This past weekend, I interviewed some of my friends and family members regarding medications and supplements they are taking. Being that the majority of my friends fall into the young adult age group, the majority of them said no, they do not take any medications or supplements. Only one said yes, in which she is taking Iron and vitamin B complex supplements. Of my family members, my mom takes Metformin, and both she and my dad take Lozartan and Atorvastatin. My sister on the other hand takes Methimazole. All the people who said yes were able to verbalize the purpose of their medications. However, to my surprise only my sister knew the side effects of the drugs they were taking. Subsequently, I was able to educate the people who said “no,” about some of the side effects of each drug they are using. I was able to educate my friend about constipation as the side effect of iron supplements and that she should take it with orange juice or some juice with vitamin C to increase absorption. We also discussed how vitamin B12 helps with DNA synthesis and Hgb production. I was also able to educate my parents about the side effects of Lozartan and how it can cause hypotension and hyperkalemia, which can lead to arrhythmias. I also educated my mom about the importance of stopping Metformin 48hrs prior to injection of contrast dye for a CT scan due to the risk of renal failure. My dad also used to take Garcinia Cambocia, which is an herbal diet pill that decrease the sensation of hunger but can also cause hyperkalemia, Hypercalcemia and Hypermagnesia. Therefore, I was able to also educate him on the danger of taking Garcinia Cambocia and Lozartan and the high risk for developing Hyperkalemia leading to manifested as arrythmias or irregular heartbeats. As for the Atorvastatin medication, my dad then was also able to recall and verbalize side effect of malaise. Lastly, my sister was also able to verbalize hypothyroidism manifested as fatigue, depression, constipation, as the side effects of Methimazole. Of all people taking supplements and medications, non of them knew the generic, brand name or safe dose of the drugs/supplements they are taking.

I asked my husband what he knew about Tums tablets that he sometimes takes for his heartburn. He knew quite a few facts about these tablets: (1) Classification – antacids, calcium carbonate (2) Indication – peptic ulcer disease and GERD, heartburn relief due to neutralization of acid in the stomach, (3) my husband was not aware of any side effects, he only knew about additional benefit of getting calcium for your system (4) dose – take 1-2 oral chewable tablets.

I did a little bit of research on Tums before talking to my husband so I could justify any information that I gave him. I wanted to make sure that any education I provide was evidence-based. I found out that calcium carbonate was once considered an ideal antacid, but its use has declined due to some of the side effects of this drug (Lehne, 2013). One of the main concerns is the acid rebound effect, which happens when acid is actually stimulated more and worsens the condition of the patient. Another big concern is constipation, belching and flatulence due to the release of CO2 in the stomach (Lehne, 2013). In the article “GERD as a motility disorder: A new way of thinking,” Dr. Galland states that Tums actually produce acid relief effect by a different mechanism (Liebert, 2012). He says that calcium carbonate tightens lower esophageal sphincter due to the calcium effect on the muscle tone (Liebert, 2012). He based his conclusion on the study published in the article “Calcium carbonate antacids alter esophageal motility in heartburn sufferers.” This study found that Ca2+ released after chewing of CaCO3 antacids may be partially responsible for the reduction of heartburn by significantly improving initiation of peristalsis and acid clearance (Rodriguez-Stanley et al, 2004). I was glad we had this blog so I could find some new facts for myself and share this information with my husband. Thank you.

References

Lehne, R. A. (2013). Pharmacology for nursing care (8th ed.). St. Lois, Mo.: Elsevier/Saunders.

Liebert, M. (2012). GERD as a motility disorder: A new way of thinking. Alternative & Complementary Therapies, 18(6), 292-296.

Rodriguez-Stanley, S., Ahmed, T., Zubaidi, S., Riley, S., Akbarali, H., Mellow, M., & Miner, P. (2004). Calcium carbonate antacids alter esophageal motility in heartburn sufferers. Digestive diseases and sciences, 49(11-12), 1862-1867.

Medication Education

This is something that happened to me recently. My friend has IBS and told me she had to go for a cortisone injection and was going to the Doctor’s office to get the injection. I noticed my friend has ben exhibiting the signs and symptoms f a cold over the last couple of says. My first question was. Has anybody educated you on cortisone? Has anybody told you about the side effects and when not to take it?. At this point my friend said what most people say. No, my Doctor told me to take it so I will take it. At this point I brought Skyscape up on my phone and showed her. Cortisone suppress the immune system and care should be taken when exhibiting sign and symptoms of colds and flu. So when she read it she called her Doctor and told him what was happening and he noted that the injection could wait a couple of days until she felt better.

My wife’s grandfather had a stroke and was put on a medication regiment of 16 medications. As a result he ended up in assisted living. When he came to visit my wife’s mother she was responsible for giving him all this medication. I asked if anybody trained her on how to give all this medication and she said. I just read the labels and give it when it is due. This was shocking to me. We trust healthcare providers and just follow the instructions. But I feel we must be educated on how to take medications correctly. Especially when it comes to a multi-medication regiment. When I looked at the medication it was overwhelming. The only thing that was listed was when to take, how to take it, and whether or not to take with food. For the side-effects and interactions I had to go online to find the information. I used pocket pharmacist an Application on my phone to check the medications and was surprised that some of the medications did have interaction warnings. Granted your Doctor has training and education in this regard but we should not just blindly follow instructions and take medications. We should always be part of the conversation and ask question, we should do research and ask more questions. I know a little knowledge can be a dangerous thing but if your healthcare provider practices Holistic medicine they would be happy to have you ask questions