Scott Webb (Host): Though our doctors and pharmacists are great resources when it comes to medications and supplements, the responsibility for knowing what we're taking, when to take medications, how to organize the various pills that we take, is really our responsibility. And joining me today to discuss medication safety are Allison Plata, she's a Clinical Nurse Specialist Intern, and Rebecca Varkett, she's a Clinical Nurse Specialist, and they're both with Summa Health. 

This is Healthy Vitals, a podcast from Summa Health. I'm Scott Webb.

It's nice to have you both here today. I know we've spoken before about other things, other topics for Summa Health. And today we're going to talk about medication safety, what to do with our medications, how to sort of keep track of them, where to store them, all that good stuff. So Allison, I'm going to start with you.

Just want to find out, like, what do we need to know about medications that we're taking? Like what are the essential things we should have in our heads?

Allison Plata, MSN, APRN, AGCNS-BC, CMSRN, EBP-C: For our medications, you should always know what medications you are taking, why you are taking those medications, the dosages of those medications, any potential side effects, or any concerns with how those medications should be interacting with activities or medications, other medications we are taking.

One resource that we have to help with some of that information can be easily found on the medication label. The label can tell you how often to take that medication, the provider who prescribed that medication, and any warnings about how the medication can interact, such as needing to take it with food, or it can cause you to be drowsy or dizzy.

A few great resources to find out about any of those potential side effects is 1. Ask the pharmacist when you're picking it up. 2. Read the pamphlet provided from the pharmacy. 3. Any instructions from the doctor's office or the after visit summary, which is the paperwork you get when you are discharged, and lastly, MyChart.

In MyChart, you can see the medication you are taking, and underneath the medication name, you can click on the words Learn More. This will take you to the website where you can read more information about the medication, such as how to take the medication, any side effects, how the medication works, and what to do if you miss a dose.

If you do miss a dose, do not double up on that dose unless you are instructed to do so by a provider, and if you experience any side effects, report those to your provider. There are also some medications that have interactions with certain foods or activities to avoid, such as blood pressure medication can affect how you feel when you stand up, causing you to be lightheaded or dizzy, and this puts you at a risk for a fall.

So, if you are taking a medication that can cause this, be mindful of position changes to help prevent a fall. Additionally, some medications need to be taken on an empty stomach or with food due to causing an upset stomach. An example of a food interaction is with iron that is a common medication that some people take and it should not be taken with milk.

Finally, some medications are dependent on the time of day or the timing is based on the reason for why you're taking that medication. For example, some medications require a certain time of day that the medication is taken such as Synthroid or levothyroxine which is for a thyroid disorder and should be taken the first thing in the morning before breakfast with no other medications.

Lastly, for some medications, the time of day is important because of how the medication works. For example, Lasix or furosemide, also known to some people as a water pill, which causes the person taking it to go to the bathroom more frequently. Therefore, this medication is not taken at bedtime because it will cause the person to have to get up more frequently in the night to go to the bathroom.

This can put you at a higher risk of a fall or injury because of being tired and limited light that increase the risk of tripping or taking a misstep. If you have any concerns or questions, you can always ask your provider when the best time would be for you to take your medications.

Host: Yeah, as you say, our providers are an invaluable resource. I actually have a friend who's a pharmacist, so, not everybody has that luxury, but when in doubt, quick text to my friend, hey, what about this? Will it interact with that? When do you recommend, you know, time of day, those types of things, but start with provider.

Pharmacists are a great resource as well. And Rebecca, just wondering, like, what's our responsibility as patients, right? We're the patients, although, I guess doctors and nurses and health care providers are also patients. But what responsibility do we have to ensure medication safety?

Rebecca Varkett, MSN, APRN, AGCNS,-BC, CMSRN: Know that you are the most vital member of your own healthcare team. Yes, your physician or nurse play an important role, but you must take the steps to ensure that you protect and optimize your own health. Healthcare is complex. Many patients see multiple providers who specialize in different areas of their care.

It is great because you are seeing the expert in that area. However, the downfall is that things can fall through the cracks or what we often refer to as the Swiss cheese effect. This can occur when one provider prescribes a medication and another is unaware and prescribes a similar medication, which may poorly interact with each other and actually increase your risk of adverse or side effects.

There are important steps that you can take to ensure medication safety, including trying to use the same pharmacy. The pharmacist is, also an important member in your healthcare team. So if you don't have a friend, um, who can help you with this, your pharmacist really is your friend, so use that resource that you have when you fill your medication.

