Recently a woman notified our organization after realizing her doctor prescribed the incorrect dose for an antimalarial medicine. The woman, who was soon going to travel to a part of the world where malaria is present, discussed with her doctor about taking medicine to prevent malaria. Having taken antimalarial medicine in the past, the woman asked her doctor to prescribe chloroquine (the same medication she has taken many years ago).
Half of all Americans use herbals and dietary supplements to manage the symptoms of illness and improve health.1 However, contrary to popular belief, a new study published in October 2014 suggests that herbals and supplements are not always safe.2
A toddler was admitted to the hospital after taking an overdose of Quillivant XR (methylphenidate). This medicine is used to treat attention deficit hyperactivity disorder (ADHD). It had been prescribed for the toddler's older brother.
Bactrim and warfarin don't mix. Some medicines should never be taken together because they can interact with each other in ways that alter their effects. These interactions can be dangerous, even deadly on rare occasions. For example, a commonly prescribed antibiotic, Bactrim (sulfamethoxazole and trimethoprim), is often associated with serious interactions with warfarin (Coumadin).These drug interactions are one of the most common adverse events leading to hospitalization in patients taking warfarin. Bactrim causes an increase in the amount of warfarin available in the body. It quickly raises the INR (international normalized ratio), which measures how fast the blood clots. A high INR indicates a higher risk of bleeding. Thus, patients taking Bactrim and warfarin have suffered widespread bruising and serious bleeding episodes. And it's not just Bactrim—other antibiotics interfere with warfarin. A 2012 study in the US found that the risk of bleeding while on warfarin was twice as high for those taking antibiotics, and a study in Canada found a four-fold increase in the risk of bleeding.
If you have diabetes and take insulin using an insulin pen, you may be one of many who are not using the pen correctly. Many insulin pens have a dial on one end of the pen to "dial-up the dose" (Figure 1, top). That same end has a button that needs to be pushed so the dose can be delivered (Figure 1, bottom).
If you keep an EpiPen Jr (epinephrine) auto-injector on hand in case a child has a severe allergic reaction, you need to know about the risk of cutting a child while the needle is under the skin if he or she moves during the injection. An EpiPen Jr auto-injector is a disposable automatic injection device filled with 1 dose of epinephrine. When the orange tip is pressed against a child's outer thigh until it "clicks" and then held there for 10 seconds, the dose is automatically delivered. Prompt treatment of severe allergic reactions in the home and community can be lifesaving and has resulted in better survival rates and less long-term effects. Most often, auto-injectors are used successfully without complications. But two children recently sustained cuts on their legs when using the EpiPen Jr.
Certain pharmacies, known as compounding pharmacies, can mix different ingredients together to produce a patient-specific product. Popular compounded products include pain creams and ointments that contain a combination of multiple potent medications. Many include drugs that can cause central nervous system depression or cardiac effects that result in slow breathing, a low heart rate or irregular beat, and drowsiness or a loss of consciousness. These drugs may include:
The teenage years can be very awkward for young boys and girls. They may feel uncomfortable because their bodies are developing slower than some of the others kids their age. Or, they may be involved in sports and feel they need to increase their muscle mass or athletic performance. For these reasons, some teenagers resort to trying steroids, drugs that mimic the actions of the male sex hormone testosterone. Steroids promote cell growth, especially in the muscles. However, steroids also have very serious adverse effects that may cause permanent organ damage.
A woman was receiving insulin from a Medtronic MiniMed Revel portable infusion pump. She began experiencing very low blood sugar (glucose) levels according to her blood testing kit. She reviewed the history of insulin doses on her insulin pump which saves information about extra doses that are given. In this case, the pump showed that the woman was getting extra doses of insulin during the night. She denied giving herself extra insulin at night. So, it was suspected that the woman had rolled over onto the pump while sleeping, putting enough pressure on the pump to release a dose.
Anyone who takes care of children knows that they have to make their home safe. Whether it's putting up a gate to keep an adventurous child from falling, or covering electrical outlets to keep a curious child away from danger, a safe home is job one. The risk of child poisonings with medicines in the home, however, may not be considered and addressed.1