The importance of not just what you take but how you take it has been emphasised by a report in last week’s issue of Australian Doctor.
A study of more than 1200 cases of medication errors reported to the Victorian Poisons Information Centre showed that many medicines are not always used in the way they were intended. Doctors’ directions, pharmacists’ advice and label recommendations are not uniformly followed.
Pain relievers, blood pressure medicines, cough/cold products and preparations to treat epilepsy were the most common groups of medications not used correctly.
While in some cases it’s clear patients have taken a deliberate decision to ignore “what the doctor ordered”, there is no doubt many errors occur through ignorance, forgetfulness or lack of attention.
Some errors might seem predictable: wrong doses (too much or too little) and medicines taken at the wrong time, on the other hand some errors were more surprising: in 10 cases patients accidentally took dog or cat medicine; and in three cases rectal suppositories and vaginal pessaries were taken by mouth.
There’s a message for all of us to take careful note of directions on the label of every medicine – whether that’s a prescribed medicine or one available without prescription.
There’s a message also for health professionals to make sure every patient fully understands how medicine should be taken. If necessary, so-called dose administration aids can be provided by pharmacists. These simple blister packs are a good memory aid to ensure medicines are taken in the right dose at the right time.
On another matter of medicine safety, the Therapeutic Goods Administration (TGA) has recently proposed a number of changes to the warning labels on a number of over-the-counter and complementary medicines.
Following a TGA review of the cardiovascular and gastrointestinal safety aspects of certain non-steroidal anti-inflammatory pain relievers, the recommendation is that these products not be used “for more than a few days at a time” unless advised by a doctor. This group of products includes ibuprofen, naproxen and diclofenac.
Other proposals include a warning to pregnant women not to take vitamin A supplements without first consulting a doctor or pharmacist and a stronger liver toxicity warning relating to black cohosh following rare but serious adverse reactions to this herbal product.
Royal jelly has long been known to have the potential to cause severe, sometimes fatal, allergic reactions; and it is suggested that the previous recommended warning to asthma and allergy sufferers to avoid royal jelly should be a requirement.
Two of the common “G” complementary medicines have come under the spotlight too. Ginger is used for a number of conditions – the relief of nausea, mild anxiety and digestive problems. However, it is generally not suitable for people taking anticoagulants or otherwise at risk of bleeding. Also glucosamine derived from marine sources should be identified to alert consumers with a possible seafood allergy.
As well, some glucosamine products contain a significant amount of potassium which could pose a risk to people with kidney disease or taking certain medicines for heart or blood vessel disease. More details about the TGA proposals can be viewed on their website www.tga.gov.au Meanwhile before you begin any new medicine or are tempted to mix some older ones together, get some advice from your doctor or pharmacist.
There are some fact cards available on topics such as pain relievers and complementary medicines (and 80 or so other topics too) from all Self Care pharmacies. Phone the Pharmaceutical Society on 1300 369 772 for the nearest location.
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