Medication errors: Cut your risk with these tips

Medication errors are preventable. Your best defense is asking questions and being informed about the medications you take.

By Mayo Clinic Staff

Medication errors refer to mistakes in prescribing, dispensing and giving medications. They injure hundreds of thousands of people every year in the United States. Yet most medication errors can be prevented. How can you protect yourself and your family?

One of the best ways to reduce your risk of a medication error is to take an active role in your own health care. Learn about the medications you take — including possible side effects. Never hesitate to ask questions or share concerns with your doctor, pharmacist and other health care providers.

What exactly are medication errors?

Medication errors are preventable events due to the inappropriate use of medications. Medication errors that cause harm are called preventable adverse drug events. If a medication error occurred, but didn’t hurt anyone, it’s called a potential adverse drug event.

An example of a medication error is taking an over-the-counter product that contains acetaminophen (Tylenol, others) when you’re already taking a prescription pain medicine that contains this exact ingredient. This mistake could cause you to take more than the recommended dose of acetaminophen, putting yourself at risk of liver damage.

Another example of a possible medication error is taking a depression medication called fluoxetine (Prozac, Sarafem) with a migraine drug called sumatriptan (Imitrex). Both medicines affect levels of a brain chemical called serotonin. Taking them together may lead to a potentially life-threatening condition called serotonin syndrome. Symptoms of the dangerous drug interaction include confusion, agitation, rapid heartbeat and increased body temperature, among others.

How do medication errors happen?

Medication errors can happen to anyone in any place, including your own home and at the doctor’s office, hospital, pharmacy and senior living facility. Kids are especially at high risk for medication errors because they typically need different drug doses than adults.

Knowing what you’re up against can help you play it safe. The most common causes of medication errors are:

  • Poor communication between your doctors
  • Poor communication between you and your doctors
  • Drug names that sound alike and medications that look alike
  • Medical abbreviations

Know how to prevent medication errors

Knowledge is your best defense. If you don’t understand something your doctor says, ask for an explanation. Whenever you start a new medication, make sure you know the answers to these questions:

  • What is the brand or generic name of the medication?
  • What is the medication supposed to do? How long will it be until I see results?
  • What is the dose? How long should I take it?
  • What should I do if I miss a dose?
  • What should I do if I accidentally take more than the recommended dose?
  • Are there any foods, drinks, other medications or activities I should avoid while taking this medicine?
  • What are the possible side effects? What should I do if they occur?
  • Will this new medication interfere with my other medication(s)? If so, how?

Your doctor can help prevent medication errors by using a computer to enter and print (or digitally send) any prescription details, instead of hand writing one.

Participate in medication reconciliation

Asking questions is essential, but it isn’t enough. Your health care providers can follow a process called medication reconciliation to significantly decrease your risk of medication errors.

Medication reconciliation is a safety strategy that involves comparing the list of medications your health care provider currently has with the list of medications you are currently taking. This process is done to avoid medication errors such as:

  • Missing medications (omissions)
  • Duplicate medications
  • Dosing errors
  • Drug interactions

Medication reconciliation should be done at every transition of care in which new medications are ordered or existing orders are rewritten. Transitions in care include changes in setting (such as being admitted or discharged from the hospital), health care provider or level of care.

Sharing your most up-to-date information with your health care providers gives the clearest picture of your condition and helps avoid medication mistakes.

Here’s what you need to tell your health care providers:

  • The name and strength of all medications you’re taking and when you take them, including prescription medications, herbs, vitamins, nutritional supplements, over-the-counter drugs, vaccines and anything received intravenously, including diagnostic and contrast agents, radioactive medications, feeding tube supplements and blood products
  • Any medications that you’re allergic to or that have caused problems for you in the past
  • Whether you have any chronic or serious health problems
  • If you might be pregnant or you’re trying to become pregnant

Avoid these mistakes

The following medication errors have happened to some people. Don’t make these same mistakes:

  • Confusing eardrops and eyedrops. Always double-check the label. If a medication says “otic,” it’s for the ears. If it says “ophthalmic,” it’s for the eyes.
  • Chewing nonchewables. Don’t assume chewing a pill is as good as swallowing it. Some medications should never be chewed, cut or crushed. Doing so may change how they’re absorbed by the body.
  • Cutting up pills. Never split pills unless your doctor or pharmacist has told you it’s safe to do so. Some medications shouldn’t be cut because they’re specially coated to be long acting or to protect the stomach.
  • Using the wrong spoon. The spoons in your silverware drawer aren’t measuring spoons. To get an accurate dose, use an oral syringe (available at pharmacies) or the dose cup that came with the medication.

