As a pharmacist, my biggest nightmare is to find out I failed to give the right medication to the right patient. Even though there are many steps we take in the process of filling a prescription to avoid mistakes, and regardless of how competent, careful, and caring we are, it is utterly impossible to not make any mistakes throughout our practice as pharmacists. So you, as a patient, need to also be more proactive in managing your prescriptions to avoid ending up with the wrong medication. As a matter of fact, you can take 10 simple but smart steps to minimize prescription errors, and potentially save your life.
- At the time of getting a new prescription form your doctor, always ask your doctor if you should discontinue any of your old prescriptions. Quite often, I encounter a patient who was given a new dosage of a medication or a substituted medication, without being clear on what medication is being changed, and ending up taking the old and the new medications simultaneously. This could cause overlapping side effects and potentially threaten patient’s life. For example, it is very common for doctors to substitute a new blood pressure medication for an old one. Taking the two medications together can drop the blood pressure too much or even affect the heart rate.
- Make sure all your doctors and your pharmacies have a complete list of your current medications. For example, a patient who is on a blood thinning medication such as Coumadin by the cardiologist may be prescribed an antibiotic for a simple strep throat by his internist. However, there are some antibiotics that can significantly interact with blood thinning medications and cause bleeding. So it is crucial that your internist be informed of your active medication list. There are many tools available on the internet that allow you to create and manage your medication list. One such tool, MedSort, lets you do just that.
- Also try to stick to one pharmacy. This could assure you that the pharmacy has a complete list of your medications in their database, which allow them to check for any significant drug interactions.
- Make sure all your doctors and your pharmacies are aware of all your drug allergies. There are some significant cross allergies among different classes of medications which patients are not aware of. For example, a patient who is allergic to sulfa antibiotics could also be allergic to Celebrex which is an anti-inflammatory/anti pain medication.
- At the time of ordering your refills wheather through the automated phone service or manually by talking to someone in the pharmacy, be sure to mention both the name and the dosage of your medication. Quite often, you may have been taking the same medication with a different dosage in the past, and if you don’t mention that on the phone, the pharmacist may end up filling the old strength of your medication. It is not always that obvious to the pharmacist what the current dosage is unless we go into the details of your profile.
- If your pharmacist tells you that he needs to call your doctor to clarify your prescription, do not resist. Let him do his job. We know you are tired and can’t wait any longer, but waiting longer is better that having the pharmacist guessing the name or the dosage of your medication and you ending up with the wrong medication.
- At the time of picking up your medication at the pharmacy, double check for your name on the medication bag. This may seem obvious, but you will be surprised how often the wrong medication bag is handed to some one with similar first or last name. Also cooperate with the cashier to verify your address at the pick up window, even if you are a regular customer. Verifying the address is one of the best ways to ensure you are handed the right medication and is not because your business as a regular customer is not being acknowledged.
- Always get consultation for any new prescriptions. The most important information you need to obtain at the time of consultation is:
- Find out what the medication is for. A very common mistake in filling a prescription occurs when two medication names look alike or sound alike. These kinds of mistakes can easily be caught at the time of consultation. For example Lamisil is a medicine for fungal infection, and Lamictal is a psychiatry/neurology medication. Thanks to the beautiful doctor’s hand writing, it is very easy to mistake one for the other on paper. By getting a consultation, you will find out which medication you are getting and you can catch the pharmacist’s mistake in case you are being dispensed the wrong medicine.
- Find out when is the best time to take your medication. For example, oral corticosteroids, such as Prednisone, are best taken in the morning since they could cause insomnia. Water pills given for blood pressure such as Hydrochlorothiazide or Lasix should be taken in the morning since they make you urinate more frequently.
- Find out whether you should take your medicine with or without food. For example, anti-inflammatory medications such as Motrin should be taken with food to avoid stomach pain and stomach ulcers. Narcotic Pain medications such as Vicodin are better to tolerated with food to avoid stomach upset and nausea.
- Find out about your medication’s common or serous side effects. For example, a common side effect of water pills such as Hydrochlorothiazide is dizziness, especially when you change positions, which over time your body gets used to. A rare but serous side effect of Trazodone which is a psychiatry/sleeping pill is periapisam. Periapism is prolonged penile erection, which is very rare but also very serious and requires immediate medical attention.
- Before leaving the pharmacy, check all your medication bottles and be sure you got everything you ordered. Quite often, we deal with frustrated patients who did not get everything they ordered. This could be due to not using the automated phone service correctly, or being out of refills and having to wait for the doctor to approve additional refills. Patients may also be on two sound alike medications which could lead to mishearing the name at the time of ordering and dispensing the wrong medication. By double checking your medications before leaving the pharmacy, you may save yourself from an extra trip to the pharmacy and lots of frustration.
- Always call your pharmacist if you notice your medication looks different from before. Most of the time, this is due to a change of manufacturer. In this case, your medicine is exactly the same, but looks different. Occasionally, though, the medication looks different because the wrong dosage or wrong medicine has been dispensed.
I hope these 10 simple steps to avoid medication errors at the pharmacy will help you on your next trip. Remember, we are all human and we need multiple checks and balances to avoid potentially serious mistakes. You can be an integral part of this process. Help your physicians and your pharmacists to help you. Good luck and be well. .