master your Medicines A guide to help older people know more about their medicines
This booklet is intended to help you get the best from your medicines.
Contents Getting the best from your medicines
1
Taking the first step
2
At the pharmacy
4
General tips for taking medicines
5
Remembering to take your medicine
7
Have you checked the expiry date?
8
What should I do if? The medicine causes side effects I forget to take my medicine I take too much medicine
9
Medicines and falls
10
Carers can help too
11
Personal Information Pack (PIP)
13
Patient Medication Record (PMR)
15
Getting the best from your medicines Medicines are likely to play an increasing role in your life as you get older, helping you to control many conditions such as high blood pressure, high cholesterol and diabetes as well as minor ailments such as colds and headaches. The doctor or pharmacist will have decided what medicine is most suitable for you, having discussed your condition with you. But at the end of the day, it is important that regardless of which medicines you take, whether it’s a tablet for hayfever or something you take every day for your heart, it is up to you to use it correctly. Taking medicines can be a complicated business especially if you are not used to taking them or have to use several medicines at once.
You are the most important person when it comes to getting the best from your medicines so read on and master your medicines!
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Taking the first step The first step to getting the best from your medicines is to ensure that the right medicine is prescribed for you. When we’re not feeling well, we often turn to our family and friends for advice. Sometimes this is not the best course of action as the treatments that suited them may not be right for you. Alternatively you may find information on the Internet, however, it may not be very detailed or reliable. Deciding to go to the doctor’s surgery or the local pharmacy may be a better option but before doing that, stop and think about what you want. Here are some useful tips that will help:
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Write down any questions you have before you visit your doctor or pharmacist so that you don’t forget them. If you don’t like asking questions, why not bring a friend, a family member, or your carer with you?
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Tell the doctor or pharmacist about all the medicines you are taking at every visit. Some medicines interact with each other, which can change the way they work. Your doctor or pharmacist may have new information about your medicines that might be important to you.
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Tell your doctor or pharmacist about any allergies or reactions you have experienced in the past.
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Make sure you understand what the doctor or pharmacist tells you. If you are not sure, don’t be afraid to ask again. Remember, it is your right to know. In particular, be sure you have the following information: -
The name of the medicine prescribed for you.
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What it is for and how it works.
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How to take the medicine, e.g. what dose, when and how often each day?
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Possible side effects and what you should do if they occur.
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Anything you should or shouldn’t eat or drink while using the medicine.
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If the medicine is likely to affect any others that you are taking (including any non-prescription medicines, herbal or homeopathic remedies or any other complementary medicines).
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If the doctor needs to see you again and if so, when?
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How long you should take the medicine for.
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What to do if you need a repeat prescription.
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What to do if the medicine doesn’t seem to be working.
You will find this information in the patient information leaflet that comes with your medicine. You will also find it on www.medicines.ie.
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At the pharmacy If you get a prescription from your doctor, have it dispensed as soon as possible unless he or she has indicated that the prescription is only to be used if, for example, you are feeling worse. Here are some tips while at your local pharmacy: •
Get to know your pharmacist. He or she is there to help you and has a record of the different medicines you get from that pharmacy.
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It is a good idea to get all your prescription medicines from the same pharmacy so that the pharmacist is aware of everything that you are taking.
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If you have forgotten any of the information that the doctor gave you about the medicine, ask your pharmacist. They can also help with questions that you forgot to ask the doctor.
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Remember that your pharmacist is an expert on medicines and can advise you on any aspect of them. DON’T BE AFRAID TO ASK QUESTIONS – if at first you don’t understand, ask again! Make sure you understand what to do because knowledge really is the best medicine!
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General tips for taking medicines •
Know as much as possible about the medicines you are taking. Remember, understanding what it is all about is one way of being in control. -
Before taking your medicine, always read the label on your medicine and the leaflet provided – here you will find lots of useful information about how to use the medicine, its side effects, what to do if you miss a dose, etc.
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Finish all your medicines, unless your doctor tells you not to. This is particularly important for medicines like antibiotics where you must take the full quantity even if you are feeling better.
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If your doctor prescribes a new medicine, find out if you should stop taking any medicines that you are already on.
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Medicines often have more than one name: -
A generic name e.g. Paracetamol. This is medical name for the active ingredient of the medicine.
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A brand name e.g. Panadol or Anadin. This is the trade name a manufacturer gives to a medicine.
This means the medicine may have several names or types of packaging. If your pharmacist gives you a medicine that looks different to the one you are used to, make sure you get an explanation before leaving. •
Don’t save a prescription for future use unless your doctor tells you to.
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Don’t share your medicine with others or use a medicine that was prescribed for someone else.
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When certain medicines are mixed with alcohol, the result can be harmful. Check with your doctor or pharmacist.
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If you are away from home, make sure you carry enough of your medicine with you to take the proper dose while you’re out. Take extra in case you are away longer than expected.
