Medications A Guide to Safe and Effective Use In The Senior Population Group

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Medications - A Guide to Safe and Effective Use
In The Senior Population Group

• Mark Gruenhagen R.Ph., CSPI
• Minnesota Poison Control System

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Todays Goal

• Provide you with information that will enable you
  to use over-the-counter (OTC) and prescription
  medications safely and effectively.
• Introduce you to the Poison Center

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Topics of Discussion

• Alternatives to medication use.
• Buying and taking nonprescription (OTC)
  medications.
• Things to keep in mind when a medicine is
  prescribed for the first time.
• Guidelines for safe use of prescription
  medications.

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Topics of Discussion

• How to store medication properly.
• Common reasons why medicines dont work.
• The importance of getting involved in decision
  making
• Patient and medication records.
• Sources of drug information

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Statistics for older adults (gt65 YO)

• Take more medications chronic conditions
• Use 30 of all medications prescribed
• Purchase 40 of all over-the counter medications
• Take between 2-7 prescription medications daily
• 40 of all adverse drug reactions reported.

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Definitions of Medication (Medicine)

• An agent such as a drug, used to treat disease or
  injury
• Come in a variety of forms
• Tablet/capsules
• Creams/lotions
• Patches
• Liquids
• Suppositories

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Tips on safe OTC use

• Select OTC products that will treat only the
  symptoms you have
• Take product EXACTLY as stated on label
• Use caution in taking more than one OTC product
• OTC products are only to be used for temporary
  symptoms
• Consult pharmacist, doctor or poison center if
  questions about use, side effects or interactions

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Safe Use of OTC medications begins and ends with
reading the label

• The label will tell you all of the following
• Product name and ingredients.
• Any recent significant product changes.
• Indications - What the medicine is for.
• Usual Dosage - Directions for use.

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Safe Use of OTC medications begins and ends with
reading the label

• Warnings - Possible side effects When to stop
  taking the medicine When to see a doctor.
• Exp. Date - When to throw it out.
• A description of tamper-resistant features to
  check before you buy the product.

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Brand name vs generic medications

• Newer isnt always better.
• Antibiotics-UTI or respiratory
• As good as brand.
• Major differences-cost
• Minor differences-color
• Non-formulary medications may work as well.
• Some prescription medications are now OTC.
• Zantac, Pepcid

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Less expensive medication alternatives

• Request samples
• Change lifestyle
• Exercise to decrease hypertension
• Diet
• Ask for cheaper medication.
• Special discounts for drug manufacturers
• www.together-rx.com
• www.pfizerforliving.com.
• www.lillyanswers.com
• www.aarppharmacy.com

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When medicine is being prescribed for the first
time...

• Inform doctor about any other medication you are
  taking currently.
• Tell doctor or pharmacist about any allergies or
  personal medical conditions you might have.
• Be sure you fully understand all instructions
  before leaving the doctors office or pharmacy.

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When medicine is being prescribed for the first
time...

• Write down instructions for future reference.
• Tell doctor any problems you foresee with the new
  medicine or with directions for use.
• Know what the goal is.
• Hypertension lt 120/80

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Safe use of prescription medication

• Never take any medicine that has been prescribed
  for a friend or relative.
• Take medications as prescribed, either until used
  up or discontinue as instructed.
• Do not take more medicine than prescribed.
• Take medication at the proper time.

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Safe use of prescription medication

• Avoid agents - either food, alcohol, other drugs
  - that may decrease effectiveness or increase
  side effects.
• Recognize side effects and know what to do if
  they occur.
• Understand indications and expectations for the
  prescribed agents
• Periodically review medications
• Get prescription refilled in advance

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Medication Interactions

• Drug-Drug
• Sedative-antihistamine
• Anticoagulant- aspirin,NSAIDS
• Drug-Herbals.
• Anticoagulant-ginkgo
• Drug-Condition
• Sedative/hypnotics-sleep apnea
• Nasal decongestants-hypertension
• Drug-Food
• Statins-grapefruit juice

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How to store medication properly

• Store medicines in a cool, dry place that is away
  from bright light.
• When possible keep medicine in the original
  container.
• Throw away medication that is past the expiration
  date.
• Never mix different medications in same container
• Discard medications that arent being used, cant
  read label or if outdated.

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How to store medication properly

• Dont store medications in refrigerator unless
  specifically instructed to do so.
• If young children are present use child-resistant
  closures (CRCs) or take other reasonable
  precautions.
• Replace CRCs carefully.
• When traveling be aware of storage problem
  potential

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How to store and use medications properly with
grandchildren present

• 36 of exposures reported are related to
  grandparent medications - USCPSC
• If visiting, keep medications in purses, toiletry
  bags and suitcases
• Be careful of weekly pill minders
• Avoid taking own medication in front of child
  like to mimic
• Place medications out of reach of children
• If administering medication to child read label

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When medicines dont work it may be due to...

• Not following the correct dosage schedule
• Interactions with certain foods or beverages
• Interactions with other medicines
• Attempting to treat yourself with OTC remedy when
  problem requires professional medical attention

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When medicines dont work it may be due to...

