwise, and be sure to tell your doctor, the Public Citizen Health Research Group recommends. And when your doctor decides to add a new drug, ask if any of your medicines can be discontinued.

Finally, schedule a drug review - going over all your medicines, the doses and what each is for - with your physician every three to six months, the group suggests. - (HealthDayNews)

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