Medication Errors and How to Prevent Them

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Many people unwittingly reduce the effectiveness of the drugs they take or worse, cause themselves great harm by mishandling their pills. The most common drug traps and how to avoid them

Trap #1: Failing to double-check your prescription.

Drug-dispensing mistakes are rare, but they do occur. In his/her haste, a doctor may prescribe the wrong drug or dosage. The pharmacist may misread the doctor’s handwriting or reach for the wrong bottle of pills when filling your prescription.

Self-defense: Before handing the prescription form to the pharmacist, jot the drug name and dosage on a piece of paper.

When you pick up the bottle of pills, compare the label with your note. If you suspect a mistake, call your doctor.

Also, consider keeping a copy of The Pill Book (Bantam) or Physicians’ Desk Reference (Thomson PDR) on hand. These books contain photos of pills.

Trap #2: Being unaware of a drug’s side effects.

Doctors are supposed to tell patients about a drug’s possible side effects. But they don’t always do so because they don’t want to “scare” their patients.

Prescription drugs can cause a variety of troublesome side effects, including sexual problems like diminished sex drive, impotence and retrograde ejaculation (in which semen is ejaculated “backward” into the bladder). If you are unaware that your medication is causing such a problem, you may worry yourself sick.

Self-defense: Before taking any newly prescribed drug, ask your doctor and pharmacist about side effects.

If you experience a problem, ask about taking a lower dose or switching to a substitute.

Trap #3: Taking one drug that interacts with another.

Nine out of 10 pharmacies now have sophisticated drug-dispensing software that screens for drug interactions.

Each time you come in with a new prescription, the pharmacist runs a computer check. If the drug interacts with any other drug you’re taking, the pharmacist alerts you.

But such systems work only if you have all your prescriptions filled at one pharmacy.

If you patronize different drugstores, you risk subjecting yourself to side effects and/or not receiving the drug’s full benefits. You may even fail to discover that you have two prescriptions for the same drug from different doctors and are double-dosing yourself.

Self-defense: Stick to one pharmacy. If you’re taking several drugs and are uncertain about interactions, ask your pharmacist or doctor for a “brown bag” session. Put all the drugs you take in a bag, and bring it in. Review the name and dosage of each drug, and what each is for.

Be sure to schedule your brown bag session in advance. Otherwise, the pharmacist or doctor may be too busy to spend enough time with you.

Trap #4: Combining certain prescription and nonprescription drugs.

In recent years, several drugs that used to be available only by prescription have gone on sale over-the counter (OTC).

This cuts costs for consumers, but it makes it harder for doctors to monitor their patients for potentially dangerous drug combinations.

Example I: In rare cases, nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Motrin), naproxen (Aleve) and ketoprofen (Orudis) can cause kidney damage. If you have kidney disease, avoid large doses. Don’t take them on a long-term basis.

Example II: The acid blocker cimetidine (Tagamet) interacts with the anti-diabetes medication sulfonylurea benzodiazepine tranquilizers like Valium and calcium channel blockers like Adalat and Procardia.

Self-defense: If you’re taking a medication on a long-term basis, ask your doctor if any OTC drugs interact with it. Or buy your OTC drugs where you have your prescriptions filled, and check with your pharmacist before taking the two together.

Trap #5: Storing drugs incorrectly.

No doubt you have already heard that heat and humidity degrade drugs. Yet most of us continue to store our medications in the bathroom the hottest, most humid room in the house. Even if you cannot discern any degradation, your pills probably are becoming less potent.

Self-defense: Store all prescription and OTC drugs in a cool, dry spot your bedroom closet, for example (or in the refrigerator, if the drug is supposed to be refrigerated). If you have children in your house, make sure to keep the drugs out of their reach.

Trap #6: Failing to have the dosage adjusted after a major change in bodyweight

If you lose a lot of weight, a dose that was once correct may become a harmful overdose. Conversely, a significant weight gain may lead to under-dosing.

Self-defense: If you lose or gain more than 10% of your body weight, alert your doctor immediately so that he can adjust your dosage accordingly.

Trap #7: Using prescription drugs without medical supervision

Many people hang on to unused pills, thinking they will save a few bucks and a trip to the pharmacy if they get sick again.

Yet even if you get the same symptoms again, prescribing to yourself in this fashion is dangerous. Your new symptoms could stem from a different ailment which calls for different treatment.

Self-defense: If you have pills left over after taking a course of medication, discard them. If you insist on hanging on to unused pills, at least call the doctor and get his approval before using them.

Trap #8: Disobeying the doctor’s orders

When it comes to prescription medications, an amazing number of people simply don’t follow their doctor’s directions.

Some patients take more medication than was prescribed on the erroneous “more-is better” theory. Others take less than the doctor ordered in a misguided effort to avoid side effects. Doctors call such behavior “patient noncompliance. ”

Self-defense: Take all medications according to your doctor’s exact instructions. If you have trouble remembering to do so, devise a plan to jog your memory at the appropriate times.

For example, jot down your dosing schedule in your date book carry your pill box in your pants pocket as a constant reminder or pick up a combination pill box/alarm at your local pharmacy.

If you miss a scheduled dose, check with your doctor or pharmacist immediately about what to do. In some cases, it’s best to continue with your regimen as if you hadn’t missed a dose. In others, it’s better to “double up” on a subsequent dose.

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