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10 Common Medication Mistakes That Can Kill
By Melanie Haiken, Caring.com
The numbers are simply staggering: Every year 1.5 million people are sickened or severely injured by medication mistakes, and 100,000 die. And yet all of those deaths are preventable. What’s the answer? We have to protect ourselves. Here are the ten medication mistakes experts say are most likely to kill or cause serious harm.
1. Confusing two medications with similar names
It can happen anywhere in the transmission chain: Maybe the doctor’s handwriting is illegible, or the name goes into the pharmacy computer incorrectly, or the swap occurs when the wrong drug is pulled from the shelves. “Most pharmacies shelve drugs in alphabetical order, so you have drugs with similar names right next to each other, which makes it even more likely for someone to grab the wrong one,” says Michael Negrete, CEO of the nonprofit Pharmacy Foundation of California.
According to the national Medication Error Reporting Program, confusion caused by similar drug names accounts for up to 25 percent of all reported errors. Examples of commonly confused pairings include Adderall (a stimulant used for ADHD) versus Inderal (a beta-blocker used for high blood pressure), and Paxil (an antidepressant) versus the rhyming Taxol (a cancer drug) and the similar-sounding Plavix (an anticlotting medication). The Institute for Safe Medication Practices’s list of these oft-confused pairs goes on for pages.
How to avoid it: When you get a new prescription, ask your doctor to write down what it’s for as well as the name and dosage. If the prescription reads depression but is meant for stomach acid, that should be a red flag for the pharmacist. When you’re picking up a prescription at the pharmacy, check the label to make sure the name of the drug (brand or generic), dosage, and directions for use are the same as those on the prescription. (If you don’t have the prescription yourself because the doctor sent it in directly, ask the pharmacist to compare the label with what the doctor sent.)
2. Taking two or more drugs that magnify each other’s potential side effects
Any drug you take has potential side effects. But the problems can really add up whenever you take two or more medications at the same time, because there are so many ways they can interact with each other, says Anne Meneghetti, M.D., director of Clinical Communication for Epocrates, a medication management system for doctors. “Drugs can interfere with each other, and that’s what you’re most likely to hear about. But they can also magnify each other, or one drug can magnify a side effect caused by another drug,” says Meneghetti.
Two of the most common — and most dangerous — of these magnification interactions involve blood pressure and dizziness. If you’re taking one medication that has a potential side effect of raising blood pressure, and you then begin taking a second medication with the same possible effect, your blood pressure could spike dangerously from the combination of the two. One medication that lists “dizziness” is worrisome enough, but two with that side effect could lead to falls, fractures, and worse.
Be particularly careful if you’ve been prescribed the blood-thinner Coumadin (warfarin). According to Pharmacy Foundation of California’s Michael Negrete, “You need just the right amount of Coumadin in your system for it to work properly; too much or too little and you could have serious heart problems such as arrhythmias or a stroke. But so many other drugs interfere with its action that you have to be really careful.”
How to avoid it: Ask your doctor or a pharmacist about potential side effects when you get a new prescription, and make sure the pharmacy gives you written printouts about the medication to review later. Keep all such handouts in a file, so that when you get a new prescription, you can compare the info provided with the handouts from your older prescriptions. If you see the same side effect listed for more than one medication, ask your doctor or pharmacist whether it’s cause for concern.
3. Overdosing by combining more than one medication with similar properties
Think of this one as the Heath Ledger syndrome, says Michael Negrete of Pharmacy Foundation of California. It’s all too easy to end up with several medications that all have similar actions, although they were prescribed to treat different conditions. “You might have one medication prescribed to treat pain, another prescribed for anxiety, and another that’s given as a sleeping pill — but they’re all sedatives, and the combined effect is toxic,” explains Negrete.
The risk for this kind of overdose is highest with drugs that function by depressing the central nervous system. These include narcotic painkillers such as codeine; benzodiazepines such as Ativan, Halcion, Xanax, and Valium; barbiturate tranquilizers such as Seconal; some of the newer drugs such as BuSpar, for anxiety; and the popular sleeping pill Ambien.
But oversedation can also happen with seemingly innocent over-the-counter drugs like antihistamines (diphenhydramine, commonly known as Benadryl, is one of the worst offenders), cough and cold medicines, and OTC sleeping pills. This type of drug mixing is responsible for many medication-induced deaths, especially among younger adults.
How to avoid it: Pay attention to the warnings on the packaging of over-the-counter medications, and the risks listed in the documentation for prescriptions. Key words are sleepy, drowsy, dizzy, sedation, and their equivalents. If more than one of your prescriptions or OTC drugs warns against taking it while driving, or warns that it can make you drowsy, beware. This means the drug has a sedative effect on the central nervous system and shouldn’t be combined with other drugs (including alcohol) that have the same effect.
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34 comments
add your comment »Herbs and supplements are beneficial to people who have chronic low-grade pain. People with moderate to severe chronic pain can't really get by on herbs and supplements. However, when integrated with pain medication, alternative therapies like accupuncture, plus massage and physical therapy can be highly beneficial. I certainly think that doctors andf patients will be better served if doctors wee more interested in looking into natural remedies. It is rather annoying that all of my supplement bottloes say "discuss your supplements with your doctor" and all of my doctors don't know anything about them, so they suggest I don't take them , since there might be an interaction, so I haveto look up the interactions myself. At least I'm lucky that my step-mom is an herbalist!
