How To Avoid Drug Errors
To help avoid medication errors, consider the following steps:
Create a list of your medications, keep it up to date, and keep it with you at all times.
- You never know when the list will be needed.
- Include on the list:
- All prescription and over-the-counter drugs
- Health related products such as vitamins, minerals, herbs and nutritional, dietary or weight training supplements.
- Include allergies and foods to avoid.
- For an easy form to use, see List of Medications.
Every time a new drug is prescribed, even when you are given samples, consider the following guidelines.
When a drug is prescribed:
- What is the drug for?
- How do you take the drug?
- How long are you supposed to take it?
- Are there activities, drinks, foods or medicines you should avoid while taking the drug?
- What are the possible side effects - and what should you do if they occur?
- Does it interfere with any of the other medicines or supplements you are taking? Review your list of medicines with your doctor or nurse to help avoid negative interactions between your drugs. This is particularly important if you have more than one health care provider. (If you don't have a list, take your medicines with you in a bag)
- Your doctor should have an up-to-date list of your drugs in his file, but don't count on it.
- In addition to assuring the new drug does not interact poorly with your current medications, your doctor may have new information about the medicines you have been taking that could be important.
- Be sure to tell your doctor about recreational drug use if you use them.
- Are there are any medications on which you can cut back on the doses? (See How To Avoid Overmedication.)
- Ask your doctor to write on a separate piece of paper the name, dosage, physical description, and instructions for taking the drug. You can then compare the information to the information on the prescription bottle when you receive it.
- If you are taking a complex drug regimen, ask for a written schedule to make it easier to follow the correct schedule. The schedule should include:
- The name of the drug that's printed on the prescription bottle.
- The proper amount of each drug you're supposed to take.
- Timing for each medication.
- Specific purpose for each drug.
- Any other important information, such as special instructions. For example, take with or without food. Avoid particular foods, drink, or activities, etc
- Get a copy of the new prescription in writing even if your doctor calls it into the pharmacy. A written prescription helps you verify that you receive the correct drug and correct instructions for taking it.
- Make sure the prescription is readable and written in a manner that you can understand. If you can understand it, so can the pharmacist
- Drug names often seem alike and the pharmacist may get it wrong. To help avoid confusion, ask your doctor to include the purpose of the medication on the prescription (such as "for pain," "for nasal decongestion.")
- Ask the doctor to avoid Latin names and abbreviations for drug names and directions for use so you can understand what is being prescribed.
- The written prescription should include detailed instructions which are written out so you can understand them. Shorthand abbreviations can be misread by pharmacists. For example, the abbreviation "BID" stands for twice a day. "QID" means 4 times a day. If the pharmacist reads the abbreviation wrong, you could end up taking 4 times the recommended dose.
- Ask the doctor to rewrite unclear words.
- If there is a decimal point, ask the doctor to write a zero before it. For example, if the prescribed drug is .5mg ask the doctor to write it as: 0.5mg
When you pick up a drug:
- Review your List of Medications with your pharmacist. If you don't have a list, "brown bag" your drugs by putting all the containers in a bag and show the contents to the pharmacist. The pharmacist can act as a double check against negative reactions among your drugs.
- Check the label of the drugs you receive against the written prescription. Check forthe following:
- Your name.
- The prescribing doctor's name.
- The name of the medication. If the name isn't the one you expect, ask about the difference. There may be a legitimate reason, such as substitution of a less expensive generic version for a brand name drug. If the pharmacist cannot explain the difference, ask your doctor.
- The strength of the drug.
- That the directions are what you expect. If you do not understand the directions, be sure to ask.
- Check the look of the drug to be sure it looks like it is supposed to.
- If it does not look like you expect, speak with the pharmacist. It may be a generic version of a brand drug which does the same thing, or it may be the same drug from another manufacturer, or it could be a mistake.
- Protect against tampering.
- If the package is sealed, look for signs of tampering such as broken seals, puncture holes, open or damaged wrappings.
- Look at the medicine. Never take medicine that is discolored, has an unusual odor, or seems suspicious in some other way.
- Check the expiration date on the bottle. Note: Most drugs are still effective beyond the expiration date noted on the pharmacy label. To learn more, click here.
- Pick a time of day to go to the pharmacy when mistakes are least likely to happen. According to Joe Graedon, coauthor of The People's Guide to Deadly Drug Interactions, you can help minimize the chance of errors by having a prescription filled between noon and 3PM. That's the slowest time of day, when pharmacist mistakes are least likely. He also suggests avoiding having a prescription filled immediately before or after work which is usually the busiest time of day.
When you get home, consider the following steps:
- Read about the prescribed drug from the package insert or from the written description that most pharmacies provide which includes information about how to use the drug, precautions to take and possible side effects. You can also search for the name of the drug in your favorite search engine. Particularly note whether there are anyinstructions about how the drug is supposed to be taken. For example,on an empty stomach, after a meal, etc, and what food and/or drink to avoid. Save the package insert and/or written description in your file for future reference.
- Keep your receipts. If your medical bills run high compared to your income, you may be able to deduct the cost of drugs as well as other medical expenses. For information, see Tax. If you have a tax advantage health savings account, you may use those funds tax free.
- Open the bottle to be sure you can. Some bottles are so child-proof, they can be adult-proof as well (at least to certain of us).
- To avoid later confusion or mix-ups, write the purpose of the drug on the label.
When you take a medication:
Mistakes can occur easily when you don't pay attention to what you're doing -- like opening one pill bottle among many. Likewise, do not reach for a pill in the dark. Turn on a light to assure you take the right pill.
- Ask your pharmacist for a "brown bag session" at least every six months to check all your medications for negative drug interactions. It's easier if you schedule the session with your pharmacist. Otherwise, you may encounter a pharmacist that's too busy to give you the attention you need.
- If you unexpectedly lose or gain a lot of weight, or have other unexpected symptoms, let your doctor know right away. It may be that the dosage of one or more of your drugs should be corrected or you can stop taking the drug.