Medications – Take As Directed

Are you taking your medications as directed? If you are not, you may be putting your health at risk. Many people are doing just that and wonder why they are having reactions to the medication. Yes, the elderly have more problems because of age, the medications have not been tested in most cases for the elderly, and therefore the side effects and potential reactions are unknown. Yet doctors prescribe the medications without this information.

Others areas doctors do not consider is the size of the pill or capsule and if the patient may have problems in swallowing it. This is a dangerous area where the elderly often have problems and crush, cut, or chew the tablet or pull the capsule apart and swallow the contents. For many medications, this is not a good idea and can create unwanted side effects.

When a patient is prescribed a timed release medication such as Glucotrol XL or Glucophage XR, doctors need to ensure that the patients understand that they should not crush, chew, or cut these pills. The medications must be swallowed whole. Many of the long-acting medications have drug names that end with a two-letter suffix. For example, CD (controlled dosing), SR (sustained release), LA (long-acting), XR (extended release) or ER (extended release).

A chart prepared by the Institute for Safe Medication Practices (ISMP) is in a PDF file that lists most of the drugs that patients need to swallow whole and not crush, chew, or cut.

The following example is cited in Diabetes in Control of what can happen if one of the sulfonylureas (Glucotrol XL) is chewed. “In one case an elderly patient was prescribed Glucotrol XL to treat elevated blood sugars. This is a specially formulated medication that releases an entire day's supply of the medication slowly over a 24-hour period. The pill was too large for the woman to swallow, so she chewed it. She soon complained of feeling dizzy, weak, listless, and lethargic. Chewing the drug caused it to be released all at once, causing dangerously low blood glucose levels, which could have been fatal.”

Some pills are coated so the medication won't be released in the stomach where it may cause irritation. Other pills have special coatings or other properties to slow the delivery of the medication into the body so that the drug is delivered over a period of time. This is done to make the medication more convenient than taking a drug several times a day. If these pills are crushed or chewed, this delivery action is destroyed and the medication may enter the body too fast. When this happens, then a large amount of the drug will be released all at once, which could cause side effects or serious harm.