So keeping up with the same pharmacy, and they review the medications you are prescribed, they ensure that you are taking the right medication. Your pharmacist can help reduce the risk of polypharmacy, or what we call it's multiple prescriptions for treating multiple conditions, again, increasing the risk of adverse medical outcomes. Always ensure that you have an up to date list of medications, including the names and doses and how often you take them. Don't forget to include your vitamins and supplements on this list as well, and make sure that you bring this list to every single doctor's appointment. MyChart is a great resource for medication information, just as Allison had previously discussed, but in addition to keeping you informed, MyChart does enable you to keep an up to date list, adding new medications, removing old medications you are no longer taking.

In addition, you can even request additional refills for medications you will soon be running out of. Another, key takeaway to being an advocate for yourself is utilize a support person. This might be a spouse, a friend, or a neighbor, someone who knows where you keep your list of medications, what pharmacy you use, and who your primary care provider is. It is important, in case of an emergency situation where you may not be able to provide the answers yourself.

Host: Yeah. A lot of good information there. A lot of good suggestions there. And, you know, Rebecca, one of the things that I invested in a long time ago was a pill organizer because I, and I'm sure a lot of people go through this where I would stand there in the kitchen where I keep my pills, you know, and I would think, did I take my pills or did I just think about taking my pills?

You know, and I finally invested the $10 or whatever it was to get that pill organizer. That way I can check and like, no, I actually did take them. No, you were just thinking about taking them. So along those lines, like what are some health habits, if you will, to help us to stay organized and consistent with our medications?

Rebecca Varkett, MSN, APRN, AGCNS,-BC, CMSRN: Yes, key habits include keeping yourself informed, incorporate into a routine, and, like you just pointed out, staying organized. Keeping yourself informed, I cannot highlight enough how important this is. Ask your physician, your nurse, your pharmacist, many questions. Know why your provider prescribed that medication to you and the key takeaways from that medication resource that Allison had shared previously.

It is important to know more than the color and size of the pill. I have many patients who tell me that they take the small yellow pill, but do not know why the small yellow pill was prescribed or any further valuable information. If you know your pills by the color and size, add that description to your list in addition to the medication name, why you're taking them and a few takeaways such as, you know, take on an empty stomach or with food. 

Incorporate your medication into your daily routine. This may look different for everyone, so only you can determine what is best for you. When you get a new medication, think about your daily routine and how this specific medication can be included. So maybe, you know, you brush your teeth every day.

Could you take it when you do that, when you eat dinner or breakfast or keeping them at the bedside, you know, and take them before you get out of bed every morning. Other habits to stay organized with your medication could be that pill organizer that you had mentioned. There's also a lot of free apps that are available to help.

They have alarms on them, you know, and help keep that organized in your list of medications when you're supposed to take them. So, utilizing those can help you stay organized as well.

Host: Yeah, and Allison, I just want to finish up here, and this is all, this is great information, you know, it's the type of information that maybe some of us should already know, right, but it's good to have experts on to reinforce this and encourage us all to be more in control of things and keep lists, and set reminders, and have organizers, and all this good stuff.

I know it could be particularly important with certain medications, you know, when it comes to handling or storing medications, like what are some of your recommendations?

Allison Plata, MSN, APRN, AGCNS-BC, CMSRN, EBP-C: Yeah, absolutely. There are a key couple of things that we need to remember about how we handle and how we store medications. When you're thinking about how you store your medications, keep in mind a safe location, especially if you have children in the home. In addition to where they are stored, be careful with how they are stored.

Pill holders that are easy to open can allow for easy access, and unfortunately medications are colorful or fun shaped, making them look like candy for children. Some of these medications have special storage considerations, such as nitroglycerin needs to be protected from light, so it needs to stay in its darkly tinted bottle, or some medications need to be stored in the refrigerator, such as some forms of insulin or antibiotics.

Additionally, if your provider changes your dose of your medication, that you dispose of that old medication so there's no confusion with that medication. Additionally, always discard any old or unused medications and not keep them for a later date for use. When you're no longer taking a medication, some local pharmacies or fire departments have safe disposal bins that you can bring your medications into, and some cities have days around the year for that safe medication disposal.

Lastly, you can always ask your pharmacist of what is the best way to dispose of your medication safely.

Host: Yeah, as I said, this is all good stuff, good information. I've done that before, you know, when my wife and I had sort of collected a bunch of empty bottles of pills or there were still some pills in this one or that one or whatever. I just went to the police station, in our local town here. They have a nice little drop box there, really convenient. And you definitely just don't want to throw those things in the garbage where anyone, you know, could get their hands on them. So great to have you both back on today. Have you both on together, talk about medication and pill safety and all that. So thank you so much.

Rebecca Varkett, MSN, APRN, AGCNS,-BC, CMSRN: Thank you for having us.

Host: And for more information, go to sumahealth.org/center-for-clinical-inquiry. And if you enjoyed this episode of Healthy Vitals, we'd love it if you'd leave us a review. Your review helps others find our educational content. I'm Scott Webb. Thanks for listening, and we'll talk again next time.