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If you are taking medicines on a long-term basis, you must visit your doctor regularly to have your medication reviewed and a new prescription issued if necessary. Prescriptions are valid for a maximum of six months unless your doctor has specified a shorter period. If you are unsure whether your prescription is still valid, check with your doctor or pharmacist. Generally your pharmacist will remind you when you need to get a new prescription.
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If you have difficulty: -
reading small print on medicine labels, ask your pharmacist to use large print on containers.
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using an inhaler or eye drops or swallowing tablets, ask your pharmacist’s advice. For example, there are devices available to help you use an inhaler properly. If you don’t ask your pharmacist, you may never find out!
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opening child-resistant containers, ask your pharmacist to use ordinary bottle tops instead. But remember to keep medicines that are in non-child-resistant containers well out of reach of children.
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To avoid mistakes, never take medicines in the dark.
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Never mix different medicines in one container. Always store your medicines in the containers they were supplied in. If you transfer medicines to other containers, you may not be able to identify them or know when they expire. The stability of certain medicines can also be affected if they are transferred from their specially designed packaging.
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Check with your pharmacist before you take any non-prescription or herbal medicines.
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At least once a year, ask your doctor or pharmacist to review all your medicines to see if they are still needed, particularly if you are taking four or more medicines.
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If you don’t feel that your medicine is helping you, talk to your doctor and ask why.
Remembering to take your medicine We have all forgotten to take our medicines at one time or other. The following hints will help you to remember! •
Take your medicine at the same time every day.
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Take it with meals (unless the label says otherwise) or other daily events, like brushing your teeth.
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Put a sticker or reminder note on your medicine cabinet or fridge.
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Get your family or friends to remind you.
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Send yourself reminders using your mobile phone or PC.
I’m on several medicines – how can I remember to take them all? If you are taking several medicines together, it can be difficult to keep track of when to take each of them. The following tips may help: •
Ask your doctor if it is possible to simplify your medication. This may be done by reducing the number of medicines or how often they have to be taken, for example, by using controlled release products (these are medicines that are designed to work over a longer period).
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Use a chart or diary to write down the details of all medicines you are taking. A patient medication record (PMR) is perfect for this and one is available at the back of this booklet. Why not have a special medication calendar or use a medicines reminder chart (see below)? You could even mark it every time you take your dose.
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Make an instruction sheet for yourself by taping a sample of each pill you have on a sheet and writing down all the information about that pill to remind you to take it.
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Get some coloured labels and stick them onto your medicine bottles to help simplify your routine. For example, blue could be for morning, red for afternoon and yellow for bedtime.
To help you remember to take your medicines you may download and print out a useful ‘Medicines Reminder Chart’ from either www.ipha.ie or www.ipu.ie. 7
Have you checked the expiry date? •
All medicines are labelled with a “best before” date or "expiry" date. This date is printed on the bottle, tube or box and also on every blister strip. (The number that appears beside the expiry date is the manufacturer’s batch number).
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The expiry date is usually in the format “Exp: 01 2012” or “Exp 01/2012” – in this example, medicine is safe to use until the end of January 2012. If a specific date is given e.g. “Exp 20/1/2012” – the medicine can be used up until 20th January 2012 but not after that date.
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Always check the expiry date of a medicine before you take it. If it is out-of-date, do not use it!
Out-of-date or unused medicines should be returned to your pharmacist who will dispose of them safely.
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What should I do if? The medicine causes side effects Sometimes when taking medicines, things we don’t expect can happen. That’s the time to call your doctor. Here are examples of signs to watch for: -
Skin rashes or itchiness
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Difficulty breathing
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Unusual headaches or dizziness
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Unexplained or easy bruising
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Mood changes
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A loss of appetite, nausea or vomiting
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Slurred speech, memory loss or impaired judgement
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Changes in sleeping patterns such as unusual drowsiness or recurring unpleasant dreams.
There is the possibility that these symptoms may be the result of your medication but they could be connected to other causes. In any case, contact your doctor or pharmacist immediately. Always check with your doctor or pharmacist first before you stop taking a medicine because of its side effects.
I forget to take my medicine -
If you forget to take your medicine, don’t assume that you should double the next dose or simply skip the missed dose. The correct course of action varies from medicine to medicine.
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The patient information leaflet that comes with the medicine includes information on what to do if you miss a dose. If you don’t have the patient information leaflet or are in any way unsure of what to do, check with your pharmacist or doctor.
I take too much of the medicine -
If you accidentally take too much medicine, don’t panic. The patient information leaflet that was provided with your medicine will tell you what to do. If you don’t have the patient information leaflet to hand, search for it on www.medicines.ie or check with your pharmacist or doctor immediately.
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Medicines and falls Some medicines that make you more likely to have a fall as they can change the way the body’s natural balance systems work. As people get older this can be more of a problem. The two main side-effects which can be a problem are sleepiness and faintness / dizziness.
Sleepiness This is one of the most common causes of falls due to medication. The medicines which may cause this are: •
Sleeping tablets;
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Tranquillisers;
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Some of the older medicines for depression;
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Some of the older medicines for hay-fever and allergy;
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Medicines used to treat mental health conditions.