Make safety a habit

Get into the habit of playing it safe with these medication tips:

  • Keep an up-to-date list of all your medications, including nonprescription drugs and supplements.
  • Store medications in their original labeled containers.
  • Keep your medications organized by using a pillbox or an automatic pill dispenser.
  • Save the information sheets that come with your medications.
  • Use the same pharmacy, if possible, for all of your prescriptions.
  • When you pick up a prescription, check that it’s the one your doctor ordered.
  • Don’t give your prescription medication to someone else and don’t take someone else’s.

A final word on medication errors

“Don’t ask, don’t tell” is never a smart policy when it comes to medications and your health. Don’t hesitate to ask questions or to tell your health care providers if anything seems amiss. Remember, you’re the final line of defense against medication errors.

If despite your efforts you have problems with a medication, talk with your doctor or pharmacist about whether to report it to MedWatch — the Food and Drug Administration safety and adverse event reporting program. Reporting to MedWatch is easy, confidential and secure — and it can help save others from being harmed by medication errors.

If you can’t remember whether you took your medication, what do you do?

What happens if you don’t remember if you took your medications?  When one is not sure if you took a pill, never, ever just take another dose yet. What could happen if you double dose?  If someone ingests an additional dose, the consequences can be deadly. In fact, an extra dose can raise the risk of harmful effects. Check your pill organizer, count the remaining pills in the bottle, or review the instructions that came with your prescription to find specific guidance. 

doctorHealth care profsionals are in agreement, “For most medications, it is safer to accidentally miss a single dose than to double dose” . Keep in mind that the pill/dosing guidelines vary drastically depending on the medication.  For example, it is different for  blood thinners or something like birth control.), it is always best to double-check with a professional.  If in doubt, call the local pharmacy you got the prescription filled.  Also, call e the America’s Poison Centers at 800-222-1222 .  This can help if you are concerned about over dosing. 

For further guidance, consult I can’t remember whether I took my medication, what do I do? on Medical News Today. To help prevent confusion in the future, you can implement some 9 Simple Strategies for Remembering To Take Your Medication or read the Why You Shouldn’t Skip Your Medication guide on WebMD.
 
If you are missing doses consistently, a few strategies can help get your routine back on track:
  • Use a weekly pillbox: These old fashion pill holders can be useful.   They show a quick visual cue to show which days  doses have been taken.
  • Use a Digital Pill Reminder: Medication reminders, like the Med-Q pill Box. have flashing guides.  These alarmed reminders help preventing over dosing. 
  • Try to do Habit stacking: Match up your daily pill-taking with a non-negotiable daily habit.  For example, your first cup of coffee or brushing yourhair.
  • Set electronic reminders: Use persistent reminder apps, alarm clocks, or simple smart phone alarm reminders.

What to do if Unsure?

The worry about over doing is real.  When unsure whether the dose has been taken, the best thing to do is speak with your health care provider or even your pharmacist. They will  advise you on the best course of action based on ythe specific medication. that is over dosed.

pill box for seniors

If you take oral tablets or capsules, you can count how many pills you have left. If you know when you started taking the pills out of that prescription bottle, this could help you determine whether you’ve taken your dose for that day.

Sometimes, when you haven’t taken your medication, there may still be time to take that dose. However, this could depend on the drug and dosing schedule.

Although in some cases, if it’s almost time to take your next dose, your doctor may recommend skipping the missed dose and taking your next dose at its regular time. Never take two doses at once to make up for a missed dose as doing so could raise your risk of side effects.

What happens if you accidentally take your medication twice?

Do not take more of a drug than your doctor prescribes. While serious side effects may be rare, for some medications, taking more than the recommended amount may lead to harmful effects or overdose. Some of the most dangerous medications to double-dose include:

  • heart maintenece medications
  • ADHD drugs, for example “Adderall”
  • medications for Type 1 Diabetes
  • prescription narcotic pain pills
  • psychiatric medications , for example “Wellbutrin.”

If you have any doubt, act quickly. 

Fist of all, contact your doctor right away.  Let them know you may have accidentally taken two doses or three doses of your daily medication. They will offer up advice.  The Healthcare profesional can often advise of what steps to take.  Also, they will let you know about symptoms to watch out for.

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