Taking Control of Taking Control of Your Medicine!Your Medicine!Kathy Orrico, Pharm.D.Assistant Clinical Professor

University of California, School of Pharmacy

Goals for TodayGoals for Today

To give you tips to help To give you tips to help ORGANIZE your medicationsORGANIZE your medications

To give you tips to help you To give you tips to help you REMEMBER to take your REMEMBER to take your medicationsmedications

To Keep You WELLTo Keep You WELL

We Know it’s We Know it’s Difficult!Difficult!

Step 1 – Map it OutStep 1 – Map it Out

Chart the NAME, STRENGTH, Chart the NAME, STRENGTH, COLOR of each pill or capsule. COLOR of each pill or capsule. (generic name and brand name)(generic name and brand name)

Chart the PURPOSE for taking itChart the PURPOSE for taking it

Chart your DOSEChart your DOSE

Chart the TIME(S) each day or Chart the TIME(S) each day or week to take each medicationweek to take each medication

Step 1 – Map it OutStep 1 – Map it Out

Update your chart when medications Update your chart when medications are stopped and startedare stopped and started

List any Drug Allergies on your chartList any Drug Allergies on your chart

Bring it with you to your Bring it with you to your appointments and to the pharmacyappointments and to the pharmacy

Give copies to your close family and Give copies to your close family and friendsfriends

Step 2 - Set It Up!Step 2 - Set It Up!

Pill Boxes – Fill at a fixed time Pill Boxes – Fill at a fixed time each weekeach week

Calendars – Help you log Calendars – Help you log missed doses and act as missed doses and act as reminders!reminders!

Step 3 – Jog your Step 3 – Jog your MemoryMemory

If possible link medication If possible link medication administration times with daily administration times with daily and weekly activities. and weekly activities. TeethTeeth Bushing, Before bed, Making Bushing, Before bed, Making coffee, Going to Worshipcoffee, Going to Worship

Strategically place your Strategically place your medication bottles to serve as medication bottles to serve as reminders. Be Carefulreminders. Be Careful

Use CalendarsUse Calendars

Weekly PillboxesWeekly Pillboxes Great organization Great organization

tooltool Easy to see when next Easy to see when next

dose is due, if you dose is due, if you missed a dose, etc.missed a dose, etc.

Features may include:Features may include: Removable daily boxesRemovable daily boxes Multiple compartments: Multiple compartments:

MorningMorning NoonNoon EveningEvening BedtimeBedtime

Step 4: Plan for Special Step 4: Plan for Special SituationsSituations

Traveling TipsTraveling Tips Know both brand and generic Know both brand and generic

name of your medicationsname of your medications Know what your medications are Know what your medications are

forfor Get extra supplyGet extra supply Carry your insurance card and Carry your insurance card and

physician’s informationphysician’s information

Step 4: Plan for Special Step 4: Plan for Special SituationsSituations

Patients with a Patients with a pacemaker, pacemaker, defibrillator or defibrillator or other implanted other implanted medical devicesmedical devices Carry a Patient ID Carry a Patient ID

CardCard

Diabetic PatientsDiabetic Patients Allowed to carry insulin or other injectable Allowed to carry insulin or other injectable

medications, lancets, an unlimited number of medications, lancets, an unlimited number of syringes, and sharps disposal containers on syringes, and sharps disposal containers on airplanes.airplanes.

Step 4: Plan for Special Step 4: Plan for Special SituationsSituations Emergency SituationsEmergency Situations

Plan AheadPlan AheadHave a supply ready to go!Have a supply ready to go!

Missed DosesMissed Doses NEVER double up unless you know NEVER double up unless you know that it is OK to do so.that it is OK to do so.

Ask your pharmacist and doctor Ask your pharmacist and doctor how to handle a missed dose for how to handle a missed dose for EACH of your medicines. Note it on EACH of your medicines. Note it on your chartyour chart

Good Questions for your Good HealthAsk Me 3Ask Me 3

1.What is my main problem?

2.What do I need to do?

3.Why is it important for me to do this?

We Want to Empower You to Take Control of Your Medicines!

GreenGreen Medication Medication

DisposalDisposal

Risks of Improper Disposal Risks of Improper Disposal PracticesPractices

Environmental Impact? Environmental Impact?

We don’t know!We don’t know! Accumulation in waterways may Accumulation in waterways may

have potentially harmful effects have potentially harmful effects on wildlife and humanson wildlife and humans

Prevent accidental ingestions in Prevent accidental ingestions in children children

Prevent illegal use or theftPrevent illegal use or theft

How Can Medications How Can Medications Impact the Environment?Impact the Environment?

Expired or unwanted Expired or unwanted medicines, if flushed down the medicines, if flushed down the toilet or drain, are a source of toilet or drain, are a source of pollution in wastewater.pollution in wastewater.

