Posts Tagged ‘Medication Safety’

With last week being National Poison Prevention Week, I wanted to share some information about medication safety. While medications can be lifesaving and an essential part of maintaining our health, if used inappropriately or incorrectly, they can potentially be harmful.

The Centers for Disease Control and Prevention (CDC) estimates that 125,000 people die each year due to medications being taken incorrectly. Additionally, each year, accidental medication ingestion by children leads to:

• 60,000 emergency room visits
• 450,000 calls to poison control

These accidents are why it is very important to make sure medications are stored and disposed of properly!

Below are some medication safety tips and guidance on safe medication storage and disposal.

General Medication Safety Tips

• Take all medications the way they are prescribed
• Never take another person’s prescription medication
• Do not abruptly stop taking any medications or skip doses without talking to your doctor or pharmacist
• Keep an updated list of all medications you take, both prescription and non-prescription
• Ask your doctor or pharmacist before starting any over-the-counter medications or supplements. We can check to make sure the medication is appropriate for you and identify any interactions it may have with your other medications.

Drug Storage

In most cases, medications should be stored in a cool, dry place. You should avoid leaving medications in the bathroom due to changes in temperature and humidity. Be sure to read storage information for all of your prescriptions, as some may need to be stored in the refrigerator. Additionally, medications should be kept in a location that is hard for children or pets to access.

Drug Disposal

If you have unused or expired medications, it is best to remove them from your household to prevent accidental or intentional ingestion by others. Most communities have drug disposal boxes at police or fire departments, as well as certain pharmacies. You can find drug disposal boxes in your area at the following website:

• https://safe.pharmacy/drug-disposal/

If you are unable to dispose of medications using a disposal box, there are ways to safely dispose of medications at home. Before disposing of medications, be sure to read the label or package insert to see if any disposal instructions are provided.

Most medications should not be flushed down the toilet, but there are certain exceptions to this. Medications that can be flushed are those that have the potential to be abused and/or can be fatal after one dose if taken inappropriately.

The following medications should be flushed if a drug disposal box is not an option. These include medications that contain:

• buprenorphine
• fentanyl
• hydrocodone
• oxycodone
• oxymorphone
• hydromorphone
• methadone
• morphine
• tapentadol

For other medications, you can mix the drugs in a plastic bag with coffee grounds or cat litter, seal the bag, and throw it in the trash.

Sharps Disposal

If you use any injectable medications, such as insulin, it is very important that you dispose of your used needles appropriately. All needles should immediately be placed in a sharps disposal container after use. These can be purchased at most pharmacies or medical supply stores. If you do not have access to a sharps container, you can dispose of used needles in an empty laundry detergent bottle or other heavy-duty plastic container.

Once your sharps container is approximately 3/4ths full, you should place the lid on the container, seal it with tape, and label the container “DO NOT RECYCLE”. You can throw the container away with household trash, but trash collectors may be reluctant to take the sharps container. You can find locations to take your full sharps container at the following website:

• https://safeneedledisposal.org/states/ohio/

If you ever have any questions about your medications, pharmacists are the experts- so don’t hesitate to ask!

References:

• Drug disposal. Safe.Pharmacy. https://safe.pharmacy/drug-disposal/. Published March 4, 2022.
• 4 medication safety tips for older adults. U.S. Food and Drug Administration. https://www.fda.gov/consumers/consumer-updates/4-medication-safety-tips-older-adults.
• Center for Drug Evaluation and Research. Drug disposal: FDA’s flush list for certain medicines. U.S. Food and Drug Administration. https://www.fda.gov/drugs/disposal-unused-medicines-what-you-should-know/drug-disposal-fdas-flush-list-certain-medicines#FlushList.
• What to do with used sharps in Ohio. Safe Needle Disposal. https://safeneedledisposal.org/states/ohio/#showTable. Published January 20, 2022.

With temperatures outside rising, it is important to keep yourself and your medications safe!

Certain medications can increase the sensitivity of our skin to the sun, cause heat intolerance, and promote dehydration. Medications themselves can also be damaged by the sun, heat, and humidity.

Keep yourself safe:

Due to varying mechanisms of action and side effects of certain medications, you may be at an increased risk of sunburn, heat intolerance, and/or dehydration. Medications that make the skin more prone to sunburn include, but are not limited to, antibiotics, antifungals, antihistamines, and NSAIDs. For a more comprehensive list, please refer to the end of this article.*

These medications may cause a severe burn, hives, rash, and an increased risk of skin cancer if you spend any amount of time in the sun without protection. To reduce the risk of this adverse event, take protective measures against the sun. Find shade, stay covered, and apply the appropriate sunscreen. Check back later this month for an article on how to stay safe in the sun!

