4 months ago
(indystar.com) -- Medication can be a powerful thing. After all, sugar pills are not likely to banish pounding migraine pain or a bacterial infection. But the flip side of a drug's ability to work is its potential side effects.
Check out a few drug advertisements, and you have a sense of the range of side effects, from dizziness or dry mouth to more severe conditions such as shortness of breath.
And don't think there's a "side- effect-free" drug out there, experts agree.
"There is no such thing as a drug that is 100 percent safe in 100 percent of the population. Every drug has side effects, period," said Amy Peak, director of drug information services for Butler University.
For some, the side effects are adverse drug reactions. Estimates suggest that reactions from both prescription and over-the-counter medications may result in as many as 700,000 emergency room trips a year. Other studies have found more than 2 million people are affected, said Bob Gold, a clinical pharmacist in Newburgh and author of "The Forensic Pharmacist.
Informed consumers, however, may be able to lower the likelihood of such events. When your doctor prescribes a medication, experts recommend you ask lots of questions.
"Don't be afraid to ask," said Shawn Becker, director of health-care quality standards for U.S. Pharmacopeia, which sets standards for the drug industry. "You should know every medication that you're taking and why you're taking it."
Find out, for example, how long it should take the drug to work and what to do if you skip a dose or take too much at one sitting. And, of course, ask your doctor about common potential side effects.
But since some side effects may be rare, health-care professionals may fail to list all that could occur.
"A lot of times doctors or pharmacists don't share all of the information with patients, because they don't want to scare them," said Patricia Darbishire, a clinical assistant professor of pharmacy practice at Purdue University.
In addition to asking questions, tell your doctor what he or she needs to know. Mention any medication allergies you have as well as drugs that have caused side effects in you in the past. Also include the experiences of any people who are closely related to you.
Make sure your doctor has a complete list of the medicines you already take, both prescription and over the counter. Include vitamins and supplements.
The work continues when you head to the pharmacy to pick up your prescription. Many pharmacists open the bottle to let you see what's inside.
If something looks different than what you expected, don't hesitate to ask the pharmacist about it, experts say. The formulation may have changed, the pharmacist may have switched to a generic, or a mistake may have occurred.
One potential way to avoid experiencing drug side effects is to have all your prescriptions filled at one location.
"That's the only way you can accurately screen for drug interactions," Peak said.
Once you start taking the medication, don't hesitate to call your doctor -- or pharmacist -- if you think you're experiencing a side effect, experts agree.
In some cases, your physician might have mentioned common side effects that should not cause concern. For instance, certain antibiotics can cause a few days of diarrhea. Ibuprofen taken on an empty stomach may lead to gastric distress.
Don't assume that you have to endure any side effect that occurs.
"I would not say that side effects are OK," said Dr. Almitra Thomas, an internist with the Community Health Network, who trained as a pharmacist.
Often, doctors will discontinue the drug, she added, rather than prescribing a new medication to treat the unintended consequence of the first one.
"You don't want to chase the side effect with another medication," she said.
Because side effects are commonly caused by interactions between two drugs, your doctor or pharmacist may be able to tweak your medication list to ease your distress, Peak said. A pharmacist may also suggest changing when or how you take the drug to address this.
One way to tell if the symptoms you have are side effects and not caused by your underlying disease or something else is to discontinue the drug for a few days. If the symptoms disappear, they could be a drug side effect.
And don't make any decisions without consulting your doctor. Some drugs should be tapered, rather than discontinued abruptly, Gold said.
How to store and dispose of medications
Your first inclination might be to store prescription drugs in the bathroom medicine cabinet, but a hot steamy environment is not necessarily the ideal place for them. If your shower is right next to the cabinet, find another place that's drier for long-term storage.
Before discarding medicines, keep in mind that with many prescriptions -- such as antibiotics or anti-virals -- you should take the entire regimen.
Other medicines, such as narcotics, should not be accessible, as abuse of prescription medications is the No. 1 drug problem today, experts say.
So what are your options for disposal? You don't want to flush them down the toilet, where they will enter the water system, or simply toss them, as a pet or person might pull them out of the trash.
Instead, experts recommend either taking drugs to a tox-away day or shaking them into a bottle with some kitty litter and then sealing that with duct tape and putting it in the trash.
Generics vs. brand names
Generics: Some people love them for their price; others hate them because they fear they do not work as well as the brand name.
But generic medications must always contain the same dose as the brand-name drug. Most experts agree that in nearly every case, generics are just as good.
The Food and Drug Administration rates all generics, said Patricia Darbishire, a clinical assistant professor of pharmacy practice at Purdue University. Those that are therapeutically equivalent are A-rated. Those that are B-rated follow a different path of action.
"B-rated doesn't mean it's lower quality," she says. "A B-rated generic might work better."
Generic drugs can make a difference when you're talking about medications such as blood thinners or those that treat thyroid disease, experts agree.
Because these tend to be prescribed in small doses, minor changes can have detectable effects.
If you make a switch between brands or change to a generic with these types of medicines, you should have follow-up lab work done to ensure the new medication is having the desired effect, said Amy Peak, Butler University's director of drug information services.
Additional Facts
It's good to ask
Here are some questions to ask your doctor or pharmacist about your prescriptions:
» What is the name of this drug?
» What is its purpose?
» How should I take it?
» When should I expect to feel an effect from it?
» What are common potential side effects?
» What foods or activities should I avoid when taking this drug? (Grapefruit juice, for instance, may interact with certain medicines.)
» Do I need to complete the course of medication, or can I discontinue its use when the symptoms abate?
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