Tuesday, May 01, 2018

8 Signs You're Taking Too Much Medication

Many people believe that drugs are evaluated by the government, and are therefore safe if taken under the guidance of competent doctors. However, even if you accept this, you should ask yourself – how might all that change if you take multiple drugs? For example, if you’re taking more than five different drugs, you’re risking dangerous interaction.
Below are 8 warning signs that you might be on to many medications.
 
1. You Have Access to Good Health Care
Just being a patient and growing old with good health insurance means that you could be at risk for over-prescribing. Prescription drugs are there to heal or manage chronic health issues, but some patients are victims of something that is known as polypharmacy – taking too many prescription drugs and over-the-counter medication, plus supplements.
At this moment in time, nearly half of men and two-thirds of women over the age of 65 in the United States are on five or more medications, which is the accepted definition of polypharmacy. Sometimes patients get prescriptions that they don’t need, or two or more pills in their routine are interacting in dangerous ways.

2. You’re Seeing Several Doctors
People assume that their doctors are in direct and constant communication with each other and coordinating their care, but this is simply not the case, due to how busy doctors are now. For example, if a patient develops an issue with the stomach while being on a certain drug, he will need to be referred to a G.I. specialist. The G.I. specialist will then be obligated to run a number of tests. The patient subsequently might be placed on medication to treat the stomach issues. Suppose the patient then develops dizziness from the combination of the medication he is on, he will then be referred to a neurologist, who will also have to run a number of tests and might prescribe medication to treat the dizziness, and so on…!
3. You Recently Developed New Symptoms
A potential sign that someone might be taking too many medications is the onset of new symptoms that they might not have experienced in the past. Taking a number of different medications comes with the risk of dangerous interactions. These drug-drug interactions might lead to a number of various symptoms such as cognitive changes, gastrointestinal upset, weakness, heart palpitations, and even skin issues.

4. You Struggle to Keep up With Dosing
If you’re taking too many drugs, you might find it difficult to keep up with the scheduled dosing of each one. If it has started to become a huge unbearable onus to keep up with the frequency and timing of all your medications, that could be a signal that you’re on too many medications. If you think this is the case, schedule an appointment with your doctor to review your current list and determine what is necessary for your care.
5. Your Mental Health is Suffering
Given that taking multiple medications is a risk in itself for emotional troubles, knowing the warning signs of depression is crucial. A very common side effect or symptom of being overprescribed is a depressed mood. Many patients will also become extremely tired and sedate while taking too many prescriptions at once.

6. You’re Under Increasing Financial Pressure
Prescribed drugs are not cheap. Therefore, another sign that you might be taking too many medications is a notably increased financial strain. You might notice over time that the amount that you’re now paying for your medications has increased significantly, due to the sheer rise in the number of medications that have been prescribed to you.
Your first priority is to make sure that all the medications that you’re taking are necessary. If they are, you should ask your doctor about generic versions of the drugs, which are cheaper than the brand names.
7. You’re Worried about Addiction
With some prescribed drugs, there’s the risk of addiction. If you think that you might be addicted to drugs, you should get in touch with your local drug treatment center, which has addiction experts who are trained to recognize the signs and provide the necessary help.

8. You Feel Your Meds Are Beyond Your Control
If you’re taking a lot of different medications, it’s crucial to have a system in place. For example, you could get yourself a pillbox and a weekly medicine chart to use as a checklist. You should include each medicine that you need to take, when you need to take it, and how often you need to take it.
You should get to know your medications as each one comes with specific instructions. For example, some medicines can cause problems if they’re taken too closely together, so a chart can help you space out when you take them. It will also help you avoid taking medicine that you have already taken.
 
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Saturday, October 07, 2017

Study links dental antibiotics to C diff cases

Antibiotics prescribed by dentists could be contributing to rising cases of Clostridium difficile, according to new research .

In a study conducted, researchers found that 15% of the patients diagnosed with community-associated C difficile infection (CA CDI) had been prescribed antibiotics for a dental procedure. And the authors of the study question how many of the prescriptions were necessary.

