PATIENT
EDUCATION MODULE
4
Medications
Your
doctor has prescribed medications for you that must be taken exactly according
to instructions. The medications
will be effective only if you take them exactly as prescribed and this will also
help your doctor develop a dosage regimen that will give you the most benefits
with the least side effects.
Do
not hesitate to ask questions or discuss side effects about your medication with
your doctor or pharmacist and make sure you give and receive clear information.
How do medications work?
Medications
are intended to relieve symptoms or to
cure,
control, prevent or diagnose
disease. After they have been at work in the body for a certain period of time
they are gradually eliminated in different ways. (through the lungs, urine,
bowel for example) The same drug may act differently in different people
especially if they are very young, old or ill. When, how, and in what period of
time a drug is eliminated from the body depends both upon the drug itself and
the individual taking it.
This is why dosage schedules are different for each drug and
sometimes vary between individuals taking the same drug.
All
medications have desirable and undesirable effects and many do not mix with each other or with
certain foods. The potential for unwanted effects can be minimized if you have
reliable information. Your doctor and pharmacist are the best sources.
Information received from friends, relatives, newspaper or magazine articles and
other non-medical sources should not be used to alter your regimen without
checking with your doctor.
What you need to know about any medication you take
– The name
– what it is for
– what it looks like (shape colour)
– how much to take
– when to take it (before, after or with meals)
– how often to take (once a day, three times a day)
– how to take it (with or without food, on an empty stomach)
– side effects
It may often be difficult to remember exactly when to take
medication & how much to take, especially if you are
taking more than one drug.
– a calendar
– chart method
– lists
– sectioned pill boxes
– special vials®colour coded
ask your pharmacist to
assist you in developing a system.
Points to note about Your Medication
1) Ask what to do if you happen to miss taking the medication at the required time.
2)
Know how long you are supposed to
take the drug and when your prescription should be filled (give proper
notice if you need refills).
3)
Know where and
how the drug should be stored
(usually in a cool, dry place).
4)
Do not adjust the dose
without directions to do so.
5)
Check with your doctor or pharmacist before taking
non-prescribed drugs.
6)
Don’t share or borrow
prescriptions. Your prescription is designed for you.
7)
Shop at one pharmacy, get to
know your pharmacist; this way continuity of your therapy can be maintained.
8)
Take your medication with you
on outings, when traveling make sure you have sufficient
quantity.
9)
Always have a list of your
medications with you with proper identification, & dosages, show the list to
any medical personnel who will be treating you (i.e.: doctors, dentists,
pharmacists, nurse)
10)
Side effects may occur from
certain drugs. Most of these will subside within a short period of time. Discuss
these side effects with your doctor or pharmacist.
11)
Certain medications can cause
sexual dysfunction. If you are experiencing this, speak to your doctor, as
there are alternative medications that may be prescribed.
How to Take Nitroglycerin
¨
Nitroglycerin relieves anginal pain by temporarily
dilating veins and arteries. This brings more blood and oxygen to the heart so
it does not have to work as hard.
·
when you have anginal pain, sit or lie down, and place one tablet (or give one
spray) under tongue. Let this dissolve completely
– hold the saliva in your mouth for 1 or 2 minutes before swallowing
– don’t stand up for a few minutes, you may become dizzy
·
you may feel headache or flushed,
don’t worry, these effects are only temporary
·
take up to 3 tablets (or sprays) — one every 5 minutes if necessary
·
if pain remains after 3 doses, call 911, get emergency assistance
·
nitro is not
habit-forming
·
keep tablets in original container (dark), they will lose their strength if
exposed to light, moisture, heat or if older than 3 months, replace outdated
tablets
·
fresh tablets and spray produce a slight burning sensation under your tongue
Always have a supply of tablets with you when you go out. Keep a bottle
(or spray) in you car, at work or home.
Nitroglycerin
is available in different strengths. If
you are in a situation where you have forgotten your supply, you may use the
supply of another person, but
realize that the effect may vary if the strength is different.
Likewise you may find that you need to lend your supply to someone else
in an emergency. Caution the other
person that the effect may be different and stay nearby to help them summon help
if the medication is ineffective.
HAVE YOU TAKEN YOUR LIFE SAVERS
TODAY?
Certain
classes of medication are used in patients with coronary artery disease to
prevent further trouble in the future. These
are known as secondary prophylactic drugs,
that is, drugs used to prevent worsening of disease that is already present.
Mainly, these drugs are used in heart attack patients but some also have
a role in those who have angina only. The
drugs are listed below by class and their action explained.
ALL OF THESE CLASSES OF DRUG HAVE BEEN PROVEN TO SAVE LIVES.
1. “BLOOD
THINNERS”: ASA, aspirin, clopidogrel (PLAVIX), ticlopidine (TICLID), and
warfarin (COUMADIN) are the drugs used for this purpose with aspirin being by
far the most common. Aspirin works
by making the platelets in the blood
less sticky and thereby reduces the chance that a blood clot will form in one of
your coronary arteries. It is used
in virtually all patients unless they are allergic or intolerant.
It reduces death rates in acute heart attack and prevents subsequent
events as well. PLAVIX and
TICLID are similar to ASA, although PLAVIX appears to be safer.
COUMADIN is a more powerful blood thinner and may be used in special
circumstances. Usually, we ask you
to avoid ASA if you are on COUMADIN although there are some specific
exceptions to this rule.
2. BETA BLOCKERS: There are dozens of choices but all
generic names end in “LOL”. Propranolol, metoprolol, sotalol, acebutolol,
atenolol are a few of the available drugs and many have more than one “trade
name”. It is easy to get confused
by the names but it is important for you to know whether or not you are on a
beta blocker. The purpose of these
drugs is to prevent recurrent heart attack.
They are also useful in controlling the symptoms of angina and preventing
some rhythm disturbances. Almost
all heart attack patients should be on one of these drugs.
People with asthma may not be able to take them and certain patients with
diabetes should also avoid these drugs.
3.
ACE INHIBITORS: Like the beta blockers, there are many of these drugs on the
market. The generic names end in
“PRIL”. Captopril, enalapril,
lisinopril, cilazapril and ramipril are a few of the available drugs and many
have multiple trade names. The
purpose of these drugs is to help the heart heal after a heart attack and
prevent the slow deterioration in heart function that can otherwise occur over
time. In so doing these drugs
prevent death and the development of heart failure.
They are usually used in patients who have more than a little damage to
the heart from their heart attack - those with “mild” heart attacks
therefore may not need these drugs. The
drugs are sometimes not used if patients have kidney disease.
4. THE “STATINS”:
This class of drug ends in “STATIN” and
all are designed to significantly lower the cholesterol. They are remarkably effective and well tolerated drugs.
Recent evidence shows that their use prevents recurrent heart attack and
death in all patient groups including women and the elderly.
Lovastatin (MEVACOR), simvastatin (ZOCOR), pravastatin (PRAVACHOL),
atorvastatin (LIPITOR), fluvastatin (LESCOL) and cerivastatin (BAYCOL) are the
preparations currently available in Canada.