welcome to ASA do I'm Kathy buio pharmacology has made incredible advances in healthcare over the past 100 years making prescription medication the most common way to improve a patient's Health now unfortunately there's also been many cases where prescription medications have led to serious health issues or even death mistakes with medications can happen at any any stage of the process now today we have Dr meline kjo Chief Pharmacy officer for Baptist Health and Dr Angelica Bernie director of specialty pharmacy at Baptist Health they're going to give us the 411 on medication safety and they're going to answer your questions so you won't have to call 911 next on ask the doc send in your questions to questions allhealth tv.com or allhealth goo on Facebook or YouTube or visit the askthe do page on our website allhealth tv.com and welcome to ASD do the show where we encourage our viewers to send in their health questions now let's kick things off with a question from one of our viewers our first question of the day comes from raldo who just reached us reached out to us through our website allhealth tv.com raldo asked Dr kjo my friend went to the pharmacy last week and they gave him the wrong medication he didn't notice it until he saw the pills were different than what he used what was used to taking that scared me and now I double and triple check my meds what protections are in place to keep this from happening that's a really important question raldo thanks for reaching out Dr Kaho what do you say to that well that is a good thing to do Ronaldo before you leave the pharmacy it is always good to open your medication bag and verify that all your bottles have your name and the medications that you normally tick on hand on the label you know go as far as open the bottle make sure you recognize the color the size of the pills or capsules if the prescription appears to be a little different and that you're a customer to or the colors different or their shape ask to speak to the pharmacist on duty immediately have them check if they've dispense the correct medication for you now if you get home and forgot and you're still not sure you can get online and enter wwd drugs.com and enter the drug name and use the pill finder Aid to match the imprint size and it will give you a visual result of what your pill is and it helps you verify if you have the correct medication but if you're not sure please go back to the pharmacy ask them show them and make sure you have the right medications before you take it thank you meline now Seth just sent a question to us another question through our YouTube page and Seth asks Dr Kaho I retired not too long ago and now I'm living on a fixed income Medicare covers some of my meds but not all of them which is quickly becoming a problem now because they're so expensive pardon my French is there somewhere I can go or someone I can talk to about discounts and or deals on prescription medications I don't know if you speak French Dr Kaho but Seth brings up a very good point he's obviously very passionate about the about the subject where can retirees and lowincome families go to pay less for a prescription medications oh M dear Seth I feel your pain I really do um you know most Americans feel sticker shock when they get to the prescription counter but there are several ways to help you reduce that sticker shock at that counter you know first thing you want to do is every year you know review your drug formulary with your insurance company and ask your inur your insurance company to give you a list of what they cover take that list to your doctor and especially for your first appointment in the beginning of the year to help your doctor select the appropriate medications for your condition at the lowest cost and that helps them coverage your medications the other thing I would do is ask your farmacist is their generic versions of your medications available you know these are medications that are identical copies of the brand named drugs and are usually available at a much lower cost you might also want to do compare prices online uh there's a website called single care out there that you can type in your drug name and your zip code and it will show you the top seven pharmacies in your area with the lowest cost so always shop around the other thing you can do is consider therapeutic uh substitutions you know talk to your doctor or your pharmacist is there a similar medication that I can take that is really less expensive and or has a lower co-pay on your insurance plan then your doctor your pharmacist can get you a new prescription for that medication um the other thing I would do is look for manufacturer coup coupons really expensive medications have manufacturer coupons on manufacturer's website many pharmacies well many pharmaceutical companies will offer discount coupons for certain medications or you can even ask your Pharmacy is one available for your medication and last I would say check online for patient assistant programs or call your Pharmacy to see if they can help find a program to help you pay for uh for your medications especially if you're on low income and can afford your expensive medications you will need to probably fill out a bunch of paperwork but it's really worth the effort you know I've listed some websites you can check their uh public websites one is called medicine assist to.org another one is wwwx assist.org or needy meds assist I'm sorry needymeds.org um these really will help you take your time to see if there are programs that can help you pay for your medications and the last thing I could say too is sometimes when you're just taking a brand new medication and it's really expensive you know at least consider asking for a smaller quantity of the medications like take it for just two weeks to see if that medication is really good for you instead of just putting it all up front and then that medication you're you're experiencing severe side effects and it may not be the right Med for you you might have to call the dock back those are good ways of trying to save a lot of money on that but last but not least the one thing you do want to do is um you