Many of us have medications at home or we have parents and other relatives who take many medications. For those that take multiple medications, it can be hard to manage them all.
It has been shown that many abusers of pharmaceuticals obtain their drugs by taking them from family or friends.
Learn from Harry Shamamian, PharmD, how to both manage and safeguard your medications.
Selected Podcast
Medication Safety 101
Featured Speaker:
Harry Shamamian, PharmD
Harry Shamamian, PharmD, is the Director of Pharmacy Services at Henry Mayo Newhall Hospital. Transcription:
Medication Safety 101
Melanie Cole (Host): Many of us have medications at home or we have other relatives who may take many medications. For those that take multiple medications, it can be hard to manage them all. My guest today is Dr. Harry Shamamian. He's the Director of Pharmacy Services at Henry Mayo New Hall Hospital. Welcome to the show, Dr. Shamamian. Tell us what's going on with medication safety as we do have many relatives that are on multiple medications. What should we know about the safety of those medications so that they're not either abused or disposed of improperly?
Dr. Harry Shamamian (Guest): Thank you, Melanie. Yes. I think it's becoming a pretty big problem in our society, the over-prescribing of medication is a common practice I would say today. You go see a doctor and you probably walk away with a number of prescriptions, depending from anywhere from a flu to a serious condition, but we don't realize that many time after we're done taking those medications, we still keep them in our house, in the household. I think that's where things become complicated where people who are not intended to take those medications have access to them. I always tell my patients or patients that come to our hospital is once you're done with your medications, please dispose of them right away. There's a practice of you know, passing those medications to family members that many think that they're doing them a service, but most of the public does not have the I would say, the experience or educational background to determine whether that medication will work for them. So, even if it's a pain medication, you definitely don't want to just give it to someone because there could be adverse effects, depending on their age, other conditions they have. So, my advice is once you know, you finish your course of medications, please dispose of them correctly or get rid of them out of your house.
Melanie: How do you dispose properly of medications that you're either done taking or that are older medications?
Dr. Shamamian: Yes, those are two different problems. One, making sure whatever you have in your medicine cabinets is up to date. I, myself, find--we don't get sick all the time, but--when I do get a flu, I go back to my cabinet, I see that even the over-the-counter medication is out of date. You have to develop a routine, maybe once a year, open the cabinet and see what do you have there and throw away the expired ones and it's not only important to replenish them if it's a routine medication you take, to get a new version in. Second is, if you did finish taking your medication, well what do you do with them? Unfortunately, we don't have too many options today. One option is DA has a drug take back days. They hold those events in many communities throughout L.A. at least once a year. Second option is in our valley, Santa Clara Valley, the sheriff's station has a drug take back cabinet or box in the sheriff's station, which you can take to. If none of those things work for you, you can go to www.fda.org website, there's some directions for safe medication disposal. One is, certain medications could be flushed through the toilet or sewer system and then the majority can be kind of put in your household trash, but there's some stretch that you need to follow. I encourage if that's the only choice you have, go to the FDA website and read directions of how to dispose them.
Melanie: You mentioned over-the-counter medications and expiration dates. So, in those over-the-counter medications, Tylenol or Ibuprofen, can those just be flushed if they're expired and what happens if you take an expired over-the-counter? Does it just not work as well or could it be dangerous?
Dr. Shamamian: There is no one answer to that question. Expiration dates are set and basically that's the potency date. So, if you passed expiration of Tylenol, for example, it may not have the same therapeutic or pharmaceutical effects, so it may not treat your headache or the fever that you have if it's passed expiration. Would it be harmful? Some medications may, but in the majority of cases, they will not be. Inactive ingredients are not harmful to you. But, again, the best practice is being either call local pharmacist, you can ask them that question, or you just be on the safe side and dispose them. And whether it's over-the-counter or prescription, disposal of the meds follow the same routines. Some could be flushed and much of the pain medications can be, but, again, the FDA website has a list of the medications you can safely flush in the toilet. For the other ones that you can't, they also have directions on that.
Melanie: While we're speaking about medication safety, certain medications, doctor, have interactions with other things. Coumadin with grapefruit, or, you know, alcohol involvement. So, how is a person supposed to know which medications they can be taking that will interact with either other medications or just food or other things?
Dr. Shamamian: That's a very good question. I think the best resource in this case is your pharmacist. I think pharmacists still remain very accessible to community. You can just walk into any pharmacy, whether it's your neighborhood pharmacy or it's a Walgreen's or Rite Aid, and they will talk to you without an appointment or insurance, checking your insurance. So, pharmacists still remain very accessible healthcare providers and they are the experts on those questions that you just asked. So, I would say, read the label. Usually the labels of medications will give you a laundry list of things, but the pharmacist can really filter that information and say what's really relevant related to your not only medications you take, but some based on your age, and kind of the other disease stage that you have.
Melanie: What about keeping medications safe from children? There are the childproof caps, but for some elderly that might be on blood pressure medication or the like, they don't want those because they're difficult to open. So, what do you tell parents with small children about keeping medications away from those children?