• Complication which demand further medical
  attention
• Misdiagnosis

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Medication Alternatives

• Change diet or fluid intake.
• Exercise
• Change lifestyle
• Example Constipation when taking opiate pain
  medications

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The importance of getting involved in treatment

• Youll feel better about following the prescribed
  treatment
• If problems arise from medication or the
  prescribed schedule changes may be possible
• If target symptoms continue, or if there are any
  new symptoms or unusual side effects, a change in
  treatment may be necessary.

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Ask your pharmacist about patient records

• Pharmacists now keep these records for you.
• Try to stay with one pharmacy.
• Keep track of all the medicines you are currently
  taking, as well as allergies and current medical
  conditions.
• This is helpful if you are being prescribed
  medicines by more than one doctor.

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Keep a record of the medicines you take

• Such record keeping can help you use medicines
  properly and safely.
• This is useful if you are particularly ill,
  taking several different medications or taking
  medications chronically.

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Who to call if you have a question about your
medication

• The prescribing physician or your clinic
• A pharmacist
• The poison center

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In summary...

• Understand what drugs you are taking and why.
• Understand endpoints of therapy
• Take prescribed medications only as directed.
• Know who to go to if you have questions about
  drug therapy or results are not satisfactory.
• Be involved in your drug therapy
• Store medications properly
• 
  

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Mission Statement

• The mission of the Hennepin Regional Poison
  Center is to assure that all service area
  residents and medical professionals receive
  accessible, high quality and cost effective human
  poison information and treatment services. This
  is achieved through maintaining a strong, full
  service regional poison center that provides the
  needed poison information and treatment
  guidelines, community education aimed at
  prevention of poisoning episodes, clinically
  based educations for health professionals, needed
  toxicology based research, and provision or
  support of other community services.

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Poison Center History

• First poison center opened in Chicago 40 years
  ago
• Early poison centers located in ED or pharmacy
• Developed as a front-line response to poison
  exposures
• American Association of Poison Control Centers
  (AAPCC) formed in early 80s
• Improve quality of poison services
• Develop national standards/certification

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AAPCC

• The U.S. is currently served by 62 poison
  centers, 51 of which have met the certification
  standards set by the AAPCC
• Sets standards for poison center certification
  including
• Staff solely dedicated to the poison center
• 24 hour service
• Medical toxicologist available for consultation
• Public professional education programs
• Data surveillance efforts

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New Chapter in Poison Center History

• New national number and logo kicked off on
  January 30, 2002.
• 1-800-222-1222The antidote for any poisoning
• Number works anywhere in the U.S. (including
  Alaska Hawaii)
• Mr Yuk retired from active duty in Minnesota
• Other numbers to the Minnesota Poison Control
  System will still be in service, but not
  advertised

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The Minnesota Poison Control System

• Funded by the State of Minnesota through the
  Department of Health
• MPCS received 75,411 calls in 2005.
• 55 of accidental exposure calls involved
  children lt6 y.o.
• 77 of cases where the MPCS was consulted were
  managed at home
• Staffed 24 hours a day/7 days a week/365 days a
  year
• Staffed by Pharmacists and Healthcare Assistants

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Medical Toxicologists on Staff
Associate Medical Directors Elisabeth Bilden,
MD Andrew Topliff, MD,  
Consultants Beth Baker, MD, Carson Harris,
MD Daniel Keyler, PharmD Mike kinnan, MD
Michael McGrail, MD, Matt Morgan, MD, Mike
Murphy, DVM, PhD Paul Pentel, MD, Matt
Sztajnkrycer, MD,
Dr Roberts Medical Director MPCS
Dr Ling Senior Associate Medical Director MPCS
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Calling the MPCS

• Call the Minnesota Poison Control System for any
  questions or exposures including
• Drug overdose
• Medication errors
• Plant, insect, reptile, mammal bites/exposures
• Drug interactions/adverse reactions
• Pill IDs
• Food poisoning concerns
• Occupational/environmental exposures

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Calling the MPCS (cont)

• Phones are answered live by CSPIs or Poison
  information Providers (PIPs) 24/7.

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Calling the MPCS (cont)

• It does not need to be an emergency to call
• No phone trees or automated answering systems
• All calls are confidential

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Calling the MPCS (cont)

• Important information needed when calling MPCS
• Age of exposed person
• Weight of exposed person
• Product or potential poison person was exposed to
• Amount of product the person was exposed to
• Current status of the person, i.e. SOB,
  unconscious, etc.
• Pertinent medical history
• Current medications
• Name, phone number and zip code of exposed person

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Poisoned people

• Over a 2 million people exposed to poison in the
  US annually
• 55 of poison exposures in MN involve children lt6
  y.o.
• Reasons for exposures
• Improper storage
• Lack of supervision
• Look-a-like products
• Childs natural curiosity

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Contact us

• www.mnpoison.org

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The End of Cruel and Unusual Punishment,
Questions?