These chemicals can be These chemicals can be released into streams, lakes, released into streams, lakes, and groundwater and affect fish and groundwater and affect fish and other aquatic wildlifeand other aquatic wildlife

How Can Medications How Can Medications Impact the Environment?Impact the Environment?

If our medicines are reaching If our medicines are reaching streams, rivers, and lakes, organisms streams, rivers, and lakes, organisms living in these habitats may be living in these habitats may be continuously continuously exposed to these drugsexposed to these drugs

Some aquatic organisms living Some aquatic organisms living downstream from wastewater downstream from wastewater treatment plants are showing signs treatment plants are showing signs of developmental and reproductive of developmental and reproductive problemsproblems

Researchers are working to Researchers are working to determine whether pharmaceuticals determine whether pharmaceuticals are causing these effectsare causing these effects

Potential Environmental Potential Environmental IssuesIssues

Current scientific data shows no Current scientific data shows no short-term effect of short-term effect of pharmaceuticals on aquatic lifepharmaceuticals on aquatic life

The potential for long-term The potential for long-term effects is currently being effects is currently being evaluatedevaluated

Isabelle Robinson & Guillaume Junqua & Raymond Van Coillie & Olivier Thomas. Trends in the detection of pharmaceutical products, and their impact and mitigation in water and wastewater in North America Anal Bioanal Chem (2007) 387:1143–1151

Recent Water NewsRecent Water News

Drinking water for Philadelphia Drinking water for Philadelphia tested positive for 17 drugstested positive for 17 drugs including medicines for pain, infection, including medicines for pain, infection,

high cholesterol, asthma, epilepsy, high cholesterol, asthma, epilepsy, mental illness and heart problemsmental illness and heart problems

Drinking water for Washington, Drinking water for Washington, D.C., and surrounding areas D.C., and surrounding areas tested positive for 6 drugstested positive for 6 drugs

Recent Water NewsRecent Water News

It is unlikely for any of these It is unlikely for any of these amounts of products to have amounts of products to have an effect on humansan effect on humans Study from 20 water treatment Study from 20 water treatment

facilities showed medications in facilities showed medications in the the parts-per-trillion rangeparts-per-trillion range; ; too small to have human effectstoo small to have human effects

Halford, Bethany. Side Effects. Chemical and Engineering News. 86;8: 13-17(Feb 2008)

Pharmaceuticals in the Pharmaceuticals in the WaterWater

Even though the Even though the USE of USE of medications is the primary medications is the primary pathway for pharmaceuticals to pathway for pharmaceuticals to reach the environment (excreted reach the environment (excreted from human body)from human body), it remains , it remains essential for consumers to know essential for consumers to know how to dispose of their unused how to dispose of their unused medicationsmedications

““Do not flush, place in Do not flush, place in trash”trash”

Flushing pills releases much Flushing pills releases much higher amounts of drug into higher amounts of drug into the water than excretion does.the water than excretion does.

Consumers who do not use all Consumers who do not use all of their over the counter and of their over the counter and prescribed medications should prescribed medications should take the following steps…take the following steps…

Procedure for Disposal of Procedure for Disposal of MedicationsMedications

DO NOT FLUSH unused DO NOT FLUSH unused medicationsmedications

DO NOT POUR them down a DO NOT POUR them down a sink or drainsink or drain

Dispose of Unused Dispose of Unused Medication in Household Medication in Household Trash – Destroy First!Trash – Destroy First!

Protect children, pets, and Protect children, pets, and the environment by…the environment by…

Pour medication into

sealable plastic bag

If If medication medication is a solid, is a solid, crush it or crush it or add water to add water to dissolvedissolve

Protect children, pets, and Protect children, pets, and the environment by…the environment by…

Adding kitty litter, coffee grounds, or other substance that makes the medication less appealing or destroys the medication.

Protect children, pets, and Protect children, pets, and the environment by…the environment by…

Sealing the Sealing the plastic bag plastic bag completely and completely and disposing in disposing in the trash.the trash.

Protect children, pets, and Protect children, pets, and the environment by…the environment by…

Removing and Removing and destroying ALL destroying ALL personal personal identification identification information (i.e., information (i.e., prescription prescription label )from the label )from the medication medication containercontainer Destroy personal Destroy personal

information information Recycle plastic Recycle plastic

containercontainer

Protect children, pets, and Protect children, pets, and the environment by…the environment by…

Mark out Mark out personal personal informationinformation

Protect children, pets, and Protect children, pets, and the environment by…the environment by…

Destroy by mixing Destroy by mixing with with

WaterWaterCoffee Coffee Grounds Grounds

Cat LitterCat LitterDirtDirt

Protect children, pets, and Protect children, pets, and the environment by…the environment by…

Place in Place in opaque opaque containercontainer

Protect children, pets, and Protect children, pets, and the environment by…the environment by…

Hide in the Hide in the trashtrash

QuestionsQuestions