What are the top 10 common medication errors that you don’t notice in your clinical practice? The National Consumers League reports that 44% of people in the United States take their medications incorrectly. In China, it is estimated that 5 million people are admitted to hospitals each year due to wrong medication taking methods, and 200,000 of them die as a result; 500,000 of the 5 million deaf children each year are also due to this reason. In addition, there are many other dangers that we do not even know are caused by the wrong way to take medication. The size of drugs is getting smaller, more powerful, better tasting, more shapes, and more beautiful packaging, but the instructions on how to take one of them have been the same for decades, always the same 8 words: once x tablets, x times a day, or add another sentence – take before meals. Not to mention that the introduction of side effects alone is much more brief than the other. In fact, the way a drug is taken is an important issue that requires as much attention as the side effects of the drug. If the way, time is not correct, with the diet is not reasonable, not only is not conducive to the effectiveness of the drug, but also may lead to a variety of dangers that you did not expect. The following are the top ten most common mistakes in taking medication: Mistake 1: Simply taking medication with three meals a day Because the drug instructions simply say “take three times a day, before meals”, you take your medication before three meals every day on time. Wrong! “Three times a day” is a rule that pharmacologists have established based on experiments to determine the metabolic rate of drugs in the human body, meaning that the 24-hour day is divided into three equal segments, and drugs are taken every 8 hours. Only by taking the medication on time can we ensure a stable blood concentration (concentration of the drug in the blood) in the body and achieve the therapeutic effect. If all three doses are scheduled during the day, the blood concentration will be too high during the day, bringing danger to the human body; while the night does not reach the therapeutic concentration. “Take before meals” means that this drug needs to be taken on an empty stomach (1 hour before or 2 hours after meals) to facilitate absorption. If you eat a large snack just before eating, then “before meals” is not the same as “fasting”. And “take after meals” refers to a full stomach (half an hour after meals) when taking drugs, the use of food to reduce drug stimulation of the stomach and intestines or to promote the absorption of drugs in the stomach and intestines. Likewise, if you have eaten a lot of snacks just before a meal, you do not have to be dogmatic and wait until after the meal to take the medication. Here are some common medications that need to be taken on an empty or full stomach: ● Fasting: ampicillin, penicillin G, amoxicillin, erythromycin, rifampin, reserpine, gastrodipine, most Chinese medicines or proprietary Chinese medicines, etc. ● On a full stomach: Penicillin V potassium, aspirin, Valium, cotrimoxazole, sulfapyridine, ciprofloxacin, paracetamol, pepsin to help digestion, etc. Mistake two: lying down to take drugs lying down to take drugs, drugs are easy to adhere to the esophageal wall. It not only affects the efficacy but also may stimulate the esophagus and cause coughing or local inflammation; in serious cases, it may even damage the esophageal wall and lay the hidden worry of esophageal cancer. Therefore, it is better to take medicine in a sitting or standing position. Mistake 3: Dry swallowing Some people swallow drugs dryly without drinking water in order to save time, which is also very dangerous. On the one hand, may be the same as lying down to take drugs damage the esophagus, or even more serious; on the other hand, there is not enough water to help dissolve, some drugs are easy to form stones in the body, such as cotrimoxazole and other sulfonamides. Mistake four: break to eat or dissolve in water after eating Some people “swallow” their own medicine or fear of children choking, they take it upon themselves to break the drug or dissolve in water before taking, which not only affects the efficacy will also increase the adverse effects of drugs. In the case of aspirin enteric tablets, for example, after breaking the drug without the protection of the enteric coating can not safely reach the intestine, in the stomach is dissolved, not only can not play a therapeutic effect, but also stimulate the gastric mucosa. Dissolving the drug in water before taking it also has the same adverse effect. Therefore, do not do this unless specifically ordered by your doctor or stated in the drug’s instructions. However, it is different when taking proprietary Chinese medicines. For example, for the common large pills, you should use a clean knife or your hands to divide the pills into smaller pieces and then take them with warm boiled water. In order to speed up the effect of the medicine, you can also use a little warm water to mash the pills into a thin paste and then take them with warm water. Mistake 5: Using drinks to deliver medicine The correct way is to use plain water with moderate temperature to deliver medicine. Because milk, juice, tea, cola and other beverages can interact with drugs, which may affect the efficacy and even lead to danger. For example, the use of juice or acidic beverages to deliver compound aspirin and other antipyretic analgesics and flavopiridol, acetylspiramycin and other sugar-coated antibiotics, will accelerate the dissolution of drugs, damage to the gastric mucosa, the heavy can lead to gastric mucosal bleeding; delivery of aluminum hydroxide and other alkaline gastroparesis drugs, acid-base neutralization will make the drug completely ineffective; delivery of cotrimoxazole and other sulfonamides, it reduces the solubility of drugs, causing urinary tract stones. With tea for the treatment of anemia iron, tea tannic acid will be combined with iron, weakening the efficacy. However, the following special cases will help the efficacy of the medicine: ● Green tea water for taking antihypertensive and diuretic western medicine. Take Chinese medicines such as Liu Wei Di Huang Wan, Qi Ju Di Huang Wan and Zhi Bai Di Huang Wan with light salt water. Take Chinese medicines such as Huo Xiang Zheng Qi Tablets and Xiang Sha Yang Gastric Pills. Take Chinese medicine for the spleen and stomach. Mistake 6: Drinking