Stay On Top Of Medications To Avoid Trips To The ER

Published by Contra Costa Times

Posted on Sun, Dec. 12, 2004

By Brenda Reilly, M.D.

An elderly woman came to the emergency room for shortness of breath. But she also had diabetes and high blood pressure, and had been taking many medicines.

The problem was that she wasn't sure which medicines she'd taken, nor how many. She had put all her pills in one container, and tried to pick the proper one by color. Unfortunately she wasn't sure what all the pills were for, and she'd left her pill containers at home. By the time we saw her, the woman was severely dehydrated, with a dangerously high blood sugar level. Most likely she'd taken too many of some pills and not enough of others.

Later that evening, a middle-aged man came to the ER for a skin infection. To avoid having to come to the doctor, he had been using his mother's leftover antibiotics. By the time he came to the ER, the man's infection was so severe he required hospital admission. He didn't realize that different antibiotics work differently, and those designed to treat one infection don't always work on another.

After the man, I saw a young girl who came to the ER for a refill of her asthma inhaler. She'd been getting worse for a week, but her parents had been too busy to call or take her to see her doctor.

In the ER, we see people like the woman, man and girl every day. They seek treatment but don't bring important information about their medication or condition. They wait until they are so ill they need hospitalization. Or they use the ER as a doctor's office. Sometimes patients take medication that isn't even their own, resulting in serious medical consequences.

Having been a patient myself, I know how tempting it is to try to avoid the doctor. Sometimes it's hard to know what information a doctor needs to treat you appropriately. And it can be a nuisance to try to contact your doctor if you aren't sure it's necessary.

Here are some ideas.

First, store each medication in its original container. Don't sort pills just by color or size; it's too easy to mix them up. It's usually best to fill up weekly pill boxes two or more weeks ahead. But keep the original containers even if they are empty, so you can show the doctor.

Don't be embarrassed to ask your physician what each prescription is for. You may want to ask the doctor to write the reason on the prescription so it will be printed on your pill container.
Second, if you aren't sure if you need to see a doctor, call your advice nurse or the nearest emergency room. They can often ask questions to determine how serious your condition is.
And, finally, contact the prescribing doctor, not the ER, for medication refills. It's often dangerous to run out of medication, so don't wait until the last minute. The prescribing doctor knows most about your condition, and what dosage changes and lab tests might be necessary. In the ER, you'll wait a long time, and probably only get a few pills.

I hope these tips will make your next doctor visit more useful and will help you avoid unnecessary ER visits.

Brenda Reilly, M.D., is an emergency doctor at Contra Costa Regional Medical Center.