Medications info

[Barry]

A brief rant, and then some advice.

Used to work in the mental health field. In mental health, the shrinks were scrupulous about informed consent with the patients when prescribing meds. They would explain in reasonable detail both the therapeutic effect of the drug, and the possible side effects of the drug. Only then would they prescribe.

Since going under the knife a couple of years ago I've been dealing with docs for the first time in my life. And I have scolded more than one for his complete disregard of informed consent. They just write the prescription or give you the pills and say, "take this".

Pester your doc for info on the drug, but still don't expect to get the full story. When you go to the pharmacy to pick up your prescription, speak with the pharmacist, who knows more about drugs than your doc ever will, and ask the pharmacist for the "medication insert" that came with the drug when the pharmacist bought it. The pharmacist will be a bit reluctant to give it to you, because the med inserts explain all the stuff about the drug, and all its potential side effects, to the extent that were you to read the med insert for aspirin you'd think it was some sort of deadly poison. So keep in perspective what you read in a med insert. But ask for one and read it.

The Internet, of course, is also a good source of info on drugs. But the most comprehensive info is likely to be on the drug insert.

I was prescribed Amiodarone, an astonishingly toxic drug with astonishingly weird possible side-effects, without being told diddly-squat. Not even that in some folks the drug turns your skin irreversably grey-green. Now, even after I got complete info myself on Amiodarone I still gave the drug a try, discontinuing only after I failed to get any therapeutic effect from it. With any drug it's a trade-off between therapeutic effects and adverse side effects, a decision that you yourself and not your doc should make.

Some docs really should have become veterinarians.

 

[Nancy]

Do a search on Amiodarone and Cordarone on this site and you'll see many posts. The half life of Amiodarone is also extremely long, something like 6 months depending on the person.

ALWAYS do a search on the net for any new medication and read thoroughly, especially if you are on many different medications. Joe takes somewhere in the neighborhood of 14-16 medications per day. When anything new is added I always look up for possible interractions. It's surprising what I've discovered, and there have been times when Joe has had to not even start taking the new one.

I also type up a list of his current meds, and at the bottom, a list of his drug allergies, and a list of his "bad" drugs, which we know will cause problems.

One of the nicest things that happened during a long hospital stay was when the hospital pharmacist came in to see him and discussed everything with him and gave him little hints about how to take each med so they would have as little interraction with each other as possible. It was a very helpful visit.

Check everything out.

 

[Barry]

...One of the nicest things that happened during a long hospital stay was when the hospital pharmacist came in to see him and discussed everything with him and gave him little hints about how to take each med so they would have as little interraction with each other as possible. It was a very helpful visit...

Yep. Pharmacists are much much better about it than docs.

Although my experience with the hospital pharmacist wasn't nearly as positive as yours. Couldn't get the med insert from pharmacy, couldn't get diddly-squat from the hospital staff, and the doc basicly just started me up on Amiodarone without telling me anything. <grumble> <snarl>

Problem perhaps rested with serious under-staffing, the staff that were there were run ragged. Good object lesson for me that being a passive patient could easily mean being a dead patient: They even prepped me for, and asked me to sign consent to, the wrong operation! [Sorry, guys, but I'm here for mitral valve replacement, not coronary bypass.]

But pharmacists at drug stores have been really good and have always given me the drug insert upon request as soon as I explain to them that I'm familiar with reading them and realize that they need to be taken with a grain of salt - often citing Aspirin as an example of a drug that if it came with a med insert and you read it you'd probably end up being scared off if you didn't know better.

 

[hensylee]

OMG, Barry - amiodarone? dirty word - cuss word - bad name - like Nancy says, we have discussed it.

 

[Marguerite53]

You always have to be careful.

You always have to be careful.

I'm not used to prescription drugs for anything other than dental prophylactic and the occasional sinus infection. Suddenly I'm getting blood pressure meds, muscle cramp meds, probably eventually cholesterol meds,etc. etc. My pharmacy always gives the insert. I always read it. I'm pretty sensitive and allergic to many antibiotic staples.

We moved so I switched pharmacy locations. Liked the new "guys" fine until I picked up my Diovan 80 mg.(for blood pressure) and looked at it. The pill was huge and a different color. Fortunately a refill so I noticed the difference and asked. No, they said, it says right here on the bottle 80mg. NO, I said, it isn't. What is this? Well, they had given me 360 mg tablets of Diovan. I suspect it wouldn't have killed me, but it probably would've been pretty darn scary for awhile. SO -- everyone -- check the pills you are given and be sure they are actually what they say they are!!

Lately I've started having constant PVC's. After unremarkable bloodwork and echo, we're starting me on beta blocker to curb the annoying sensation of these.....so I'm adding 25 mg atenolol to my "diet". I opted for the pharmacist counseling (I use RiteAid, by the way) and had a very good discussion with him. He said that there are so many different kinds of blood pressure medicine that quite often several types of low dose are given. Especially, the European habit is to prescribe several types of low dose, rather than just increase the dose of a current, not working well enough, Rx. I thought that was very ineresting. That the European fashion is to attend to a problem by addressing all the variables almost individually whereas US practioners tend to just increase the dosage in the hopes of a blanket cure. The pharmacist ended the conversation by saying, "remember, that's why they call it medical practice .