know ask your pharmacist to help you don't be afraid that if you can't afford your medications many people are in that boat I know medications have gotten really expensive but there are ways the pharmacists can help guide you on that but the one thing I would say before I I get off this soap opera is please one thing you don't want to do is stretch your meds by taking half the dose that's not going to help you if anything that can help um and you can end up getting sicker or end up back in the hospital so make sure you do what you can and always ask the pharmacist they always have great ideas to help you save money informative feedback Dr Kaho and we got another question here it's something I've never given much to it's quite interesting Millie's question is Dr Kaho I was about to flush some of my expired prescriptions down the toilet last week when my granddaughter who's visiting me from New Jersey read me the riot act and stopped me mid flush she said something about these medicines not dissolving ending and ending up in our drinking water how do I get rid of these old pills so that I don't get yelled at by my granddaughter again okay Angelica what can we do and so that Millie doesn't get yelled at and we dispose of medicine properly well Kathy I'm not looking to point any fingers here but Millie's granddaughter is absolutely absolutely right so flushing medications down the toilet can definitely impact our environment including the water we drink and the water where certain animals might live into um I would say it's definitely so important to safely dispose of expired and unused medications for your safety and for the environment so I thought I'd include a list with some additional information so first I would say let's check for any takeback programs that communities may have um a lot of um institutions and Hospital hital definitely may have a site where you can actually drop off and discard the medication often times these are no questions asked they won't ask where this medication's from the type of medication if it's yours a family member someone you found that's a really great place to start next though a really important factor is to make sure that you remove any labels so that you're protecting your privacy or the privacy of whoever's medication that is um you don't want to have your name any um identifiers such as the type of medication maybe where you filled it so go ahead and just either remove it or if you're not able to you can go ahead and use a Sharpie to Black that out also a next thing is if you don't have access to those um takeback programs the FDA provides great guidance so what they recommend is try dissolving the medications with some water then mixing it in with something like coffee ground maybe dirt cat litter something to make it a less appealing to either be taken or eaten by someone who shouldn't be using it next place that mixture in the sealed container like a plastic bag or an empty container because we want to prevent any leaks and we want to keep it contained together as much as possible then we'll dispose that medication in the trash right we said trash make sure not to dispose of this in the toilet unless you are advised to by your provider or pharmacist or if there's some indication on the medication to do so we want to avoid having any of that medication go into potential drinking water the next thing too is how do we really dispose of these needles and syringes that may accompany some of the medications that we take so make sure to put those in a puncture resistant container or some type of Sharps container if you're on insulin or something that requires those needles often times you'll get a a Sharps container provided by the pharmacy or you might need to purchase one they're great and really make sure that you're keeping yourself and others safe around you don't put those in a trash bin or recycling bin because they can actually um Pierce and um stick out and actually cause harm to others now in case you missed it the first time here's another opportunity to find out where to send in your questions send in your questions to questions allhealth tv.com or allhealth go on Facebook or YouTube or visit the askthe do page on our website allhealth tv.com all right the next question comes to us from Jasmine who reached out through YouTube and asked my mother moved in with us not tooo long ago after my father passed away not only do I have two young kids to force feed medication and vitamins to but now I have my elderly mother who needs help taking her meds Dr Kaho can you give me some tips on how to easily and safely give medications to both my kids and my mom without wanting to strangle them I love the honesty here we have to give them that well wow that is that's tough Jasmine you know uh first if you have small kids you make sure your medication containers you know have safety Cups have safety caps and keep them Out Of Reach and out of sight of children that's really important uh store your mom's meds and children's meds in their original container in different locked cabinets in the house and always put back the medications after using them you know you can always consider also buying like a lock box for your mom's medic medications and lock them up in her room um both your mom and kids the most important thing is to always take your medications as directed that is especially on the bottle follow the schedule exactly you know add and make sure that you take the exact dose prescribed it's important to give medications in in the proper intervals during the day so if the if your bottle says you know take it every 12 hours then divide it by those doses evenly like as possible like 12 hours so give it every 12 hours or if it needs to be taken three times a day then give it every eight hours and and that way you can really space out your your you're not taking meds right on top of each other for your kids a lot of me medication comes in liquids so um use a medicine syringe or dropper don't use a kitchen spoon because they're not always accurate so always be careful to give the correct dose and measure it out exactly the other thing is never refer to medications