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Title: Taking Care: A Guide to Managing Your Medications
Author: Justin L. Faherty
Publisher: Do It Now Foundation
Publication Date: August 2000
Catalog Number: 181


..Who Do You Trust?

If medical
misinformation were water, we’d all be drowning.

Think about
it. We’re up to our ears in it every day — and it’s getting
deeper:

“I’m no doctor, but I play
one on television…”

“Fill-in-the-Blank speeds
to your headache three times faster and is kinder and gentler
to your stomach…”

“Hospital-tested Preparation
8. Nine out of 10 doctors recommend it to 3 out of 4 patients.”

Sound familiar?
You bet.

And it isn’t
just TV commercials, either.

Today, we can
choose from a gaggle of TV doctors and health reporters on the
morning, noon, and evening news, doggedly trying to clarify a
topic that’s increasingly anything but.

The result?
We begin to be unsure about what we do know about taking care
of ourselves. And even worse, we wonder what to believe and if
it’s even worth the bother.

That’s why
we’ve put together this pamphlet.

In it, we’re
not going to run down what’s hot and what’s not or follow up
on the latest media health fad. But we will review some ways
that we can all take better care of ourselves — particularly
in the area of managing our medications.

Because even
though it’s raining facts and figures out there, we don’t all
have to drown in the flood.


..Point/Counterpoints

If you’re thinking
that you’ve been “managing” your own medicines for
years (and wonder why you should make a big deal out of it now),
you raise an interesting point.

Still, we have
a good counterpoint — more than one, in fact. And each centers
on the special risks that medications pose as we get older.

First, we tend
to use more drugs than younger people. In fact, adults over 60
consume about a third of all prescription medications and two-fifths
of the non-prescription drugs sold each year.

We also suffer
more drug-related problems. Consider what a recent federal study
had to say about medicine use by older Americans:

More than half of all deaths
and a third of all hospitalizations due to drug reactions occur
in adults over 60.

Every year, an estimated 32,000
older people suffer hip fractures during drug-induced slips and
falls.

At least 160,000 experience problems
with memory or thinking brought on (or made worse) by medicines.

The tragedy
is that most problems can be prevented simply by taking care
in what we take medicinally — and how we take it.


..Body Changes

Some problems
come about simply because we are older. Our bodies are changing,
and don’t react the same way to medications as they once did.

For one thing,
aging reduces the amount of water and lean tissue in the body,
and replaces it with fat. This affects the length of time a drug
stays in the body, how it’s absorbed, and how long it acts.

Metabolism
also slows. The kidneys and liver are less efficient, so many
medicines stay in the body longer still.

Health problems
also play a part. Ulcers, diabetes, and chronic heart, liver,
or kidney disease can also affect how quickly and how well a
drug works in the body.

On the other
hand, side effects can make existing problems worse. Examples:
Medications containing high levels of sodium (antacids, for instance)
can aggravate high blood pressure and heart disease, while some
diuretics (Lasix, Dyazide) can worsen diabetes.


..Double Trouble

Another frequent
source of trouble is the use of more than one drug for more than
one problem.

It happens
every day. We see one doctor for one problem and another doctor
for another problem. Each doctor writes a prescription for a
different drug without knowing about the other doctor or the
other prescription.

It’s a lot
more common than you might think.

In fact, according
to a recent federal study, at least 37 percent of us use five
or more drugs at the same time, while another 19 percent take
at least seven.

And drugstore
remedies — laxatives, cold and allergy products, sleeping aids
— can also disrupt the actions of prescribed medications.

The more medications
you use, the greater the risk of an unexpected drug reaction.
That’s because many drugs produce synergistic effects when taken
together. This means they either add to, take away from, or otherwise
change each other’s effects.

That’s the
best reason to keep your doctor informed about all the medications
you use and how well they seem to be working.

That way, you
can stop problems before they start — or before they stop you.


..Handle with Care

Over-the-counter
(OTC) medicines — drugs you buy without a prescription — should
be treated like any other drug: very carefully.

Because even
the most time-honored non-prescription remedies can carry serious
side effects.

Consider common
pain relievers. They all work well enough, but they can all cause
problems.

Acetaminophen
can cause kidney damage over time. Heavy, long-term use of aspirin
or ibuprofen (Advil, Nuprin) irritates the stomach lining and
can cause internal bleeding. In fact, stomach bleeding is the
most common drug side effect reported by arthritis sufferers,
causing some 20,000 hospitalizations and 2,600 deaths each year.

Other medications
are safer, but unnecessary. Problems that we diagnose and treat
ourselves with OTC drugs can often be corrected — simply and
safely — by changing our diet or lifestyle.

The point is
simple, but important: Drugs are drugs, whether we buy them over
the counter or by prescription. And they’re all capable of causing
problems that are easier to avoid than cure.


..Small Choices

All the issues
we’ve raised thus far point in the same direction, so it’s no
real surprise that they come to the same conclusion: that each
of us is responsible for our health and well-being, right down
to managing the medications we use.

So get involved!
Next time you take a prescription or an over-the-counter drug,
know why you’re taking it and when you should stop.

Ask your pharmacist
about any precautions you should be aware of and report any side
effects to your doctor immediately.

Whatever you
do, remember that taking care of our health starts with taking
charge of our lives — from where we are right now. Remind yourself
that big changes can flow from small choices. Then think small.

Because health
isn’t something a doctor prescribes or a pharmacist slips into
a bottle, but something we create every day of our lives.

And if that
sounds like a lot of trouble to you, remember: It sure beats
the alternative.


..Sidebar | Drugs
& The Mind

At the top
of any list of medicines to avoid mixing are psychoactive (or
mind-altering) drugs.

These include
such prescription painkillers as Darvon and codeine, and such
tranquilizers and sleeping aids as Valium, Xanax, and Halcion.

As a group,
these drugs can stir up a hornet’s nest of problems, from confusion
and memory loss to overdose and addiction.

They can sting
in other ways, too: Studies show a higher risk of falls and fractures
among older adults who take tranquilizers and sleeping pills.

Given the dangers,
many doctors no longer prescribe such drugs without clear-cut
medical need.

You can help
things along by changing your point of view, if necessary —
from thinking there’s a pill for every ill and every emotion
to making the kind of lifestyle changes that really can resolve
problems once and for all.


..Sidebar | Taking
Charge: What You Can Do

The best way
to avoid risks in managing your medications is to get involved
in your own health care.

And that involves
being responsible for your medicines and knowing how and when
to use them.

Many find it
helpful to develop a system for taking medications in the right
doses at the right times. A system can be as simple as a daily
checklist or as complicated as using a pillbox or other device
for dispensing individual drugs.

A good medication
management system should also include at least a once-yearly
review of all the medications you use — including over-the-counter
drugs.

A “brown-bag
inventory” — where you drop all the prescription and over-the-counter
drugs you use into a bag you take along to your next doctor’s
appointment — can help sort out your special needs, and weed
out potential problems, and any old or unnecessary drugs.

The important point is not how
fancy your system is, but how well it works for you. And it will
only work for you if you follow it.


This is one in a series of publications
on drugs, behavior, and health by Do It Now Foundation.
Please call or write for a complete list of available titles,
or check us out online at
www.doitnow.org.


 

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