Marguerite

 

[Harpoon]

Ok, not here to badmouth amiodarone.

The difficulty is that it seems to be a drug that's VERY effective for some people and totally pointless for others and you can't tell until you've taken it for a while.

I was on the stuff, at about half the general "maintenance" dose for about 8 months or so. It didn't seem to do a whole lot for me with my arrhythmias so, after discussing it with my doctor, I was weened off of it.

Turns out, the arrhythmias stayed for another few months then went away on their own, though they DID get worse for a little while after I stopped taking the drug.

Early on when I got home after valve surgery I purchased a copy of "The Pill Book," essentially a consumers version of the PDR and it's published by the same people. The book is great, very thorough listing of most of the prescription pills out there in the US market. They update it every year (mine's two years old now) and it's been useful on a number of occassions not only for me but for other members of my family who've wanted to check on drug interactions and or side-effects.

It doesn't list liquid medications though, I don't know if there's another book out there that does. Most of the stuff we give my son (he's 5) is in a liquid form and it would be nice to be able to check up on it.


The warnings for amiodarone are usually for when someone's on the prescribed average dose (or higher) and taking it for an extended period of time, years usually. While it affects people differently, from what I've found online and in talking wiht my physicians, the more "alarming" effects of the drug don't come into play unless you've been on it for an extended period of time and at a higher than normal dose.

Or you've been ingesting things that can heighten the effects of the drug such as grapefruit juice.


It's more or less a drug of last resort in treating rhythm problems in the heart and I've heard of a number of alternatives that seem much safer and just as effective.

Ask your doctor before dissavowing the stuff if you're on it. Going off amiodarone is kinda serious too and you need to be monitored some when doing it.

My cardiologist was calling me every few days to see how I felt when I finally went off it. We went a week at half the dose I was taking (just split the pills I had) then off completely. A month later I had a 24hr holter study in part, because I was off the amiodarone.

And I stuck to my "grapefruit fasting" for another 6 months after that...


By the way, I LOVE grapefruit juice and it was one of the main reasons I wanted off the "evil" amiodarone. =)

 

[Harpoon]

Oh yeah, a nice and simple site for checking drug information on-line:

I've cross-referenced it once or twice with the Pill Book that I have and everyhtign seems to be the same.

You can probably buy the Physicians Desk Reference (PDR) if you really wanted it through Amazon or your local bookstore, however, the medical jargon isn't for the "easy readers" out there. I've read through some of it on occassion, you have to be a doctor to understand it all. PDR Health On-line

 

[DuchessBear]

The best site I've found for drug info is www.rxlist.com. They give you the full prescribing information, but in a little more readable format than the pharmacist's package insert. Also, you can usually find the full prescribing info on the web site of the drug manufacturer.

 

[lance]

DVMS, Dentists and veterinarians

DVMS, Dentists and veterinarians

A brief rant, and then some advice.

Used to work in the mental health field. In mental health, the shrinks were scrupulous about informed consent with the patients when prescribing meds. They would explain in reasonable detail both the therapeutic effect of the drug, and the possible side effects of the drug. Only then would they prescribe.

Since going under the knife a couple of years ago I've been dealing with docs for the first time in my life. And I have scolded more than one for his complete disregard of informed consent. They just write the prescription or give you the pills and say, "take this".

Pester your doc for info on the drug, but still don't expect to get the full story. When you go to the pharmacy to pick up your prescription, speak with the pharmacist, who knows more about drugs than your doc ever will, and ask the pharmacist for the "medication insert" that came with the drug when the pharmacist bought it. The pharmacist will be a bit reluctant to give it to you, because the med inserts explain all the stuff about the drug, and all its potential side effects, to the extent that were you to read the med insert for aspirin you'd think it was some sort of deadly poison. So keep in perspective what you read in a med insert. But ask for one and read it.

The Internet, of course, is also a good source of info on drugs. But the most comprehensive info is likely to be on the drug insert.

I was prescribed Amiodarone, an astonishingly toxic drug with astonishingly weird possible side-effects, without being told diddly-squat. Not even that in some folks the drug turns your skin irreversably grey-green. Now, even after I got complete info myself on Amiodarone I still gave the drug a try, discontinuing only after I failed to get any therapeutic effect from it. With any drug it's a trade-off between therapeutic effects and adverse side effects, a decision that you yourself and not your doc should make.

Some docs really should have become veterinarians.

Hi Barry

Some students that didn't make the cut to go to veterinary college did indeed go into human medicine and dentistry.

It's true though, frequently my equine practitioner gives me so much information I alway keep a pad and pencil handy to take notes. She is very explicit about the drugs she prescribes.