as candy for your kids because it's can confuse children and sometimes it'll tempt them to think that they're they want to eat candy and may get into any any adults medications especially when you're not watching so do make sure you don't ever refer to uh medications to candy and then remember that a lot of over-the-counter medications or adult drink you should never be giving children uh any any of those medications talk to your pharmacist or your pediatrician for any safer options thank you Dr kameho I'm going to use that tip as well because I have been guilty of the kitchen spoon so thank you for that feedback so now a quick a quick heads up because the next YouTube question from Yuri has a big SAT Word in there that you probably know but it's got me stumped and Yuri asked I recently learned that many common meds should not be taken with other common meds I've heard the problem is so serious that some people have died from what's called poly Pharmacy what is it and how can I avoid a bad situation so are you going to feel this question or maybe you're going to pass it on to the director of specialty pharmacy Angelica who will take it uh Kathy I think I'm gonna punt this one to Angelica yes so something we definitely deal with in our specialty pharmacies and Retail pharmacies so so hi Yuri so poly Pharmacy it sounds scary but really what it is it's something that's referred to when you are on more than normally five medications at a time okay sometimes poly Pharmacy can be necessary it may be needed to manage certain conditions so it really does depend on what it is that you're taking medications for but poly Pharmacy does come with some risk so that includes increased potential for medication errors and the likelihood also of some side effects so it's very important to always understand the medications that you're on as Healthcare professionals and as a pharmacist it's always the goal to avoid medications um that are not needed whenever possible there's several reasons that this may occur right but one of the main reasons that you might have poly Pharmacy is because having multiple medic medical conditions that can actually be managed by different Specialists so let's think about that right you might have a a medication that you use for blood pressure that might have been prescribed by your primary care physician but then you might have a medication that you Ed for your cholesterol right and that could be prescribed then by your cardiologist then you might be on something let's say for your stomach that's going to be prescribed by a gastroenterologist something for let's say depression that might be by a psychiatrist or another doctor so that's going to be one way that you see po poly Pharmacy happening a lot of these different Specialties and providers may not know what you're on so very important to always have a medication list also filling medications at different pharmacies can also contribute to poly Pharmacy because your Pharmacy that's filling one Med may not know that you're filling another at another place that also can lead to other unwanted things such as side effects and other issues that we'll address you know in a little bit here so how can we avoid this right I would say the biggest thing is recommend to get all your medications filled at one Pharmacy this way they can check for your interactions they know exactly what you're on they can communicate back to your providers if necessary and they're going to help educate and support you if you have any questions they know exactly what they can help um answer if there's something that you're just not sure about the second thing too is to always regularly review your medications with your pharmacis provider sometimes your phy will ask you to come in and they might do something what's called a comprehensive medication review your provider might ask to do that and there's reasons for that they want to make sure that you are taking the medications as needed there's some medication that we can actually replace with Alternatives and actually simplify so you might be on two one two or three different meds that might there might be one medication that serves all the same purpose so making sure to talk to your health care provider or pharmacist is going to be key the next thing too I would say is communicate that's the biggest thing communicate all your medications that includes those over-the-counter The herbal the vitamins everything that you're on it's all about it communication so talk to your pharmacist or provider there's a reason why why they have you fill out the medication portion of when you go to a to a doctor's office right there is a reason behind it so thank you Angelica for that and yes we have another question from all Health TV I get a little excited when we get questions from our website and this one comes to us from andrees who has a medication medication safety question for Dr Kaho I'm hearing that there are certain foods like grapefruit that you shouldn't mix with drugs what's up with that I thought the doctor was kidding when he told me grapefruit is the only fruit I can get my kids to eat when I'm giving him his meds help well Dr Kam you're going to have to help Andres find another type of fruit for his kid to eat and I mean very quickly Pronto you know oh oh boy I am telling you that um andrees is giving me a heart attack right now because never give grapefruit or grapefruit juice with medications um or any other citric fruits like oranges tangelos fruits are just a no no to mix with meds and one of the reasons is specifically with grapefruit is that blood levels of certain drugs um get you know raise up because of grapefruit and can cause serious side effects not just for kids but for adults you know grapefruit has the ability to affect medications levels anywhere from one to three days so it lasts in your drug in your actually in your system much longer so medications that should never be taken with grapefruit are like cholesterol medications called statins blood pressure medications like Procardia or Kar heart rhythm medications antibiotics if you're giving kids your antibiotics no no blood thinners and