October was American Pharmacist Month and hopefully it raised awareness about pharmacy and pharmacists. If you’re like most of us you’re probably annoyed when your doctor hustles you in and out of his exam room in 15 minutes flat. But I’d bet even 10 minutes is too long to wait when you’re picking up a prescription. Once the doc has written that prescription we tend to put our brains in neutral. But what do you really know about that pill you’re about to pop? Unless you have a very unusual physician it’s likely that he or she doesn’t (1.) discuss your prescriptions with you and (2.) doesn’t know a whole heck of a lot about the benefits and downsides of the drugs he prescribes. There is, however, a remedy for this rather scary and pathetic situation: your friendly neighborhood pharmacist is a drug expert and the master where everything pharmaceutical is concerned. You just need to know which questions to ask:
Why am I taking this medicine? Now there’s a concept – actually understanding why a particular drug has been prescribed for you. Yet you’d be amazed at how many people never think to ask. My mother, for instance, a depression era baby, would never dream of questioning her doctor. In her generation it just isn’t done. What’s your excuse? All drugs, including prescription ones, are potentially dangerous – even lethal. Ask your doctor WHY you need the medicine being prescribed and how it’s going to help you. Discuss your concerns and get all the information so you can decide if you want to take it. (Yes, it really is your decision.) If you don’t want to take it, ask your doctor for a treatment that is more acceptable. If your doctor resists, ask a pharmacist. Oh, and then find a different doctor.
Brand name or generic? If you weren’t confused enough already, that drug you’ve been prescribed has more than one name. The first one, its brand name, refers to a new drug that has been developed by a pharmaceutical company. After a new drug is formulated, its maker files for a patent to protect against other companies copying and selling it. At this point the drug has two names: the generic, or the drug’s common scientific name and the brand name that makes it stand out in the marketplace. Think acetaminophen vs Tylenol.
Generics in the U.S. must match the brand name med in almost every way, both in the strength of the active drug it contains and in the way it acts in your body. This is called “bioequivalence”. The real differences lie in the way the products look (color and shape) and how much they cost. (Occasionally the difference in inert ingredients can present a problem for some individuals – ask your pharmacist if the generic is right for your situation.)
Brand names cost more because manufacturers want to cover the costs of researching, developing and advertising the drug – don’t think it’s because the brand name is superior.
How do I take this medication? According to Dr. Dorothy L. Smith, author and patient education expert, the cost to purchase all prescription medications in the U.S. in 2000 was about $111 billion dollars. But the cost to treat complications from home medication errors was $177 billion! Add to that another $100 billion to cover employer costs resulting from absenteeism and loss of productivity from home medication errors. Deaths from medication mistakes at home increased from 1,132 in 1983 to 12,426 in 2004 – an increase of more than 700%. Americans not only don’t know what they’re taking, they don’t know how to take it. Consider these tips:
§ The average person forgets 50% of their doctor tells them – ask your pharmacist to go over the instructions.
§ If you don’t feel comfortable talking to the pharmacist over the counter, ask for a private area. More and more pharmacies have them.
§ Lots of people stop taking their medicine because they think they’re allergic to it. Actually, they may have had a minor side effect. But allergic reactions can be very serious. Ask if you have a question!
§ Know how to take your medicine correctly. This might seem like a no-brainer, but “Take one tablet 3 times a day” doesn’t give you enough information. Your pharmacist can help you work your dosage schedule around your meal times and activities. Also, some medicines, such as asthma inhalers, are complicated to take. Your pharmacist can make sure the medicine reaches your lungs, not your throat.
§ Understand what to do if you accidentally skip a dose. Understand the sometimes serious side effects that can occur if you stop taking your medicine suddenly.
§ Are you taking OTC drugs or herbal remedies? They can interact with your prescription. Make sure you discuss them with your pharmacist.
§ Side effects – every drug has them. You need to know how recognize them because some are serious. Others are just annoying but you need to know how to manage them.
§ If you’re having trouble remembering to take your medicine, don’t be afraid to tell your pharmacist. They can help you find a way to jog your memory.
§ How long should take your medication? Some drugs are for a specific duration, like antibiotics or pain meds. Others, like heart medications or diabetes drugs, are for life. Stopping antibiotics prematurely can have dire consequences, so take your meds for the time prescribed and let your pharmacist know if problems develop. Never, never, never, stop taking antibiotics prematurely because you feel better and think you don’t need them!
How do I store this medication? Again, this is one of those things that seems obvious, but drugs can become toxic or inactive when stored improperly. Some drugs need to be refrigerated, for instance. Some are light sensitive or can degrade when exposed to the air. Most drugs should be stored in a cool, dark, dry place – they don’t do well in temperature extremes or in high humidity (like bathroom cabinets). Combining different meds into one bottle or vial is not a good idea, nor is keeping them in a plastic bag where they may break open or get crushed. Transdermal patches should be discarded carefully so kids and dogs don’t get into them. And you know those pesky childproof caps? If you don’t have kids around, you may not want them. I had no idea that the white plastic locking kind can simply be turned upside down and screwed on until my pharmacist pal showed me.
How do I choose a Pharmacy? Most people choose a pharmacy based on location or convenience (like the Walgreen’s around here that also sell booze – no, really!). But there are a ton of other services you may not know you want until you need them:
§ What are the pharmacy hours? Are they open when you might need them most – like on holidays or in the middle of the night?
§ Does the pharmacy deliver? What are the restrictions? Charges?
§ How are emergencies handled during and after business hours? Is there a dedicated emergency phone number?
§ How long does it take to have a prescription filled?
§ Does the pharmacy stock the drugs you take?
§ Does the pharmacy staff look stressed? Are there long lines at the counter? (If you suspect staffing problems behind the scenes, don’t risk an error or sacrifice service – find another pharmacy.)
§ Is there a drive-through? Pharmacists hate them. I love them. (Never equate your pharmacist with the burger flipper at McDonald’s. She’s a professional and protecting your health and safety takes time.)
§ Are there exceptions to the kind of insurance they accept?
§ Do they accept credit cards? Do they have credit accounts available?
§ What health services are offered? Vaccinations? Blood pressure or cholesterol screening? Medication management for chronic conditions like diabetes?
How do I choose a pharmacist? Choose a pharmacist, you ask? I just go over to CVS and take my chances! Pharmacists don’t just put pills in a bottle. The role of today’s pharmacist is expanding and involves establishing a relationship with the patient to develop care plans for drug therapy. Ask friends and family for a pharmacist referral. Then get to know him and make sure he knows your medical history. Some other things to think about:
§ How does the pharmacist handle the phone? Is she harried? Disinterested? Or polite and informative?
§ Does the pharmacist have any specialties in disease management? This can be a real advantage if you have a chronic illness such as heart disease.
§ Is he easy to talk to? Does he take the time to explain new medications and answer your questions in a way you understand?
§ Select a pharmacist with the same care as choosing a doctor. A good one will go the extra mile for you when it really counts.
Your pharmacist is the real drug expert and is probably a lot more accessible than your doctor. So take an active role in your own health care – get to know your pharmacist and get to know your meds. It could save your life or the life of someone you love some day.
Next week – the questions you’re better off NOT asking the pharmacist!