Faintness / dizziness This can be caused by lowering of blood pressure. It is the other major cause of falls in older people. This is usually noticed as a feeling of faintness or dizziness as you stand up when you have been sitting or lying down. Some medicines which may have this effect are:
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Medicines used to treat blood pressure;
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Medicines used to treat other heart problems;
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Medicines used to treat urinary problems;
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Some types of eye drops for glaucoma;
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Some older medicines for depression;
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Medicines used to treat mental health conditions;
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Medicines used to treat Parkinson’s Disease.
It is important to remember that you should not stop any of these medicines suddenly. If you feel that one of your medicines may be making you feel drowsy, faint or dizzy, refer to the patient information leaflet that came with the medicine or ask your local pharmacist to check whether it can cause these effects. If the medicine(s) could be a problem consult your doctor. Together, you and your doctor will be able to decide what is the best thing to do.
Carers can help too Most of the information in this booklet is aimed at older people who can manage their own medicines. However, some people may not be in a position to look after their own medication such as older people and people with physical or learning disabilities. Here their carer (who may be a family member, friend or minder) has a very important role to play in helping them to take their medicines properly. If you are a carer, •
Accompany the person in your care when they go to see the doctor or pharmacist.
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Seek information and assistance from the doctor or pharmacist on how best to help them take their medicines correctly.
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If you do not have enough information: -
About the side effects of any medicines be sure to ask the doctor or pharmacist. Alternatively you may visit www.medicines.ie for this information.
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About any medical procedures which may need to be conducted e.g. injections, catheters, be sure to ask the doctor or pharmacist.
Carers with daily contact with older people should be monitoring and evaluating the capabilities of older people in their care and should be aware of the links between patient assessments and medicine taking. They should be aware of the action to be taken if they have concerns about the older person in their care.
Read this booklet carefully – it has lots of suggestions that will be of use to you.
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Personal Information Pack (PIP) PIP is a pack containing an insert with relevant medical and personal information about its owner which is intended to help medical and emergency services ascertain a person medical and medicines history. It is kept in the fridge and its owner carries a key ring to enable emergency services and hospital staff identify that they have a PIP. A green sticker is also provided which is inserted in the inside frame back of the hall door in order for emergency services and GP’s to identify home-owners with a PIP. From a GP perspective this means that if called to the care of a patient whom they don’t know they can retrieve the PIP from the fridge to ascertain their medical and medicines history. Similarly, fire fighters, Gardaí and ambulance personnel may retrieve the PIP from the fridge to discover the person’s history and in turn they may bring the PIP to the hospital, should the person need hospitalisation. This means that when the patient arrives in the emergency department, staff have a good idea of the past medical and medicines history of the patient, along with personal information relative to carers, next of kin, allergies, donor information etc. The reason for keeping the PIP in the fridge is two fold. Firstly, most people have a fridge and this is an easy ‘common location’ for storage, and secondly the fridge is usually the last thing to burn in the event of a fire.
You can buy a PIP from your local pharmacist at a cost of €2. You should ask them to help you in completing the details in it.
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Patient Medication Record (PMR) Name: Address:
Tel. No.: Blood Group: Medical Card Number: Drugs Payment Scheme Number: Long Term Illness Scheme Number: Doctor’s Name: Doctor’s Tel. No.: Pharmacy Name: Pharmacy Tel. No.: Health Centre: Health Centre Tel No.:
IN CASE OF EMERGENCY PLEASE NOTIFY: Name: Address:
Tel No.: Relationship:
PLEASE TICK ANY OF THE FOLLOWING WHICH APPLY TO YOU: I am allergic to Morphine Aspirin Penicillin Insect bites
Gluten Peanuts Shellfish Sulpha drugs
Codeine X-ray contrast dye Other
Glaucoma Epilepsy Abnormal ECG Hearing aid Kidney problems
Dialysis Hypertension Removable dentures Pacemaker Other
I have Heart condition Emphysema Contact lenses Arthritis Diabetes
This medication record will help you to keep track of your medicines. Keep it up to date with all prescription and non-prescription medicines you are taking. Carry it with you at all times and show it to your doctor each time you visit. If you see more than one doctor, make sure each one knows about all the medicines you take. Show it to your pharmacist when you pick up a prescription or non-prescription medicine.
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List all prescription and non-prescription medicines Date
Name, Dose and Directions
Reason
Visit www.medicines.ie for medicines information. 16
Other booklets useful in helping you get the best from your medicines include
Tips for Taking Medicines Feel Better – a guide to managing your minor ailments effectively Ask Your Pharmacist about Pain Relief and all are available from your pharmacist or through the Health Service Executive. Visit www.feelbetter.ie for more information on managing your minor ailments effectively. Visit www.medicines.ie for medicines information.
Produced by The Irish Pharmaceutical Healthcare Association www.ipha.ie
and the Irish Pharmacy Union www.ipu.ie
in association with Age Action Ireland www.ageaction.ie
Š IPHA 2008