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While I don't like the track record & many of the practices of the pharmaceutical companies any more than many others,
I do have to say that there are people who need medications to survive & those who need them to have a decent quality of life.
That said, I think that both people & their medical doctors would do well to study alternative health options that may better
address the needs of those who prefer another way than prescription drugs.
If taken properly, supplements can be used to help support health & maintain it. Herbs can be extremely beneficial when used correctly and provide people with a gentler approach to dealing with chronic pain, without negative side-effects of many other medications.
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Pretty much all medications today are derived from natural sources. Opium is derived from poppies and made into opiates; aspirin is made from willow bark. The major problem (and blessing) of this is that we're destroying our natural habitat faster than we can investigate new natural avenues to cures. For example, there is a South American frog who secretes a sticky, antibiotic, anti-microbial and anti-viral foam that it then coats its eggs in to protect them. This could be the source of our next generation of antibiotics. And in fact it will be stronger than antibiotics because it will also be antimicrobial and antiviral. Nature is and has always been our best source for treatment, but many treatments are, in fact naturally derived. So if you want to keep the number of medications you're on down, look into what they;re derived from. If you don't have bleeding issues, take aspirin instead of tylenol, aleve or ibuprofen, for example. Sorry I can't think of other examples, but just look into the medications you're on, because many are nature-derived and beneficial.
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The best factory of drugs is mothe Nature do you remember her? artificial medication usualy helps on the left to destroy on the right. If we descover again powefull products of nature, our treatment it will be more eficient as all unnatural thigs we are using today.
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James, I think exploring natural remedies and buying toxin-free, natural products is a very wise investment in your health, but it is not "simple" to have a condition like I do (spinal cord injury) and not take medication. Saying that if people just follow good health advice they "won't need any pills at all" is dangerous and insensitive. It doesn't matter how healthy I was before or after the accident that crippled me, the damage to my spine was done and I am living with the consequences. A healthy diet and exercise could not prevent this condition and certainly aren't going to repair my spine. Now, a lot of people in my condition just assume that the ten or so medications theur docs put them on are all necessary, but this is not true, depending on your condition. And often natural remedies are more effective. For example, if I didn't take4 a cranberry supplement every day, I'd probably get several times the amount of urinary tract infections I currently do. Calcium helps with my muscle pain, and chromium helps my energy levles. However, these things do not cure chronic pain, or muscle spasms, or my anxiety disorder (yes, I've tried St. John's Wort and it made me worse).
People who follow your advice will be healthier for it but sometimes people just need medication. They can still fall victim to conditions their genes predispose them to. People shouldn't be made to feel that if they have to take medication then they've somehow failed at taking care of their own health.
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If you possibly can avoid the drugs altogther and keep your body clean of the garbage the pharma companies keep trying to sell you. Watch also the ingredients on your hair, teeth, cleaning products so many of the popular brands are full of stuff that is just bad for our bodies.....and we wonder why our children get so many allergies......
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GREAT stuff Melanie! Thanks!
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I'm a student pharmacist currently in my 5th year of 6 years of school. One of the things that most people don't realize is that filling your prescriptions at more than 1 pharmacy is very dangerous. I know a lot of people do it to save money, but if you fill prescriptions at different pharmacies (and I'm talking about CVS vs. Rite Aid vs. Walgreens, etc., not 2 different pharmacies of the same chain) then each pharmacy does not have a complete record of your medications. All pharmacy computers systems are programmed to find interactions between drugs, drugs and disease states, and drugs and food. However this is only with the medications you filled at that pharmacy or chain!! Please please please for your own safety fill all your prescriptions at ONE pharmacy. This creates a relationship with your pharmacist, who is the best person to help you manage any number of medications you're taking.
Pharmacists don't get paid by drug reps to sell or promote certain medications. We are often overlooked as mindless pill counters in white coats, but like others have said we know more about medications than any doctor ever will, including over-the-counter products (and even if we don't know for sure, we know the correct resources to check).
Also, I think natural product chemistry and pharmacognosy are fascinating fields that need more research (which is what I plan on pursuing after graduation), but sometimes there is just no substitute for prescription medications.
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As we age, we metabolize drugs less effectively. This means, the same amount of drug will take more time to leave the body. This is called the drug's half-life. The longer it takes for a drug to leave the body, the faster the build up of the drug in the body. In other words, if only a quarter of the drug is disposed of by your liver and kidneys, then three-quarters remains in your body. Meanwhile, as you take the same dose daily, the second day your now have 1.75 dose, the third day you have 2.5 dose, the fourth day you have 3.25 dose. This is what is meant by 'building blood levels'. Unfortunately, for many elderly, continue to take the same dose over a few years without adequate blood test monitoring. This happened to my father. Despite taking blood tests, his doctor overlooked the tests in favor of appointment assessments. My dad feigned 'feeling fine' because he believed ill health reflected weakness and he never wanted to less fit than mom. He died of a coumadin overdose, which overly thinned his blood, prescribed for high-blood pressure. He took the same dose for three years and never suspected that the drug he attributed to saving his life after a heart attack, weakened him until death.
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It's SIMPLE !!! LIVE WISELY WITH RESTRAINT, DRINK PLENTY OF GOD'S CLEAR WATER, WALK AROUND THE BLOCK REGULARLY, AND YOU WON'T NEED TO TAKE PILLS AT ALL. GOOD GRIEF !!!
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