Ellen Campbell Grizzle - Pharmacy Today THIS IS the age of the informed consumer. Effective communication with patients is central to any effort to achieve safe medication use. Some patients complain that they do not understand the rationale behind some of the medication instructions that they are given and consequently are not persuaded to heed them. There appear to be some glitches in the present pharmacist and patient communication process.
Some instructions are simple and easy to understand. Others may be more complex and an advisory or cautionary tag may be attached to the container. These warnings often highlight conditions under which the drug may not be safely used or seek to foster the creation of conditions that will assure the best outcome from the use of the drug.
Standard wordings exist for proper guidance. However, the following clarifications should reinforce their value:-
Do not take indigestion remedies at the same time of day as this medicine some tablets are coated to resist gastric acid. However, we must also avoid the possibility of premature break up in the presence of alkaline pH such as that produced by many antacids used to treat indigestion and heart burn.
Do not take indigestion remedies or medicines containing iron or zinc at the same time of day as this medicine several drugs, including some commonly- used antibiotics, incorporate calcium, iron and zinc into their structure and are rendered less effective. Calcium-containing antacids and preparations containing iron and zinc are considered incompatible with such medicines and should be taken two to three hours apart.
Do not stop taking this medicine except on your doctors' advice there are drugs that need to be taken over a long period of time without any perceived benefit (for example, anti-tuberculosis drugs). Hazardous effects may occur with the sudden cessation of some therapies (for example, clonidine for high blood pressure).
Allow to dissolve under the tongue. Do not transfer from this container. Keep tightly closed. Keep eight weeks after opening to be used on glyceryl trinitrate containers to remind patients that this tablet cannot be stored in plastic or other vials. Plastic adsorbs some active ingredients and can reduce product strength and effectiveness.
Take with plenty water plenty means 150ml of water. Many times a large amount of water is needed to aid the passing out of some drugs or their dissolution.
Do not take with any other paracetamol-containing product. Do not take more than two at any one time. Do not take more than eight in 24 hours paracetamol (acetaminophen) doses must be closely watched. This further explains the "as required" basis that may appear on some containers. There are serious consequences of overdosage with paracetamol.
Take with or after food. This is important when you are taking a drug that will upset your stomach or those that are better absorbed with food. Do not gorge, a small amount of food is always sufficient!
Remember, knowledge about your medication is a key protector against communication glitches. These standard warning tags are designed to address various circumstances relating to the use of a particular drug or group of drugs. However, the need of each patient may be different and explanations and clarifications are important. Whenever you are receiving your medication, ask your pharmacist to tell you if there is any additional cautionary information, you have the right to know!
Ellen Campbell Grizzle, President of the Caribbean Association of Pharmacists (CAP) and Director, Information & Research, National Council on Drug Abuse (NCDA).
