Taking Medications? Do It Safely

'Five Rights' medication administration guidelines may help keep patients safe

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

June is National Safety Month, which means it may be a good time to learn medication safety to help protect yourself and your loved ones.

The "Five Rights" of medication administration — the right patient, the right medication, the right time, the right dose and the right route — are guidelines used by doctors and nurses to prevent medication errors, but these guidelines can also provide patients with some structure to prevent the same.

"Age brings with it many issues when it comes to medication safety," said Travis Hale, PharmD, pharmacist and vice president at Remington Drug Co. in Virginia, in an interview with dailyRx News. "One obvious issue is the fact that with age the number of medications one takes tends to increase. The increase in number of medications increases the risk of drug-drug interactions, adverse drug reactions, and drug adherence issues."

Taking medication is something that needs to be done carefully and taken seriously. Stopping a drug abruptly — even accidentally — can create a host of problems for any patient, according to Dr. Hale.

"The human body gets accustomed to having a certain drug in the bloodstream doing what it was designed to do," Dr. Hale said. "As the body adapts to the activity of the drug, it may stop doing a process that it normally would do, it may stop producing a chemical that it would normally produce, or it may function at a fraction of the rate that it normally would. When that drug is removed, the opposite of what that drug was doing may occur."

Checking to make sure all “Five Rights” are in place before you take a medication may help keep you and your loved ones safe and free from harm.

The Right Patient

Before a medication reaches a patient's hands, doctors and pharmacists must go through a long process with many steps. For instance, the doctor first orders a medication. The prescription is then faxed, carried or sent electronically to the pharmacy. The pharmacist then selects the medication, dispenses it and labels the prescription.

Although computer-generated prescriptions have helped, human errors can still result in one patient receiving another patients’s medication.

The Centers for Disease Control and Prevention (CDC) recommends always checking that your name is on the prescription bottle and never sharing your medications with anyone else.

The Right Medication

Many medications look the same and have similar names. Adding to the confusion is that, once a drug's patent expires, that drug is typically known by the generic rather than the brand name. For instance, if a patient picks up the small round pill labeled atorvastatin (a generic medication), it is actually the same drug as the oval pill labeled Lipitor.

If a medication looks different or has a different name, always double check with your pharmacist to be sure you have the right medication.

According to the US Food and Drug Administration (FDA), many pharmacies also include the use of a medication on the label. If your previous medication was labeled for pain and your new medication is labeled for sleep, check with your pharmacist.

The Right Time

The time of day you take a drug can make a difference.

Some medications should be taken as close to the same time as possible — to make sure the levels of the drug in your blood remain steady. For instance, taking multiple doses of a pain reliever too close together may lead to overdose. Some medications should be taken only on an empty stomach, while some can or should be taken with food. In rare cases, taking two medications at the same time may cause a negative interaction or make one of the medications ineffective.

The label on the bottle should include information about this. Talk to your pharmacist if you have any questions.

The "right time" also includes safety precautions regarding outdated medications. Taking medicine that went out of date several years ago is never a good idea.

The Right Dose

According to the CDC, patients should always take what is prescribed — no more and no less.

Taking too much medication may result in an overdose. For instance, pain and sleeping medications can be dangerous and even deadly if a patient takes more than prescribed. On the other hand, antibiotics may not be effective if the patient doesn't take all that is prescribed and the full dose each time.

If you have children or teens who take prescription medicine, monitor how they use it.

The Right Route

Medications can come in many forms — the same medicine might come in a capsule, tablet or liquid. These different forms offer flexibility but can also pose some problems.

Some tablets are designed to withstand the high-acid conditions of the stomach and break down later in the small intestine. But, if you break the tablet in half or crush it, the medication may irritate your stomach.

Extended-release tablets and capsules are designed to slowly dissolve and allow medication to be gradually absorbed. If you empty the capsule or crush the tablet, you could get a big dose of the medication at once and become very ill.

If you can’t swallow a pill, ask if the medicine is available in liquid form. Never swallow medicine that should be injected, or dissolve a tablet in water or other liquid.

Special Considerations for Older Adults

According to Dr. Hale, older patients are more likely to take multiple medications, and patients who take several medications at various times of the day are more likely to miss a dose. Older people are also more likely to have vision problems, which can lead to problems reading prescription labels.

"Adherence can also be affected by outside factors that become an issue such as a delay in a doctor's office sending in a refill, or maybe the mail order package containing medication has not arrived," Dr. Hale told dailyRx News. "The more medications one takes, the higher the likelihood that some of these outside factors can play a part in one's adherence."

Older patients may also have problems metabolizing or breaking down medications, according to Dr. Hale.

"The normal decline of our bodies that comes with age causes our bodies to react to or process medications differently," Dr. Hale said. "The kidneys and liver play a large part in the elimination and breakdown of medications. The organ's ability to perform these processes declines with age, possibly causing some medications to hang around in the body longer longer than intended and with continued consumption, medication levels can increase, and adverse reactions can occur."

Other Safety Strategies

In addition to the Five Rights, other strategies may also help you stay safe when taking medications.

Store your medication properly — in a cool, dry place. The CDC recommends using child-safe bottles and keep all medication out of the reach of children.

Some medications require regular lab tests. Make a note to remind yourself or your doctor when it’s due, and keep a written list of your medications with you. Show this list to your doctor and pharmacist before starting a new medication.

If you have any questions about medications, talk to your doctor or pharmacist.

Review Date: 
June 5, 2015