Watching Whats on your Prescription
Before she walked out the door, your physician
handed you several pieces of paper with scribblings that make Egyptian hieroglyphics easy
to decipher. Now that you look at them are they supposed to be eye drops (ophthalmic), or
ear drops (otic)? Are you supposed to take one tablet once a day ("q.d."), or
four times a day ("q.i.d.")?
You bring the
encrypted missives to the pharmacy, where they are miraculously converted into the potions
needed to make you well. But if you think you have problems deciphering the chicken
scratches on the form, well, so do pharmacists. Some estimate they call physicians'
offices for clarification of one out of every six prescriptions brought to them.
Even the identity of the drug itself sometimes is
miscommunicated. It is a significant enough problem that professional journals regularly
include quizzes and articles to educate pharmacists about common drug mix-ups. The
Institute for Safe Medication Practices, a nonprofit organization, provides information to
health-care professionals about drugs, including "sound-alikes" and
"look-alikes." Recent alerts have included several cases of Flomax (for benign
prostatic hypertrophy) and Fosamax (for post-menopausal osteoporosis) being mistaken for
each other. Neumega and Neupogen are both cancer treatment drugs, but one has a dosage 10
times as great as the other.
Such opportunities for error make it a good idea to
read the prescription form carefully before leaving the doctor's office to make sure it is
legible, accurate and complete and that it matches what the doctor told you.
Here's what to look for:
- The physician's name, address and phone number
should be pre-printed across the top.
- Your name (Is it your name? Is it spelled
correctly?) and the date are filled in on the next line.
- The blank space in the middle is for the name of
the medication, the dosage (number of milligrams for pills, strength for ointments or
drops) and directions for taking the medication ("q.d." means once a day,
"b.i.d." is twice a day, "q.i.d." is four times a day,
"q.h." is every hour and "p.r.n." is as often as needed).
- A refill indication is provided, where the
physician marks whether the prescription can be refilled and, if so, how many times.
- The physician's signature.
- In some states, there is an additional line for
the physician to choose between "substitutes permitted" (meaning that a generic
form of the medication may be used) or "dispense as written" (it can be filled
only with the brand-name drug).
the drug information before giving it to the pharmacist so you have something to compare
with the label after you get the prescription.
Finally, even if the drug is exactly what the doctor
intended, there are still opportunities for unexpected complications. To protect yourself,
report all allergies to the pharmacist. And don't forget to mention the over-the-counter
medicines you take, including any herbal products. Some herbs interact with prescription
drugs by increasing their effect or cancelling them out.
The bottom line is: You are your own best advocate.
Know what you are getting and why, read the label and review everything with a pharmacist
before starting a new medication.
Good Health Return