medicine into the bottle This is especially common when drinking syrup or combination. On the one hand, it is easy to contaminate the medicine and accelerate its deterioration; on the other hand, it is impossible to accurately control the amount of medicine intake, which either fails to achieve the effect of medicine or increases the side effects of overdose. Mistake 7: Taking multiple drugs together It is difficult to avoid the interaction between drugs, and it may even cause some trouble that you did not expect. ● An unplanned pregnancy may not be caused by missing the pill, but by taking an anti-tuberculosis drug or a drug to prevent a cerebral hemorrhage at the same time as the pill, making the pill ineffective. ● Uncontrolled symptoms of depression are not necessarily due to ineffective medication or individual differences, but rather to taking anti-allergy medication at the same time as the medication for depression. ● The cause of failure of medications for heart disease may be those licorice tablets used to treat cough. ● If thyroxine supplementation for low thyroid is accompanied by magnesium supplementation, then the thyroxine is wasted. But we have to admit that very few physicians ask us which medications we are taking when they prescribe them to us, or pharmacists when they sell them to us. Therefore, if you suspect that several medications you are taking or are about to take may have adverse interactions, be sure to take the initiative to consult with your physician or pharmacist, but remember not to stop or change medications on your own. Mistake 8: Drinking too much water after taking medication is not okay? Yes, because this will dilute the stomach acid, which is not conducive to the dissolution and absorption of drugs. Generally speaking, 1 small glass of warm water is enough to deliver solid medication. For special preparations like syrup, especially cough syrup, the drug is needed to cover the surface of the inflamed pharyngeal mucosa and form a protective film to reduce the mucosal inflammatory response, block irritation and relieve coughing, so it is recommended not to drink water within 5 minutes after drinking the syrup. Mistake 9: Exercise immediately after taking medication Like after eating, you should not exercise immediately after taking medication. This is because it generally takes 30 to 60 minutes for a drug to be dissolved and absorbed by the stomach and intestines and to function, during which time sufficient blood is needed to participate in circulation. And immediately exercise will lead to insufficient blood supply to the gastrointestinal organs and other organs, the absorption effect of the drug is naturally greatly reduced. Mistake 10: Not paying attention to dietary contraindications during medication Not only Chinese medicine is concerned about dietary contraindications, Western medicine is also the same. Irrational diet during medication can reduce the effectiveness of the drug, and in serious cases, it can be life-threatening. The following provides some common drugs during the taking of the diet taboos: ● blood pressure drugs, anti-angina drugs to avoid drinking grapefruit juice, avoid eating food containing high salt. Because the grapefruit juice in the naringin can affect the role of certain enzymes in the liver, and this enzyme is precisely related to the metabolism of blood pressure and anti-angina drugs. In the case of the treatment of angina pectoris, for example, a glass of grapefruit juice can make the body’s blood concentration rise 134%, equivalent to taking more than two times the drug, an obvious overdose, greatly increasing the side effects. The salt will cause an increase in blood pressure, reducing the effectiveness of antihypertensive drugs and aggravating the degree of angina. Avoid drinking alcohol while taking headache medication. The reason is that alcohol needs to be oxidized into acetaldehyde after entering the body, and then further oxidized into acetic acid to metabolize it. These drugs can prevent the oxidation of acetaldehyde to acetic acid, leading to the accumulation of acetaldehyde in the body and aggravating headache symptoms. Also, alcohol tends to make people drowsy, which can overlap with the effects of barbiturates, which are mostly contained in these drugs. Antidepressants, dysentery, anti-tuberculosis drugs, anti-tumor drugs Avoid eating cheese, bananas, avocados, soy milk, beer and other foods that contain more tyramine. The mechanism of action of antidepressants is to inhibit monoamine oxidase (MAO) in the body. However, this MAO inhibitor easily reacts with tyramine to produce norepinephrine, and gathering too much will make the blood pressure rise abnormally, showing nausea, vomiting, abdominal pain, diarrhea, dyspnea, dizziness, headache and other adverse symptoms, and the purpose of antidepressants cannot be accomplished. Dysentery, some anti-tuberculosis drugs (such as Remifentan, etc.) and anti-tumor drugs (such as methylbenzylhydrazine, etc.) also contain MAO inhibitors, which are prone to trouble when they come across foods containing tyramine. ● Bitter stomachic medicines, digestive aids and Chinese herbal medicines Avoid eating sugar or sweets. This is because bitter stomachic and digestive drugs mainly stimulate the peripheral nerves and reflexively secrete digestive juices such as saliva and gastric juices in order to help digestion and promote appetite. Sugar or sweet food will cover up the bitter taste and reduce the effectiveness of the medicine. For Chinese medicine, sugar or sweets also tend to react with many ingredients in the medicine, reducing the content of active ingredients and reducing the effectiveness of the medicine. Avoid taking calcium supplements such as spinach, tea and almonds, which are rich in oxalic acid. This is because oxalic acid combines with calcium in the small intestine to produce insoluble substances that cannot be absorbed and may form stones while preventing the absorption of calcium. Avoid eating too much animal and vegetable fats and oils with iron supplements. This is because fats and oils can inhibit the secretion of gastric acid and affect the transformation of trivalent iron ions into divalent iron ions, which is detrimental to the absorption of iron in the gastrointestinal tract and weakens the effect of iron supplementation. ● Iodine supplements avoid spinach, peaches, pears, etc. Because these foods will prevent iodine from entering the thyroid gland.