"Many of these prescriptions may not be meeting current prescribing guidelines," lead author and  epidemiologist  told reporters. "All prescribers, including dentists, should examine prescribing behavior for appropriateness."

CDI causes inflammation of the colon and severe, sometimes deadly diarrhea. The leading cause of healthcare-associated diarrhea and one of the most common healthcare-associated infections, CDI was responsible for nearly half a million infections and was associated with approximately 29,000 deaths in 2011. Cases of CDI most frequently occur in older patients who are taking antibiotics for other infections. The antibiotics disrupt the normal gut flora, wiping out both good and bad bacteria and allowing C difficile, a common environmental bacterium, to flourish in the intestinal tract.

Disconnect between medical and dental care

In the study, who perform regular surveillance for CDI , interviewed 1,626 people who had been diagnosed with CA CDI from 2009 through 2015. The cases were defined as CA CDI if the patients had not had an overnight stay in a hospital in the previous 12 weeks. Researcher said the majority of CDI cases occur outside the hospital and are driven by antibiotic use in community or outpatient settings.

Of the 1,626 patients, 926 (57%) had been prescribed an antibiotic, and 136 of those patients (15%) had been prescribed an antibiotic by their dentist. The patients who had received an antibiotic for a dental procedure were older than those prescribed antibiotics for other indications (57 years vs. 45 years) and were more likely to be prescribed clindamycin (50% vs. 10%), an antibiotic that causes diarrhea and has been associated with a higher risk of CDI.

The researchers also noted, however, that among the patients who had taken antibiotics for a dental procedure, more than a third (34%) had no mention of antibiotics in their medical chart. That finding, author said, highlights a disconnect between dental care and medical care; many patients aren't telling their doctors about drugs they've been prescribed for dental care, and dentists may not be warning patients about the potential side effects of antibiotic use.

"Better communication is needed between patients, dentists, and medical providers," author said. Patients should be sure to tell their primary care provider about any medications they are taking for dental reasons, and doctors should ask patients about dental visits and medication, and dentists should counsel patients about the risks of antibiotics.

Inappropriate antibiotic use in dentistry

According to the most recent estimates, dentists are responsible for roughly 10% of outpatient antibiotic prescriptions, writing more than 24.5 million prescriptions a year. Dentists most often prescribe antibiotics to treat oral infections caused by tooth abscesses, or prescribe them prophylactically to prevent infections in patients with heart conditions and artificial joints. But updated guidelines recommend prophylactic antibiotics only in a small number of patients with heart conditions, and not at all in patients with artificial joints.

In their interviews with a subset of the patients and reviews of their medical records, the  researchers found that nearly 10% didn't meet current  guidelines for receiving prophylactic antibiotics. In addition, author added, antibiotics may not be the best treatment for oral infections, either. She noted that under current recommendations, antibiotics aren't warranted for a tooth abscess in healthy individuals unless there are signs of systemic infection. Roughly 43% of the patients had received an antibiotic for an oral infection.

The website of the dentists says the organization supports responsible use of antibiotics to minimize the risk of adverse effects like CDI and the development of drug-resistant bacteria. But when they  surveyed dentists in 2015, they found that 36% prescribed antibiotics in situations generally not recommended by the association. In addition, fewer than half of the respondents said concerns about adverse effects influenced their prescribing.

Author said she has shared findings of the study with the  Dental Association, and that they are looking at ways to raise awareness of the issue and work with dentists to discuss barriers to appropriate prescribing. One of the problems is that while dentists are aware that CDI is a risk of antibiotic use, they aren't informed when their patients develop diarrhea and have to go to the doctor.  

"Dentists need to be included in antibiotic stewardship programs," author said. "They've often been overlooked, and it's absolutely critical that they are included to improve prescribing."

A professor of medicine  said the research is an important advance in the field, given the toll and costs of CDI. "The primary driver of Clostridium difficile is antibiotic use, and so the more we understand about how antibiotics are used, in which settings they are used, and how often they are used appropriately versus inappropriately, is incredibly important."

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