drmargaret

People get prescribed medications for a variety of things. One of my neighbors was given an antibiotic and we were having a conversation about it. I was a pharmacy clerk for a couple of decades so I know a bit about medications.

Medications are labeled very specifically by the pharmacist in accordance with the prescription given to them by the doctor. The prescription has the name of the person to take the medication, the date the medication is filled by the pharmacist, the number of tablets in the container, how the medication is to be taken, the name of the doctor, and the phone number of the pharmacy, and the number of the prescription for reference. These things are all required by prescribing laws. The pharmacist isn’t allowed to pour medications back into old containers. Sometimes if there is a shortage of medications there can be an amendment made to the number of pills made in the container but that’s about it.

Now how people take medications is a completely different story. The person asking me about her antibiotic was asking me if the three times a day label was a suggestion or if she really should take it that much or if she felt worse to take more and if she felt better to take less. So for all of those people out there who are unsure let me answer this once and for all. Think of it as a commandment from God. You take it exactly as it says on the bottle. You don’t take too much. In the case of the antibiotic, if you take too much you will get the runs. You don’t take too little. In the case of the antibiotic, if you take too little the bacteria in your system ir was killing off will start to grow and multiply again. So you take it exactly as directed.

So the big question for a lot of people is what does three times a day mean. For some people you might want to ask your pharmacist. For most medications, three times a day means morning, afternoon and evening. For some medications it means every eight hours exactly, set your clock to wake you up if you need to.

This adherence to labeling is very important in using psychiatric medications. A lot of psychiatric medications take time to work. In many cases a couple of months before they start to become effective. Then they require a constant amount of medication to be in the blood stream to maintain that effectiveness. If someone only takes medications when they feel depressed, or anxious or psychotic then the medications will not work at all they will only produce side effects.

All medications have side effects. Side effects are things that are not the general intended effects of the medications. Not all side effects are bad, in fact some medications are specifically prescribed for their side effects!

It’s also important that you read all the stickers that come on the container that your medication comes in. They tell you important things about your medication. Some medications need to be taken with food. Some medications need to be taken on an empty stomach. Some make driving hazardous.

Make sure you tell the doctor who is writing the prescription about every single other medication you are taking. Make sure in the list of medications you include all the herbal medications and vitamins and over the counter remedies and all that stuff that you “borrow” from other people. If you are using illegal drugs, make sure your doctor knows about it.

Now for those of you that go “doctor shopping” to obtain illegal drugs, it’s not that hard for someone to figure it out. I’m frequently amazed how long it seems to take an MD or series of MDs to catch on. I’m not allowed to report stupid things people do to themselves. When someone comes into an evaluation with four bottles of medication and two of them have someone else’s name on them I get to ask about the other person for whom the medication was intended. When the medication is a narcotic I start getting suspicious. When I see four bottles of a narcotic for the same person filled within a week by four different physicians I’m not suspicious of anything except if the MDs know each other is filling the same medication for the same person. It’s bad practice. Ultimately it’s going to hurt someone.

At least once a week I see someone with long term effects of illegal drug use. Some of these are young people. Some of the effects contine long after the drugs stop. There’s a recent practice of mixing pharmaceutical medications with illegal drugs. Some of these combinations are fatal. There are tremendous spikes in blood pressure and the areas which regulate temperature and the the midbrain fail to work correctly and nothing can fix it. In some cases the heart goes into an arrythymia and beats wrong. It’s a mess.

Some medications interact with things like food. Sometimes you might see a label saying don’t take this medication with grapefruit juice or some other food. The food will either reduce the effectiveness of the medication or will make it too strong.

Finally there’s a book I want to mention. It’s called the Physician’s Desk Reference. It’s published every single year on all of the medications. It’s put out by the manufacturers of the medications. It tells what the medications do, the chemical properties they have and the side effects, their effective dose, and they have pictures of what common medications look like. It’s a collection of all those little pamphlets that come with the medications. The book is either red or blue in color and most libraries have a copy at their reference desk.

For professionals, there’s a book which is updated by researchers on medications. It’s called Facts and Comparisons. It’s available at Medical Libraries. It lists the research on the medications done by researchers, not just the research done by the drug companies. It compares the medications across classes. There are monthly supplements. Check with your local Medical Library to see if they have a copy.