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Medicines: Harmful or helpful?
Posted: Wednesday, January 25, 2012 7:15 PM
Joined: 02/05/2008
Posts: 392

You probably didn’t mean any harm, but you were working long hours and feeling quite sleepy. You felt awful and couldn’t imagine another whole shift feeling so lousy, so you grabbed some medicine from your crewmate that seemed like it might do the trick, popped the pill and went on your way.

We’re guilty of taking medications for granted, especially those that we take fairly regularly.  But medicines can be helpful or harmful, depending on how you take them and how your body reacts. In general, any medicine that is potent enough to have an effect will have one or more side effects.

The last thing you want, or need, is for your medication to make your feel even worse. Or, scarier yet, for the medication to cause more harm than help.

Whether you are taking medicine to treat or prevent an illness or infection, or relieving symptoms of disease, how you take medication sometimes is as important as what you take.

In addition to only taking medication prescribed to you, always follow the below steps when taking medicine to ensure the best treatment and outcome.  

Read the label
The insert packaged with the prescribed medication contains important information. It includes the name of the medicine, the strength, the quantity and the directions for taking the medicine.  The label should note the prescribing doctor's name, the generic or chemical name for your prescription, the date it was dispensed and the name of the dispensing pharmacy.

Sometimes a label will caution that contents are “NOT TO BE TAKEN.” This applies to preparations such as suppositories, creams and eye drops, all of which are not to be swallowed.  The label also may warn you to avoid alcohol while taking the medication or whether or not you can expect to feel drowsy.  If so, it is unwise to operate machinery while taking that medicine.  Ask a fellow crewmember to help you.

Pay attention to the expiration date on medications. While the medicine may still be potent, it also may make you very sick. Don’t risk it. Discard all old medication.

• Follow all the instructions on the label. When, how often and for how long you take your medicine are very important questions.
• Organize a system for taking your medicines.
• Keep all medicines out of reach of children.
• Never take medicines prescribed for someone else.
• Discard all old medicine. Ask your captain or first mate what the policy is for discarding medicine on your yacht.  

Research and ask
There are a number of drugs that don’t play well with other drugs. Certain drug interactions can render medicines ineffective. For example, some antibiotics lessen the effectiveness of the oral contraceptive pill. Some drug interactions can cause serious side effects. Provide doctors or telemedicine services with a current list of all crewmember medications, including those bought over the counter. If you are on long-term medication, seek advice from your doctor before purchasing any new medicines without a prescription.

Inform your doctor if you are pregnant, nursing or planning to become pregnant to confirm whether or not there are any potential issues with the medicine being prescribed.  

If you are ever in doubt…ask! It’s in everyone’s best interest that a person understand the drugs s/he is taking, why these drugs are being administered, how long they should be taken and how and when use should be discontinued.

Take as directed
Be sure to administer medication as directed. Should you have difficulty swallowing large tablets, opening foil packaging or feel that you have not fully understood the instructions on how to use medicines like suppositories or nasal sprays, talk to your telemedicine service or doctor.  Medicines only will work when used correctly.

Watch for side effects
Some medicines may cause side effects.  Report any unusual symptoms that develop while taking medicine to your captain or telemedicine service; this includes allergic reactions. Keep a record of these side effects and symptoms and make sure they are noted in your medical records so you are not prescribed the same medicine in the future. 

Some medicines cause skin sensitivity and other reactions when users are exposed to sunlight.  This requires that you cover your skin to avoid burns or rashes.

No two people react to medicines the same way. A person’s age and overall health also affects the length of time a medicine stays in the body and the amount of medicine absorbed by body tissue. These factors should be considered when reviewing dosage amounts to reduce the severity of potential side effects.

Side effects of some medicines can lead to giddiness, falls, depression or confusion. Drug dependency is another side effect to be cognizant of as you take certain medicines, such as sleeping pills and pain relievers.

Researching any medicines you take and how they may affect you can help bring about safer treatment. 

By Rene De Jongh, MD, Medical Director of Assistance Services for MedAire, which provides medical advice, training, and medical equipment for crew at sea and ashore.