Most of us visit the pharmacy, quickly dash in and dash out with a lethal “poison” we hardly know!In reality,all medicines are poisons; right from drug composition, compounding, storage and eventual dispensing, all handled by the drug expert called Pharmacist,the patient is right on the mind of these professionals! So what is in it for you, what questions should you ask your pharmacist? Why can a medicine suddenly become a toxic chemical? No doubt, you stand to lose nothing if you leverage on your interaction with your caregiver including the pharmacist. If you are an out-patient in a hospital, the pharmacy may be your “last line of defence” against wrong use of your medication and fatalities.
The conversation with your pharmacist is a two-way street: both parties should be listening, asking questions, and offering information. The pharmacist should ask you for relevant information about your medical history, tell you about the medication, and answer your questions while you, in turn, should ask questions, talk about your concerns, and provide any necessary health information to the pharmacist.You should choose your pharmacist as carefully as you choose your doctor. Find a pharmacist that you are comfortable talking with, and one who takes the time to help you with your medications.
To get the most out of your visit to the pharmacist, make sure you ask the following questions:
1. If the person attending to you is not appropriately attired in the white coat with the name tag, you need to ask if he/she is a registered Pharmacist.
Now, this may look simple but you need to be sure that you are being attended to by a pharmacist!
2. What is written on my prescription? For most prescriptions written long-hand, most patients have difficulty reading the handwriting of the prescrbers.Don’t always assume that you have the right prescription and there could not be spelling error. Some drugs actually sound alike or look alike. e.g Aminophylline and Amitriptyline.
3. What is the medication called?
Each medication has two names: the common (also called generic) name and the brand name. The brand name is the name under which a specific manufacturer markets a product (e.g., Panadol®). The common name is the standard name of the medication (e.g.,Paracetamol). The label on your medication will state the brand name, common name, or both. If more than one company makes a medication, its common name will be the same. The brand name will be different for each company e.g Gsk has panadol® while Emzor’s brand name is Emzor paracetamol, Tylenol in the USA. So in other countries, the brand name may be different, but the common name is usually the same.
4. What is the medication supposed to do(also called Indication)?
Some medications, such as antimalarials, are used to kill the malaria parasite or some used to prevent the malaria parasites from surviving in the blood (e.g Fansidar ®). Others, such as pain medications, are used to control the symptoms like fever and joint pain that come with malaria.It is good to know what to expect from your medication, so that you have a realistic idea of what it can do for you.This would be an opportunity for you to know if the prescriber and the pharmacist’s professional judgment tally.For most times, it does but if not, you will see from the countenance of the pharmacist who may seek further clarification. If not convinced, he may not service the prescription!
5. How should I use the medication?
What is the best time of day is best to use the medication? Some medications must be used at exactly the same times every day to be effective,for example, most antibiotics need to maintain the effective amount in the blood to kill or stop further growth of the disease-causing germ. For others, it is okay to use the drugs at approximately the same time each day, for example ulcer-regimen drugs.
6. Should the medication be taken without or with food?If it’s to be taken with food,what kind of foodis better taken with my medication?
Some drugs are better taken on empty stomach because of the acidity of the stomach when you have not eaten. For example, Ketraconazole, used for treating fungal infection dissolves in the presence of stomach acid. If the acid is not there, it’s”baggage in, baggage out! !”.Such drugs may be excreted without them doing their job in the body. If it can cause serious problem for your stomach, then it’s better taken with food. Pain killers like Ibuprofen can cause stomach ulcer if taken without food while drugs like Arthemether are better and quickly absorbed in the presence of fat and oil so it should preferably be taken with oily food.
7. If the medication is to be taken by mouth, can it be crushed or split?Some drugs must never be crushed before they are taken. They may be bitter, nauseating in smell or corrosive to the mouth while some, like Bisacodyl,immediately lose their potency if crushed. ‘Scored’ tablets are easy to split along the line designed along their middle in the event that you need lower dosing. For example,20mg Lisinopril(used for managing High blood pressure)can be split equally in the middle to get 10mg in the absence of a single unit tablet of 10mg while so drugs like Dequadin are licked.So it’s wrong to assume that all tablets are taken same way!
8. What should I do if I miss a dose?
This is very important if you depend entirely on a medication for sucour. Some drugs automatically”fail” if you miss a dose. Contraceptive drugs is a very good example of drugs you need to know what to do when you miss a dose.
9. How will I know if the medication is working, and when should I expect it to start working?What do I do if it doesn’t seem to be working?
It is important that you know when your medication will start working, and what you can expect it to do. This way, you will be able to monitor to see if it is working, and take action if it is not.
10. How long will I need to use the medication?
Some medications are used for the short term, others for a lifetime. Knowing how long you will need to stay on a medication can help you prepare yourself for a lifestyle change if necessary.For some medications, such as antibiotics, the whole course of treatment must be completed, even if you feel better after a couple of days while for most cardiovascular drugs, HIV, Asthma etc, you may have to take drugs for the rest of your life.
11. Are there any activities, foods, or other medications that I should avoid while taking this medication?
There are many situations, such as driving, drinking, eating, operating machinery, exercise and even sexual libido, that may be affected by a medication . Please ask your pharmacist. Can you imagine a newly married young man on drugs that have a libido-reducing side effect?
12. What are the side effects of this medication? What should I do if they happen? How can I reduce or cope with the side effects? Which side effects need medical attention?
Some side effects are very serious, and require immediate medical attention, while others are milder. It is very important to find out all serious side effects, and have an emergency contact number.Before you decide to stop taking a medication because of side effects, ask your pharmacist whether there is a way to deal with them.
13. Is this medication safe to take if I am pregnant or breastfeeding?This is a question that you must not forget to ask your pharmacist.
It’s seriously unethical to experiment drugs on pregnant or breastfeeding women, so only few drugs can be vouched for to be clinically safe for use in this category of people. The experience of the pharmacist on all the chemical components of the drug and the pharmacology(study of how drugs act on the human body and vice versa) places him in good stead to advice you.
14. How should I store this medication?Poor storage has capacity to result into deterioration of the drug into harmful break down products or contamination of the drugs outrightly by germs or another chemical.So be careful before you change the container of your drug,please ask your pharmacist.
15. Are there any refills on this medication? If so, what do I need to do to get a refill?Not all drugs are qualified for refill so you don’t stock them unnecessarily. Where a refill is recommended, cross-check the fact with your pharmacist.It is very important to be sure of the expiry date of your new refill.
16. Is there any written information about this medication that I can take home?
Please don’t be shy to jot down important points you need to be aware of .Perhaps, you can go over the instructions once more with the pharmacist.
You must ensure you tell your pharmacist any of these “anys”:
Any information that you would like to have repeated or explained in more detail.
Any concerns or questions that you may have about the medication.
Any side effects or other problems that you have had with any of your medications.
Any reasons you decided not to take one of your medications as prescribed.
It is in your interest to let your pharmacist know your challenges so he/she may be able to help sort out the problems that have caused you to decide not to take your medication appropriately.
Finally, if your pharmacist thinks that you are taking a medication when you actually aren’t, they may think that the medication is not working, and recommend to your doctor that a higher dose or a different medication should be used.
Don’t feel guilty about telling your pharmacist that you haven’t been taking your medications as prescribed – it is their job to help, and not to judge, you.
See you when next you visit the pharmacy!