many more in general never never eat grapefruit when you're on any medication but if your child won't take their meds because it tastes bad and you want to give them you want to make sure they take it give your kid a frozen popsicle you know before you give them their medication it will help numb their taste buds or mix it with strong tasting food like a jam or even a little chocolate syrup it will make the medicine go down easier it it's so true what Mary Poppins once say a spoonful of sugar makes the medicine go down it's really true just not grapefruit right Dr kameho never grapefruit not grapefruit okay so now this question uh I know that a lot of our viewers are going to want to know about and it's from carolanne on Facebook and she asks doctor I can't really even ever get to speak to my pharmacist I go to a very busy chain Pharmacy and the tech hands me my meds Rings me up and that's about it I know good communication with the pharmacist is key but they're always super busy what can I do Kathy you're absolutely right I get this question asked all the time at the end of the day communication we're going to say that about medication safety communication is key you know don't just pick up and scattle with the bag in hand you know take the time to talk to your pharmacist especially when you get a new medication it's important because every medication or any over-the-counter Med has the potential to cause side effects would you know what symptoms to look out for right you wouldn't so it's important to take the time talk to the pharmacist if you need guidance or need a question answered about your specific medications ask to speak to the pharmacist on duty it is your right and you should have a good understanding on how to take all your medications and what they're for you know remember always to take your medications that's directed on the ptle always stick to one Pharmacy we can't say that enough don't go to different pharmacies because then the pharmacist won't have complete histories but the most important thing is you know your medication know what their you expected side effects are and the only way you're going to know that is to speak to that pharmacist on duty thank you Dr kameho now if you've got questions we've got answers and just in case you missed it the first couple of times here's yet another chance to find out where to send in your questions send in your questions to questions allhealth tv.com or all Health go on Facebook or YouTube or visit the ask the do page on our website it allhealth tv.com we actually just got a question in right now I'm going to let Dr kameho and Angelica handled this one and a a a c someone wants to know can you mix Mucinex and PSE Sudafed I'm GNA let Angelica answer that one yep so it's a great question especially when you are sick you know wanting to know what you should be taking and not taking so it's very important to understand what's inside each of those medications the first thing to always ask is your pharmacist um ask them that because Sudafed normally is behind the counter so that is something that you're going to have to usually use an identification to obtain and be able to obtain from your pharmacist some psea feds actually are mixed in already with um the Mucinex so you'll see Mucinex D um which is a combination of the two products so that's why it's going to be key working with that pharmacist um to see if there's anything mixed in let's say Tylenol right so Tylenol also is a separate medication that sometimes is in com in combination with different medications so um when we're looking at just Tylenol alone and just Mucinex the two together are generally safe to take but you want to make sure that you don't have any risk factors like any issues with your liver anything that could also impact how these medications work together but again key is talking to that pharmacist because a lot of these products could be mixed in together um if you're just taking them separately generally they're safe to take with Mucinex I always like to make sure patients take it with a full glass of water so you get that full effect um but again your pharmacist at your uh local pharmacy if you have the the actual package will be key to making sure that you're able to mix and and match as necessary Angelica a quick followup to Julio's question which is I think sometimes when you're sick you just want to layer on so many medicines because you think the more you take the quicker the the better you're going to feel is that necessarily true or not it's not necessarily true and you don't want to just take everything like I said a lot of these medications that are out there Mucinex there's different versions of Mucinex right so you don't want to just take Mucinex because maybe the one you have already has penol in it or might have some other type of medication some of these meds take a little bit of time to work you also want to make sure the timing of the medications is important some medications can cause you to you know have some side effects where you might stay up a little later so you might want to take one in the morning versus evening Tylenol for example they recommend to take every 4 to 6 hours as needed for fever for pain um and making sure then that you're also not exceeding the maximum dose that's allowed within a certain day so it's very important to take exactly how it's prescribed on mentioned on the bottle for use um but layering in is not always the the best or safest answer sometimes it's needed sometimes you can definitely do it but making sure you're looking exactly what is inside that medication you may not realize there might be another ingredient in there thank you so much Dr kameho and Angelica I love when we get so many questions for our viewers it just means another reason to do an AA do with you both so we don't have enough time for more questions but please keep sending those questions in thank you again for being here with us I'm Kathy buo and I'll see you next time on ask the dock send in your questions to questions at allhealth tv.com or allhealth go on Facebook or YouTube or visit the ask the doc page on our website allhealth tv.com e