Question of the Week

March 26, 2007


Monday morning, it was big news:

"Anna Nicole Smith died of an accidental drug overdose with traces of nine prescription drugs in her blood, including anti-depressants and sedatives, Florida officials said Monday [March 26, 2007]. ... There was no evidence of illegal drugs in her body, said Broward County Medical Examiner Joshua Perper..."
National Post

While many in the United States (and others around the world) paid attention to the headline because it contained the name "Anna Nicole Smith," there is more to the story.

"Mixing medications can be dangerous -- even deadly ... A report this month by the Centers for Disease Control and Prevention found that deaths from accidental drug interactions rose 68 percent between 1999 and 2004, continuing a steady climb since the early 1990s. Unintentional drug poisonings accounted for nearly 20,000 deaths in 2004, said the CDC, making the problem now the second-leading cause of accidental death in the United States, after automobile accidents."
Washington Post

Anna Nicole Smith had "traces of nine prescription drugs in her blood." As people age, or struggle with various health problems for which there are more and more medications, the chances of a dangerous combination increases.

It doesn't take nine medications to cause a problem. People can have adverse reactions (side effects and/ or allergic reactions) to even one medication. When combining two medications, a patient needs to be even more careful, as one can affect how the other interacts with the body. With each new medication that is added, the potential for a negative interaction increases.

"Keeping track of your medicines is very important. Making sure that they are stored properly, that they have not expired when you take them, and that prescriptions are refilled requires time and attention. Also, taking many different medications at the same time is difficult. It can be hard to remember what each drug is for, when you should take it, and how you should take it. This is especially true for people with memory problems. However, there are simple strategies you can use to help you manage your medicines wisely. Keep a checklist of all the prescription and over-the-counter medications you take. For each medicine, mark the amount you take, the time of day you take it, and whether it should be taken with food. ... Review your medicine record at every visit to the doctor and whenever your doctor prescribes new medicine. Your doctor may have new information about your medicines that might be important to you. Whenever possible, have your health care provider write down advice and instructions for taking the medication."
National Institutes of Health

Whether you are helping a family member keep track of their medications, or taking medications for a health issue of your own, it is important to know what each medicine is, what it does, and how it might potentially interact with any other medications.

Even if you only have one prescription, there is still the possibility of a negative interaction.

"Talk to your doctor or pharmacist about the drugs you take. When your doctor prescribes a new drug, discuss all OTC [Over the Counter] and prescription drugs, dietary supplements, vitamins, botanicals, minerals and herbals you take, as well as the foods you eat. Ask your pharmacist for the package insert for each prescription drug you take. The package insert provides more information about potential drug interactions. Before taking a drug, ask your doctor or pharmacist the following questions:

  • Can I take it with other drugs?
  • Should I avoid certain foods, beverages or other products?
  • What are possible drug interaction signs I should know about?
  • How will the drug work in my body?
  • Is there more information available about the drug or my condition (on the Internet or in health and medical literature)?"

It is generally a good idea to fill all of your prescriptions at one pharmacy. Even if you are just buying an OTC cold medication, it is always a good idea to check with a pharmacist about possible adverse drug interactions that might occur. Also keep in mind that it is not just what you take, but how you take it...

"Tips on Reducing the Risk of Adverse Drug Effects:

  • Read the drug label carefully.
  • Make sure you know what ingredients the product contains and understand any warnings or possible adverse effects. ...
  • Don't stir medicine into your food or take capsules apart (unless your doctor tells you to). This may change the way the drug works.
  • Don't take vitamin pills at the same time you take medicine. Vitamins and minerals can cause problems if taken with some drugs.
  • Don't mix medicine into hot drinks unless the label tells you to. The heat may keep the drug from working as it should.
  • Don't take medicine with alcoholic drinks."

Questions of the Week:
What do you and your peers need to know about the possibilities of adverse drug interactions, even if you are not currently taking any prescription medications? What do others in your family need to know? What questions do you need to have answered before starting any new medication (OTC or prescription). What information do you need to share with your doctor and/ or pharmacist in order for them to help you reduce your chances of suffering a possible adverse drug interaction? How can you help your family members and/ or peers understand how important it is to check with a medical professional before mixing any OTC or prescription medications?

Please email me with any ideas or suggestions. Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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