Chapter 5: Keeping Track of Medicines

Medicine Chart

A medicine chart is a basic guide to your own or your loved one's medicine use. It usually includes the following information:
     - Drug Name (what it is called)
     - Purpose (what it is for)
     - Description (color, shape. Other identifying features)
     - Directions (when and how it should be taken)
     - Special instructions (other pertinent information, possible side effects, or precautions)

A large sheet of paper may be used to make a poster-sized chart and smaller sheet to make a chart you or your loved one can carry with you when you visit the doctor or pharmacist, or are away from home. If the shape, size, colors, or when and how you or your loved one should take the medicine changes, correct the description on the medicine chart.

The Prism Medical Manager includes a medication chart and other resources to help you manage medications and your relationship with your health care providers.

Weekly Check-Off For Medications

A check-off chart can be used to guide and document the medicine schedule. To make one, use 8 ½ x 11- inch ruled paper. Starting from the right side, mark off seven ¾ inch columns. Label these columns for days of the week, starting with Sunday. In the column to the left of the day columns, list the name and dosage for each medicine, and the time to be taken. Each time you or your loved one take a medicine, check it off on the chart. You may want to make photocopies of the chart.

Color-Coded System

A coding system, used in combination with a medicine chart or check-off chart, can be particularly useful if you or your loved one have difficulty reading prescription labels. Use colored self-adhesive labels or colored markers to code the labels of the medicine containers. Put a color mark by the name of the medicine on the chart that matches the color mark on the label of that medicine's container. (If you or your loved one take more than five or six medicines, you may want to use letters of the alphabet instead of colors.) Consider these suggestions?
     - Use colors that are distinctly different from one another. (To some older people, dark green, navy blue and black look the same.)
     - Make sure you or your loved one can see the color clearly, but do not obscure label
information.
     - Be sure to mark the medication containers, not the caps. Caps may be returned to the wrong containers
     - When refilling a prescription, be sure to give the new medicine its proper color code.

Calendars

Calendars can help remind you or your loved one to take medication. If you or your loved one take medicine only once a day, consider using a daily tear-off calendar. Tear off the dated page after the medicine is taken.

If you or your loved one take multiple medicines, a calendar with large squares may be helpful. Mark on each day when medicine is to be taken. Each time you or your loved one take a medication, check it off in the square.

Envelope Systems

An envelope system can be particularly useful if it is difficult for you or your loved one to open bottles or read medication labels. There are two types of envelope systems:
     - System One. Put each medicine in a separate envelope. Write the name of the medication, dosage, and times to take it on the envelope.
     - System Two. Put a day's worth of pills into one envelope. Label each envelope with the day of the week, the dosage of each medicine, and when to take it.

Container Systems

A container system works best if you or your loved one take the same pills in the same dosages every day and if it is easy to tell the difference between the pills. An egg carton works well to make a daily system. For example:
1.    Label each of the 12 slots for hours of the day.
2.    Put the pills into the appropriate slots each morning.
3.    Take pills that are in the 8 A.M. slot at that time, and so on.

An egg carton also can be used to make a weekly system:
1.    Label seven of the slots according to the day the pill is to be taken.
2.    Put the medicine for one day in each of the slots.
3.    Write on the inside of the carton lid the time when each pill is to be taken.

Commercial medication containers are available for multiple and single dosages by the day or the week. You, or a friend or relative, can fill the container for a week and then you or your loved one can take the medicines at the specified times. Ask your pharmacist about the different types of systems available. Also, be sure a system is right for you and your loved one and that it is easy to use. Check with your doctor or pharmacist before using an envelope or container system to verify it is suitable for your own or your loved ones medicines.

Cautions on using any container system: If you or your loved one often have children visiting, be wary of using any container system, since it requires leaving medicines out in the open. Also, some drugs, such as nitroglycerin, lose their strength if exposed to the open air; others must be kept refrigerated. Before using any container system, check with your pharmacist or doctor to find out whether your own or your loved ones medicines will deteriorate if left out in the open for a few hours.

The Calendar (or Blister) Card

The calendar card is a day-by-day dosage card for people who take several medicines at different times.

Each card contains 31 separate sections (called blisters) large enough to hold several pills or capsules. Each blister has the day of the month next to it (from 1 to 31), with corresponding stickers indicating the day.

A card is prepared by the pharmacist for each time of day a person takes medicine. If a person takes medicine four times during the day, four cards are prepared. All doses are sealed into the card. Cards are customized for each person and repackaged to accommodate changes in prescriptions.

Ask your pharmacist if your own or your loved one's medicine can be packaged and dispensed in a calendar card. You may have to pay a little more for the service, but if it helps you or your loved one take the medicines properly, it's worth it.

Your responsibility for your own and your loved one's health care doesn't end with getting instructions and developing a good system for taking medicines. To stay as healthy as possible, you should pay attention to how your own and your loved one's body responds to medicines and be sensitive to side effects.

Why? When you or your loved one take several drugs each day, there may be unusual
combination effects. One drug may neutralize or strengthen the effect of another. Some of these interactions are well known and are actually used by doctors to your advantage. Other interactions can cause problems. Further, when a person ages, his or her body may absorb the drugs differently than when he or she was younger. Just as an elderly person usually needs less food than a younger person needs, he or she may need less medicine.

In most cases, if medicines act on your own or your loved ones body in negative ways, your doctor can prescribe substitute drugs or drug combinations that can do as good a job without the bad side effects. However, before the doctor can make such decisions, you must gather and report the information to him or her.

In some cases, a prescribed medicine will have an unavoidable side effect for most users. For example, some muscle relaxants make the patient feel drowsy. At this stage of medical science, there may be no alternative drug available. You need to be aware of such side effects and take them into account in your own or your loved ones plans each day.

Do not believe that adverse effects of medications are necessarily "natural" especially for older people. This may be so in a given case, but the judgement should be made by your doctor. To reduce the risk of adverse effects from medicines, we recommend the following:
     - At every visit to the doctor, inform him or her of all the other medicines- including non-prescription drugs-you or your loved one are taking. This information will help the doctor avoid prescribing a medicine that will interact negatively with others being taken. Further, if you or your loved one already are having bad reactions to medicines, this information will help your doctor diagnose the reasons for these reactions.
     - When the medicine is prescribed, ask the doctor what you or your loved one should
expect to feel and what can be done if a common side effect does occur. If the effect occurs, you or your loved one will then know whether it is only to be expected or if the doctor should be contacted.
     - Take medicines as directed. Taking a drug incorrectly may cause some bad reactions. Perhaps you or your loved one are taking it too often or in too large a dose or not often enough or in too small a dose. If you or your loved one must return to the doctor for advice on how to reduce bad side effects, tell him or her how you or your loved have one been taking the drug
     - Be aware, beforehand, of what to do if anything goes wrong in taking medicines. Know who to contact and how to reach him or her. Keep the phone numbers of your own or your loved ones doctors on hand-next to the telephone on a card you carry in your wallet or purse and in the Prism Medical Manager.

Continue to Chapter 6: Your Prescriptions: Questions to Answer...