The Rancho Los Amigos Post-Polio Support Group has been privileged to have drug expert Judy Shigemitsu, Pharm. D. as a speaker on several occasions. She is a very popular speaker at local support groups. For the past 17 years she has been a staff pharmacist at Torrance Memorial Medical Center (near Los Angeles). Pharmacy must be "in her blood" since she is the third generation pharmacist in her family to graduate from University of California (USC). Her daughter (fourth generation) is now following in her footsteps at USC.

This report provides some understanding of medications (meds) and their effects on the human body. Included are over-the-counter (OTC) pharmaceuticals, prescription medications, and herbs. The concluding section provides many tips for managing medications.

The Basics

In order to understand medications and their effects it is best to consider some basics:

• All medications, including prescriptions, over-the-counter, and herbs, contain a chemical that can be potentially dangerous. The active chemical in the product is the important factor, whether it is a root, leaf, stalk, etc.
• The body absorbs these chemicals in the lower stomach and upper intestine.
• Most drugs are then metabolized through the liver.

As a person ages they become more sensitive to medications because:

1. Some muscle mass changes to fat.
2. Kidney function slows down.

Generic versus Brand Name Drugs

A generic drug is supposed to contain the same bioavailability of compounds as a brand/trade drug. So if your body can tolerate the generics, the necessary chemicals will be absorbed.

When generic drugs first became available there were many small manufacturers; now many of these companies are out of business. Currently there are many large pharmaceutical companies that also have their own separate generic brands. In some cases they market the same product but under a different label.

OTCs

When selecting over-the-counter drugs find the product that works for you. Read beyond the fancy words; find and compare the basic active ingredients.

When a package says "aspirin-free", it usually means it contains the active ingredient that is in Tylenol.

Standard minimum doses are:

• 325 mg. Tylenol (acetaminophen) used for fever and pain
• 325 mg. Aspirin (acetylsalicylic acid) used as anti-inflammatory, analgesic, or anti-platelet
• 200 mg Motrin (ibuprofen) used as anti-inflammatory and pain relief

Herbs

If herbs had not been used long ago we wouldn't have the drugs we have today. It is important to see how any drug works for the individual. Dr. Shigemitsu cautions, "Don't read every testimonial for belief. " She also cautions that many herbs are not purified.

Whether they are prescription medications, or OTCs, or herbs, realize that "more" may not be "better". In addition to the increased possibilities of side effects, some drugs have a narrow margin of safety and too much could be toxic.

Self Help

1. Learn about your medications Always read the label and auxiliary labels on a package or bottle.
   • names: generic and brand
   • dosage and frequency
   • indication: what it is being used for
   • special instructions for administration and storage
   • length of therapy
   • possible side effects that may occur
   • potential interactions with food or other medications

2. Remember to take medication as prescribed
   • Find a good method of remembering to take your medications.
   • When taking pills, always be in an upright position and take with 2-4 ounces of water.
   • If you think a medication is causing a side effect or is ineffective, talk to your doctor or pharmacist before stopping. It may be harmful to stop some medications suddenly. Perhaps the dose may need to be adjusted to your body's response.
   • Plan refills early enough to avoid missing doses.

3. Periodically review with your doctor all your prescriptions, OTCs, and herbs.

4. Find one good pharmacy – consider these factors:
   • convenient location, especially for refills
   • pharmacist with whom you are comfortable – someone who will talk with you and explain things (California pharmacy law now requires a consultation on each drug that is new for the patient.)
   • someone who will keep your records
   • cost

5. Don't be afraid to ask:
   • for easy-open tops
   • about compliance aids (charts, calendars, logs, and devices)
   • about timing doses (morning, with meals, etc.)
   • about any restrictions (alcohol, driving, etc.)
   • about change in color/shape of medication
   • if new medication is similar to any current meds

6. Don't be afraid to tell the doctor:
   • if you have trouble swallowing
   • if you have trouble remembering the dosage schedule
   • when warning signs appear

7. Avoid these pitfalls:
   • borrowing or trying someone else's meds
   • self-medicating with extra dose or skipping dose
   • stopping a medication without checking with the doctor
   • use of multiple pharmacies (those which don't maintain your complete record)
   • neglecting to tell each doctor your full history
   • neglecting to update your pharmacist on allergies and medical conditions

Conclusion

A person can become a better consumer of medicinal products by reading labels and understanding that all medications contain chemicals that can be potentially dangerous. Whether these medications are prescription, over-the counter, or herbal preparations the active chemicals will be absorbed by the body and then metabolized through the liver. It is wise to periodically review with your doctor or pharmacist all products you are currently using.

For More Information

1. "Food and Drug Interactions" is a 14 page booklet produced by the National Consumers League in cooperation with the U.S. Food and Drug Administration. It is available online at www.nclnet.org or by mail. If you would like a hard copy of the brochure, please send $2 for postage and handling to the National Consumers League, 1701 K Street, NW, Suite 1200 Washington, DC 20006.

2. Consumer Information Center has free booklets, found under the heading Drugs & Health Aids at www.pueblo.gsa.gov or toll-free 1-888-878-3256 to request a free catalog.