Dr. Shamamian: Yes, unfortunately, we still do see a lot of adverse events associated with children getting access to medications. A lot of it is because some medications are shiny and colorful and they look like candy. So, when patients come to our pharmacy, my advice is always get child-proof caps. I do also have a lot of elderly patients that do take medications that cannot open those caps. In those cases, we have to, it's actually a law, we cannot give any medications out without childproof caps, and they have to be extremely vigilant and careful and lock up your medicine cabinets, and make sure they're out of reach of both children and pets. Believe it or not, a lot of pets get into those bottles as well. That's why it's also important that disposal is safe, too, because, you know, you put things in trash and a toddler can get into the trash, or one of your pets. So, that's another reason why there’s strict, kind of guidance, on how to dispose meds as well.
Melanie: What do you advise elderly patients? If they're on pain medication, doctor, then what do you tell them about keeping track? Sometimes pain medication can make you a little bit forgetful or you don't remember when you took the last one and then there could be an abuse problem.
Dr. Shamamian: Yes, it is difficult. If you are on around-the-clock pain medication that you have to take throughout the day, I recommend putting some sort of alarm. Today, our smart phones are equipped with many different kinds of apps that will remind you on when to take your medications. I also recommend, even to my own parents who take multiple meds, have a pill boxes which breaks down what hour of the day which meds you have to take and kind of daily fill them, or weekly even. Sometimes they get into routines and I think it's easier for them to remember, but those are kind of a few of the tools I recommend to our elderly patients.
Melanie: So, wrap it up for us with your best advice about medication safety, what you tell people every day about making sure to dispose properly of medications they haven't finished, getting rid of medications, keeping them safe from children, and watching for signs of abuse in their elder relatives that might be on pain medication?
Dr. Shamamian: Yes. One thing I like to tell my patients, which is not something you probably hear from a pharmacist, you know, make sure if you do take medications that you really need to take. We forget that medications are still chemicals, they have a lot of side effects, along with the desired, there's also a number of undesired effects. So, unless you really need to and your physician and the pharmacist are aware of it, do not think that if you can proactively take something, it's going to prevent you from getting the flu. So, only take it when prescribed. Do not borrow medications from family. Do not volunteer to give your family other medications. Intentions are good, I understand, but, again, it's a lot more complicated than just giving somebody two pills of an antibiotic. You know, you will probably cause more harm than benefit to that patient. Definitely keep all your medications up-to-date, locked up. Going back to my first point, these are harmful chemicals. You don't want children or pets to have access to those and that's my best advice I can give.
Melanie: Thank you so much for being with us today, doctor. It's really great information. You're listening to It's Your Health Radio with Henry Mayo New Hall Hospital and for more information, you can go to www.henrymayo.com. That's www.henrymayo.com. This is Melanie Cole. Thanks so much for listening.
Medication Safety 101
Melanie Cole (Host): Many of us have medications at home or we have other relatives who may take many medications. For those that take multiple medications, it can be hard to manage them all. My guest today is Dr. Harry Shamamian. He's the Director of Pharmacy Services at Henry Mayo New Hall Hospital. Welcome to the show, Dr. Shamamian. Tell us what's going on with medication safety as we do have many relatives that are on multiple medications. What should we know about the safety of those medications so that they're not either abused or disposed of improperly?
Dr. Harry Shamamian (Guest): Thank you, Melanie. Yes. I think it's becoming a pretty big problem in our society, the over-prescribing of medication is a common practice I would say today. You go see a doctor and you probably walk away with a number of prescriptions, depending from anywhere from a flu to a serious condition, but we don't realize that many time after we're done taking those medications, we still keep them in our house, in the household. I think that's where things become complicated where people who are not intended to take those medications have access to them. I always tell my patients or patients that come to our hospital is once you're done with your medications, please dispose of them right away. There's a practice of you know, passing those medications to family members that many think that they're doing them a service, but most of the public does not have the I would say, the experience or educational background to determine whether that medication will work for them. So, even if it's a pain medication, you definitely don't want to just give it to someone because there could be adverse effects, depending on their age, other conditions they have. So, my advice is once you know, you finish your course of medications, please dispose of them correctly or get rid of them out of your house.
Melanie: How do you dispose properly of medications that you're either done taking or that are older medications?
Dr. Shamamian: Yes, those are two different problems. One, making sure whatever you have in your medicine cabinets is up to date. I, myself, find--we don't get sick all the time, but--when I do get a flu, I go back to my cabinet, I see that even the over-the-counter medication is out of date. You have to develop a routine, maybe once a year, open the cabinet and see what do you have there and throw away the expired ones and it's not only important to replenish them if it's a routine medication you take, to get a new version in. Second is, if you did finish taking your medication, well what do you do with them? Unfortunately, we don't have too many options today. One option is DA has a drug take back days. They hold those events in many communities throughout L.A. at least once a year. Second option is in our valley, Santa Clara Valley, the sheriff's station has a drug take back cabinet or box in the sheriff's station, which you can take to. If none of those things work for you, you can go to www.fda.org website, there's some directions for safe medication disposal. One is, certain medications could be flushed through the toilet or sewer system and then the majority can be kind of put in your household trash, but there's some stretch that you need to follow. I encourage if that's the only choice you have, go to the FDA website and read directions of how to dispose them.
