Medication Safety - Fact Sheet

An acquired brain injury may result in an ongoing need for a range of medications, each of which needs to be taken in the right dose, at the right time, and under the right conditions

Medications commonly prescribed for people who have suffered an ABI include;

These are of course in addition to any other medications required for treatment of health problems unrelated to an ABI.

Some people may find themselves taking numerous medications each with its own specific requirements and potential problems.

Management of these complex medication regimes can be confusing and mistakes can be dangerous.

Medication errors are not restricted to hospitals. Research in 1999 indicated that each year 80,000 hospital admissions, costing $350 million, are caused by medication errors Australia-wide (Roughead, 1999). In 2007, Anecdotal evidence from Queensland Health indicates that a substantial percentage of patients presenting at emergency departments have made, or been a victim of, a medication error. However statistics on this are not kept and current figures are not available.

Over the Counter Medications

The Queensland Health (Drugs and Poisons) Regulation 1996 sets out detailed requirements for the use of scheduled drugs and poisons. The schedules, used to group all medications and poisons by how potentially dangerous they are, are:

Over the counter medications are generally schedule 2 medicines or herbal remedies which are strictly speaking not considered medicines at all and so are not scheduled.

Literally thousands of drugs are available for purchase "Over-The-Counter" (OTC), which means that a person does not need a prescription to buy them. Just because OTC drugs can be purchased without a doctor's prescription does not mean they are harmless. Many of these drugs have side effects or may negatively interact with other medications being taken. This is particularly true of herbal medicines which are not scheduled at all.

Not every condition requires medicine for treatment. For many mild conditions, such as colds, rest and fluids are just as effective as most over-the-counter products. The best way to prevent side-effects is to take medicine only when it is needed.

Always check with a pharmacist or physician about possible drug interactions before taking any over-the-counter medication and if you are taking prescription medications avoid taking any herbal remedies at all.

When taking medications it is important to remember the 5 R’s

Just as you shouldn’t mix prescription drugs with OTC medication, never mix medications with alcohol or illicit drugs without consulting your physician.

Check the ‘use by’ date on your drugs, they may be ineffective or even harmful.

Some medications may be harmful to an unborn child or are excreted in breast milk so advice your prescribing doctor if you may be pregnant or are considering becoming pregnant.

If you have ever had an allergic reaction to a medication, be sure that your doctor is aware of it before prescribing you any new medication.

Medications and food

Some medications should only be taken with food, while others need to be taken on an empty stomach.

Make sure you understand any dietary restrictions that must accompany any new medications (for example, some older types of antidepressants can cause life-threatening side effects when combined with cheeses and a range of other foods).

Medications and children

Never tell a child that medication is a lolly.

Don’t take your own medication in front of a child, they love to copy adults.

Always keep medications out of children’s reach.

Storage

Keep your medicines in their original containers.

Don’t remove the labelling from containers – they include important instructions on how to store your medicine and expiry dates.

Store medicines out of direct sunlight in a cool, dry place.

Some medicines need to be refrigerated – if you leave them out of the fridge by accident, or they freeze, check with your pharmacist whether they should be thrown out or used within a certain time.

Questions to ask your pharmacist or doctor

What is the appropriate dosage – how much should I take, how often should I take it and at what times of day?

Should I take the medicine on a full or empty stomach?

Do I need to swallow the pills whole or can they be crushed or chewed?

What should I do if I miss a dose?

For how long should I take the medication?

Are there problems with taking the medicine if I have a particular condition?

What are the possible side effects, such as drowsiness, and how can I manage these?

What are the signs and symptoms of serious reactions that I need to watch out for?

Are there potential interactions with other medicines I take or may take?

Can I have a Consumer Medicine Information leaflet? (These are included in the medication packaging, but sometimes the packaging is discarded by the pharmacist if a medication has to be mixed before dispensing. All pharmacists are required by law to ensure that patients have access to CMI).

Other strategies to keep you safe

If you are not certain that you can remember the dosage instructions, write them down, ask your pharmacist to write them down or ask your doctor or pharmacist about a dose administration aid (like a dosette box). This is particularly important if you are taking more than one medicine.

If your prescription medicines are crucial for your health and wellbeing, consider carrying a list of your medicines and their dosage instructions with you in case of an emergency or if you are admitted to hospital.

Read all the labels on the container carefully before you use the medicine. Do this with every medicine.

Make sure your doctor knows about every medicine you take, including prescription, non-prescription and over-the-counter medicines, illicit drugs and alternative medicines such as vitamin, mineral and herbal supplements. Under the Home Management Reviews (HMR) program, Medicare rebates are available for a doctor and a participating pharmacist to assess, plan and monitor the medication usage of individuals living in the community.

If you think someone has ingested (swallowed or taken into their body) a poison or taken an overdose call the Poisons Information Centre on 131 126. This is a 24 hour service.

The Mater Hospital in Brisbane staffs a national Adverse Medicines Events Line, from 9am to 6pm Monday-Friday, which can be reached on 1300 134 237 and allows people to report adverse reactions, medication errors or ‘near misses’.

In an emergency you should always call triple zero (000) for an ambulance.

References and Resources

• Better Health Channel: Medication Safety Issues:
  http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Medicines_safety_issues?OpenDocument
• Drug Therapy for Traumatic Brain Injury: http://tbi.unl.edu/savedTBI/drugs/homepage.html
• Health (Drugs and Poisons) Regulation, 1996 (Qld): http://www.austlii.edu.au/au/legis/qld/consol_reg/hapr1996340/
• Home Medicines Review program, Australian Government Department of Health and Ageing:
  http://www.health.gov.au/internet/wcms/publishing.nsf/Content/health-epc-dmmr.htm
• Queensland Health: Medication Management:
  http://www.health.qld.gov.au/mental_hlth/factsheets/medication_management.asp
• Roughead EE. The nature and extent of drug-related hospitalisations in Australia, 1999. J Qual Clin Pract 1999; 19: 19-22.
• Standard for the Uniform Scheduling of Drugs and Poisons:
  http://~Standard_for_the_Uniform_Scheduling_of_Drugs_and_Poisons#Schedule_3_Pharmacist_Only_Medicine