Medications Questions Checklist

Questions I find useful to have answers to, whenever I have to take medications. For any type of medication. If I’m not sure, well, asking a doctor or a pharmacist doesn’t hurt.

  • How is this medication supposed to work? Is there a theoretical basis for this medication? There are some medications that don’t have a theoretical basis *cough* lithium *cough* but having a theoretical basis is reassuring and useful in helping me predict how I might react.
  • What should I expect from this medication? What side effects am I likely to get? What rare side effects should I be aware of and look out for? Are there side effects that, if they appear, mean that I should proceed directly to the hospital, not passing go and not collecting two hundred dollars? (Example – the Lamictal Rash)
  • What should I do if I accidentally miss a dose? With some medications, the dose is just skipped. In others, you can make up for it. Additionally – what does “missed” mean? How big of a window do I have? Some birth controls have very small windows.
  • Does this come in generic? Generics are in general cheaper. This isn’t just “does this specific med come in generic”, it’s also “does something in this class come in generic?” If you get a branded combo med, can you take the two parts separately, as generics, and is that cheaper?
  • How is this metabolized? Is it primarily hepatic, renal, or something different? If hepatic, what liver enzymes does it rely on? There are quite a bit of variation to liver enyzmes; if you happened to get a less effective variant (or maybe even a super effective variant), asking your doctor about adjusting medication dosage may help.
  • Does this medication have any special instructions? Do I have to take it with food? Or drink a certain amount of water with it? Must I avoid grapefruit? Stand on my head?
  • Corollary: Does this medication interact with any other medication I’m taking, or any of the supplements? I don’t supplement much – multivitamin, D3 (for which I am borderline deficient in), fish oil (which has pretty good evidence), B-complex, and caffeine, so in general I don’t have many issues with supplement-med reactions. Some medications react badly with supplements or generic medications: St. John’s Wort makes birth control less useful, for example, and some cold medications raise serotonin levels, which is dangerous if you’re on a SSRI.
  • If I discontinue this medication, what should I be aware of? What are the chances I’ll be able to discontinue? When can I discontinue? Am I looking for a specific outcome, or will I be done with this medication after a certain amount of time, or do I have to take it forever? What are the chances that I’ll be forced to discontinue, especially forced to discontinue quickly?

Monday Miscellaneous: The Ebola Edition

XKCD Alt text: “People often say that same-sex marriage now is like interracial marriage in the 60s. But in terms of public opinion, same-sex marriage now is like interracial marriage in the 90s, when it had already been legal nationwide for 30 years.”

XKCD hits the nail on the head as always, but honestly, I think that this lack-of-decision is just that – a lack of a decision that can be easily changed. And honestly, I don’t expect this to stick, so, uh, get married while you can?

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Monday Miscellaneous

Diphenhydramine

Source: Wikimedia

Benadryl can cause hallucinations.

A 24-year-old man presented to the emergency department with acute anticholinergic symptoms, hallucinations, and bizarre behavior following a large ingestion of diphenhydramine (Benadryl).

Weird. I guess Benadryl joins cold medication and Tylenol in the category of “OTC drugs that can do a quite a bit of damage.” Just goes to show that OTC ≠ safe.

A couple of snippets from Harvard’s School of Public Health:

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Lithium and other rants

  1. Apparently the marathon method of doing things I don’t want to do is fairly effective. pdoc appointment quickly followed by buying new bras (hate hate hate hate doing this, I am not a woman, I’m genderqueer arg) followed by picking up the lithium is more effective than having to psych myself up three times to get things done. Despite the long T rides for each of these.
  2. With regard to starting lithium. I’m hoping this goes okay. It better go okay. Please let it go okay with minimal side effects. Please.
  3. With regard to buying bras. Yes. I have small breasts. Yes, I would like compression bras, preferably in a natural material. Arg. Please. None of this nylon/polyester bullshit. Cotton. I would like cotton. And yes, I said compression. Compression, not push up. I know I sound a privileged little wanker for complaining about this stuff, but seriously. Arg.
  4. Why have I never considered knitting on the T before?

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