cover bar Title: Taking Care: A Guide to Managing Your Medications
Author: Justin L. Faherty
Publisher: Do It Now Foundation
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.


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.
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