Some medications can also cause heat intolerance. Tricyclic antidepressants, such as amitriptyline, and antihistamines, including Benadryl, cause individuals to sweat less. This increases internal body temperatures and results in an increased risk of heat intolerance. Beta blockers, typically used for blood pressure or heart rate control, reduce blood flow to the skin. This also increases the risk of heat intolerance. Overheating due to heat intolerance can lead to heat stroke, characterized by symptoms of nausea, vomiting, changes in heart rate, confusion, and fainting. To reduce the risk of heat intolerance, stay hydrated, seek shade or air conditioning, and avoid strenuous physical activities outside.

Medications, including water pills, such as furosemide and other diuretics, work by eliminating fluid from the body and increasing the risk of dehydration. Laxatives also increase the risk of dehydration due to fluid loss. These medications, in addition to too much fun in the sun without the proper hydration, can be a dangerous combination. A good way to reduce the risk of dehydration is by maintaining an adequate fluid intake and avoiding alcoholic beverages.

Reach out to your pharmacist if you have questions regarding if these side effects are common for any of your current medications.

Keeping your medications safe:

It is also important to consider any and all products that are temperature sensitive themselves, to ensure safety and effectiveness. Medications that are required to be stored under refrigeration should be kept around 35-40°F. Those that are to be stored at room temperature should be kept around 75-77°F, away from humidity and light. If a medication should be kept at room temperature it is best to store it in a cabinet or a drawer outside of the bathroom and out of the reach of children and pets. This storage prevents exposure to fluctuating temperatures and humidity. Otherwise, these medications can lose their potency and effectiveness, meaning you are not receiving the appropriate therapeutic amount of medications. If you do not receive therapeutic doses of insulin, blood sugar may drastically increase; if you do not receive therapeutic doses of antibiotics, infections may worsen or become resistant.

Although there may not always be a physical sign, some medications may have noticeable changes if they are damaged by the heat. Changes in smell, taste, color, and form may be observed. If you notice any of these changes, call your local pharmacy to ask questions and request refills.

0Medications that have not been stored correctly should be disposed of properly. Various police stations and fire departments have drop off boxes to dispose of damaged and/or expired medications. Additional locations will take back medications on national prescription drug take-back day, which will take place this year on Saturday, April 27, 2019 from 10:00am. to 2:00pm. Otherwise medications may be disposed of by mixing them with cat litter or coffee grounds and throwing the mixture into the garbage.

Additional tips to keep your medication safe:

• Do not leave medications in the car.
• If you are traveling, keep your medications in a cooler or insulated bag.
• If you are traveling by plane, keep your medications in your carry-on; use a cool pack if needed.
• Travel with only as much medication as you need for the trip.
• If you wear an insulin pump, consider changing the insulin more frequently in the summer.

Ask your pharmacist if you have any questions regarding a medication that may have been stored incorrectly.

* Antibiotics: ciprofloxacin, levofloxacin, ofloxacin, doxycycline, tetracycline, sulfamethoxazole/trimethoprim (Bactrim)

Antifungals: voriconazole, itraconazole, fluconazole, griseofulvin

Antihistamines: cetirizine, diphenhydramine, loratadine, cyproheptadine

Cholesterol lowering agents: simvastatin, atorvastatin, lovastatin, pravastatin

Diuretics: hydrochlorothiazide, chlorthalidone, chlorothiazide, furosemide, triamterene

NSAIDs: ibuprofen, naproxen, celecoxib, ketoprofen

Oral contraceptives and estrogens

Antiemetics: chlorpromazine, fluphenazine, promethazine, prochlorperazine

Psoralens: methoxsalen, trioxsalen

Retinoids: acitretin, isotretinoin, tretinoin

Sulfonamides: acetazolamide, sulfadiazine, sulfasalazine, sulfisoxazole

Sulfonylureas: glipizide, glyburide

Miscellaneous medications: amiodarone, lamotrigine, quinidine.

Resources:

1. Harrelson L. Summer Weather Doesn’t Mix With Some Medications. Accessed April 2019. https://www.agingcare.com/articles/medication-affected-by-summer-heat-151887.htm.
2. Polk County Health Department. Keep Your Medications Away From Summer Heat! Accessed April 2019. https://www.polkcountyiowa.gov/media/189984/medication-handout.pdf.
3. Rathner JL. Medications Can Make You More Sun and Heat Sensitive. Accessed April 2019. Published August 2012. https://www.lhsfna.org/index.cfm/lifelines/august-2012/medications-can-make-you-more-sun-and-heat -sensitive/.
4. Stoller-Conrad J. Why you should keep medicines out of the summer heat. Accessed April 2019. Published July 2012. https://www.npr.org/sections/health-shots/2012/07/10/156575072/why-you-should-keep-medicines-out-of- summer-heat.
5. Tunno BB. Heat and medication: pharmacists share tips to keep your prescriptions safe. By Bianca Barr Tunno, AccuWeather staff writer. Accessed April 2019. https://www.accuweather.com/en/weather-news/how-does-heat-affect-medications/70001730.
6. US Food and Drug Administration. The Sun and Your Medicine. Accessed April 2019. Updated September 2015. https://www.fda.gov/Drugs/ResourcesForYou/SpecialFeatures/ucm464195.htm