When you take a drug, you expect it to ease your symptoms or cure your medical problem. However, the drugs you take can sometimes cause serious harm—or even death—if there is a medication “error” (such as taking a wrong dose or an inappropriate drug).
Frightening statistic: Each year, up to 1.5 million Americans are affected by preventable errors involving both prescription and over-the-counter (OTC) drugs, according to the Institute of Medicine. Most of these errors are minor and unlikely to cause serious problems—with dangerous exceptions.
Example: A baby in one hospital needed 0.5 mg of morphine for sedation and/or pain relief. The doctor who wrote the prescription didn’t put a “0” before the decimal point. A nurse who didn’t see the decimal point gave the child 5 mg. This tenfold error was doubled when the child, who later died as a result of the overdose, was given an additional excessive dose.
Medication errors can occur in several ways. Often, patients skip doses, stop a drug without medical advice or neglect to tell their doctors about other drugs and/or supplements they are taking, exposing themselves to the possibility of a dangerous interaction.
But health-care professionals also can play a role in medication errors. Common reasons for medication errors that occur in doctors’ offices and at pharmacies and hospitals…
Incorrect doses. Most prescription drugs come in standard doses, such as 10 mg or 100 mg. On occasion, doctors may accidentally omit a “0” or jot down a decimal point that’s difficult to see.
Self-defense: When your doctor hands you a prescription, confirm the dose (the specific number of milligrams, for example) before leaving his/her office.
Abbreviations. When writing prescriptions, doctors use abbreviations that can be easily misread by pharmacists.
Example: The abbreviation “QOD” means every other day…”QD” means every day…”BID” means twice a day…and “QID” is four times a day. If the pharmacist reads “QD” as “QID,” the patient will be taking four times the recommended dose, which can lead to side effects.
Self-defense: Make sure you understand the intended dosing instructions (for example, once or twice daily) before leaving your doctor’s office. Then confirm the drug and dose with the pharmacist before leaving the pharmacy to ensure that you’re receiving both the correct medication and dose.
Wrong drugs. There are more than 10,000 prescription drugs and as many as 300,000 OTC medications on the market. Some of these drugs have similar names that are easily confused—either by the doctor who is writing the prescription or by the pharmacist who’s filling it.
Example: It’s easy to confuse buproprion, an antidepressant, with buspirone, an anti-anxiety drug.
Self-defense: Know the exact name of the drug you’re supposed to be taking (both the generic name and the brand name)…why you’re taking it…and what it looks like—consult the Physicians’ Desk Reference online at www.pdrhealth.com to view photographs of commonly prescribed drugs.
Check the drug name before you leave your doctor’s office. Repeat the name out loud when you order the drug at the pharmacy. In the example above, buproprion is the generic name for the brand-name drug Wellbutrin. Buspirone is the generic name for Buspar.
Helpful: Prescription tablets and capsules are imprinted with numbers that are specific to particular drugs and doses from specific manufacturers. When you first fill a prescription, write down the manufacturer’s number and keep it in a safe place. When you get the prescription refilled, double-check to ensure that it has the same number.
If you take medication…
Consult the pharmacist. About 95% of patients don’t ask questions about how to use their medication, according to research published by the California Board of Pharmacy and other groups. These patients may not understand not only how much of the medication to take or when and how often to take it, but also what side effects might occur or how to tell if the drug is working.
Self-defense: Consult with the pharmacist every time you start a new prescription—particularly if you’re also taking other drugs with which it might interact.
Important: Many people who work behind the counter are pharmacy technicians. When asking questions about a medication, make sure that you’re talking to a pharmacist. Look for the title “Pharmacist” or “RPh” (Registered Pharmacist) on the person’s jacket (or nameplate)—or ask the person’s title.
Helpful: A patient who takes multiple drugs can prevent many errors by buying them all at the same pharmacy. Virtually all pharmacies now have computers that track medications and will automatically give an alert if a patient adds a new drug that might interact with others that he is taking.
Tell your doctor about everything you take. Adults over age 65 account for 13% of the US population but take one-third of all prescription drugs. Anyone taking numerous drugs may experience side effects and/or drug interactions—many of which could be avoided if patients periodically reviewed medication use with their doctors and/or pharmacists.
Doctors usually ask patients what medications they’re currently taking. They don’t always ask about—or patients fail to mention—supplements and/or OTC drugs.
Self-defense: Every time you see your doctor, bring a list that includes everything you’re taking. Don’t assume that supplements, including herbs, don’t count. Many of these products can interact with prescription drugs.
Example: The husband of one of our employees was admitted to the hospital with a bleeding disorder. The condition had developed because he was taking the blood thinner warfarin (Coumadin) to prevent clots but hadn’t told his doctor (or pharmacist) that he also was using the herbal supplement ginkgo biloba, which increases the risk of bleeding—especially when combined with warfarin.
