Avoiding harm from the drugs you take

Ten Eight Rules for Safe Drug Use

Before surgery the medications you take should be listed accurately and in detail – their names, doses, and the times at which you take them. Medications that you purchase without a prescription may be as important as those prescribed by your doctor.

Why is a medication history important before surgery? Your anesthesia provider needs to know what you’re taking. Your surgeon and the hospital nursing staff too. Drugs that you take may interact with anesthesia drugs, or with drugs prescribed specifically for your recovery – e.g. antibiotics or anticoagulants (“blood thinners”). Drugs you take on a regular basis are usually taken for a good reason so should be continued during a hospital admission, and afterward. Some drugs however, such as anticoagulants, may need to be stopped, or surgery cannot go ahead.

“Adverse drug events” (ADE) are surprisingly common, both in and outside hospitals, especially among the elderly, so there may even be unrecognized problems with the combination of drugs you take, though these are best managed by your primary care doctor.

How do you avoid such problems? Here are a few rules that can help keep you out of trouble:

Rule 1: Have regular “brown bag sessions” with your primary doctor to review all your drugs, their doses and the reason you are taking them.

Rule 2: Find out if you are having any adverse drug reactions.

Rule 3: Assume that any new symptom you develop after starting a new drug could be caused by the drug.

Rule 4: Before leaving your doctor’s office or pharmacy, make sure the instructions for taking your medicine are clear to you and a family member or friend.

If you’re in the hospital things get a bit more tricky, because there are more people involved in the prescription, transcription, distribution and administration of drugs. And, more drugs. Also, you may not always be in a state where you are able to pay attention to what is being done for you, or told to you, by doctors, nurses, and hospital staff.

Rule 1: Take a friend or family member with you who can ask questions about your drug treatment when you are not fully able to play your part in the conversation.

Rule 2: Make sure you understand the instructions for taking any new drugs before you leave the hospital, including the dose, the timing, and any side effects to look out for.

Rule 3: Ask what any new drug is for.

Rule 4: Make sure the new drug is not the same as, or similar to, something you have previously had a reaction to. In other words, dont’ be embarasses to remind your doctors or nurses about any allergies or adverse reactions to medication that you have had.

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