Melanie: You mentioned over-the-counter medications and expiration dates. So, in those over-the-counter medications, Tylenol or Ibuprofen, can those just be flushed if they're expired and what happens if you take an expired over-the-counter? Does it just not work as well or could it be dangerous?
Dr. Shamamian: There is no one answer to that question. Expiration dates are set and basically that's the potency date. So, if you passed expiration of Tylenol, for example, it may not have the same therapeutic or pharmaceutical effects, so it may not treat your headache or the fever that you have if it's passed expiration. Would it be harmful? Some medications may, but in the majority of cases, they will not be. Inactive ingredients are not harmful to you. But, again, the best practice is being either call local pharmacist, you can ask them that question, or you just be on the safe side and dispose them. And whether it's over-the-counter or prescription, disposal of the meds follow the same routines. Some could be flushed and much of the pain medications can be, but, again, the FDA website has a list of the medications you can safely flush in the toilet. For the other ones that you can't, they also have directions on that.
Melanie: While we're speaking about medication safety, certain medications, doctor, have interactions with other things. Coumadin with grapefruit, or, you know, alcohol involvement. So, how is a person supposed to know which medications they can be taking that will interact with either other medications or just food or other things?
Dr. Shamamian: That's a very good question. I think the best resource in this case is your pharmacist. I think pharmacists still remain very accessible to community. You can just walk into any pharmacy, whether it's your neighborhood pharmacy or it's a Walgreen's or Rite Aid, and they will talk to you without an appointment or insurance, checking your insurance. So, pharmacists still remain very accessible healthcare providers and they are the experts on those questions that you just asked. So, I would say, read the label. Usually the labels of medications will give you a laundry list of things, but the pharmacist can really filter that information and say what's really relevant related to your not only medications you take, but some based on your age, and kind of the other disease stage that you have.
Melanie: What about keeping medications safe from children? There are the childproof caps, but for some elderly that might be on blood pressure medication or the like, they don't want those because they're difficult to open. So, what do you tell parents with small children about keeping medications away from those children?
Dr. Shamamian: Yes, unfortunately, we still do see a lot of adverse events associated with children getting access to medications. A lot of it is because some medications are shiny and colorful and they look like candy. So, when patients come to our pharmacy, my advice is always get child-proof caps. I do also have a lot of elderly patients that do take medications that cannot open those caps. In those cases, we have to, it's actually a law, we cannot give any medications out without childproof caps, and they have to be extremely vigilant and careful and lock up your medicine cabinets, and make sure they're out of reach of both children and pets. Believe it or not, a lot of pets get into those bottles as well. That's why it's also important that disposal is safe, too, because, you know, you put things in trash and a toddler can get into the trash, or one of your pets. So, that's another reason why there’s strict, kind of guidance, on how to dispose meds as well.
Melanie: What do you advise elderly patients? If they're on pain medication, doctor, then what do you tell them about keeping track? Sometimes pain medication can make you a little bit forgetful or you don't remember when you took the last one and then there could be an abuse problem.
Dr. Shamamian: Yes, it is difficult. If you are on around-the-clock pain medication that you have to take throughout the day, I recommend putting some sort of alarm. Today, our smart phones are equipped with many different kinds of apps that will remind you on when to take your medications. I also recommend, even to my own parents who take multiple meds, have a pill boxes which breaks down what hour of the day which meds you have to take and kind of daily fill them, or weekly even. Sometimes they get into routines and I think it's easier for them to remember, but those are kind of a few of the tools I recommend to our elderly patients.
Melanie: So, wrap it up for us with your best advice about medication safety, what you tell people every day about making sure to dispose properly of medications they haven't finished, getting rid of medications, keeping them safe from children, and watching for signs of abuse in their elder relatives that might be on pain medication?
Dr. Shamamian: Yes. One thing I like to tell my patients, which is not something you probably hear from a pharmacist, you know, make sure if you do take medications that you really need to take. We forget that medications are still chemicals, they have a lot of side effects, along with the desired, there's also a number of undesired effects. So, unless you really need to and your physician and the pharmacist are aware of it, do not think that if you can proactively take something, it's going to prevent you from getting the flu. So, only take it when prescribed. Do not borrow medications from family. Do not volunteer to give your family other medications. Intentions are good, I understand, but, again, it's a lot more complicated than just giving somebody two pills of an antibiotic. You know, you will probably cause more harm than benefit to that patient. Definitely keep all your medications up-to-date, locked up. Going back to my first point, these are harmful chemicals. You don't want children or pets to have access to those and that's my best advice I can give.
Melanie: Thank you so much for being with us today, doctor. It's really great information. You're listening to It's Your Health Radio with Henry Mayo New Hall Hospital and for more information, you can go to www.henrymayo.com. That's www.henrymayo.com. This is Melanie Cole. Thanks so much for listening.