Counseling Patients on Proper Use of Medications
 

Introduction :
    The pharmacy profession functions within a health care system that is expanding rapidly in every dimension - number of patients, work force, facilities, services and cost of therapy not withstanding the efforts to control that growth. Pharmacy profession is undergoing its own vigorous expansion worldwide with pharmacists working in different areas, including community pharmacy, home-care, geriatric pharmacy, clinical practice specialties and research. There is a need for such a growth in our country and steps taken by the pharmacists in simple areas could prove to be vital by increasing the influence, stature and respect for the profession. There are major differences between providing information to patients and counseling them. The provision of information to patients can be automated and done very effectively by machines. Counseling, on the other hand, is the skill of integrating drug information, patient information, communication, and patient assessment.

    The following are the few selected formulations wherein the patients need proper counseling from the pharmacists, which will enable them to use safely, appropriately and effectively.

  • Proper Use of Your Medicine: Take medicine only as directed, at the right time, and for the full length of time presented by your health care provider. If you are using over-the counter (nonprescription) medicine, follow the directions on the label, unless otherwise directed by you health care provider. If you feel that you medicine is not working for you, check with your health care provider.

    It is best to keep your medicines tightly capped in their original containers when not in use. Do not remove the label since directions for use and other special information appear on it. To avoid mistakes, do not take medicine in the dark. Always read the label before taking, nothing especially the expiration date, if any, of the contents
  • For oral (by mouth) medicines: In general, it is best to take oral medicines with a full glass of water. However, follow you health care provider’s directions. Some medicines should be taken with food while others should be taken on an empty stomach. When taking most long-acting forms of a medicine, each dose should be swallowed whole. Do not break, crush, or chew before swallowing unless you have been specifically told that it is all right to do so.
    If you are taking liquid medicines, you might consider using a specially marked measuring spoon or other device to measure each dose accurately. Ask your pharmacist about these devices. The average household teaspoon may not hold the right amount of liquid.
    Oral medicine may come in a number of different dosage forms such as tablets, capsules, and liquids. If you have trouble swallowing the dosage form prescribed for you, check with your health care provider. There may be another dosage form that would be better for you.
  • For skin patches: Apply the patch to a clean, dry skin area with little or no hair and free of scars, cuts, or irritation. Remove the previous patch before applying a new one. Apply a new patch if the first one becomes loose or falls off. Apply each dose to a different area of skin to prevent skin irritation or other problems. Do not try to trim or cut the dhesive patch to adjust the dosage. Check with your health care provider if you think the medicine is not working, as it should.
  • For nasal (nose) drops: How to use: Blow your nose gently, without squeezing. Tilt your head back while standing or sitting up or lie down on you back on a bed and hang your head over the side. Place the drips into each nostril and keep your head titled back for a few minutes to allow the medicine to spread throughout the nose. Rinse the dropper with hot water and dry with clean tissue. Replace the cap right after use. To avoid the spread of infection, do not use the container for more than one person.
  • For nasal (nose) spray: How to use: Blow your nose gently, without squeezing. With your head upright, spray the medicine into each nostril. Sniff briskly while squeezing the bottle quickly and firmly. Rinse the tip of the spray bottle with hot water. Replace the cap right after cleaning. To avoid the spread of infection, do not use the container for more than one person.
  • For otic (ear) drops: To prevent contamination of the eardrops, do not touch the applicator tip to any surface (including the ear).
  • How to apply: First, wash your hands. Lie down or tilt your head so that the ear into which the medicine is to be placed faces up. (For children, gently pull the ear lobe down and back to straighten the ear canal). Drop the medicine into the ear canal. Keep the ear facing up for several minutes to allow the medicine to run to the bottom of the ear canal. A sterile cotton plug may be gently inserted into the ear opening to prevent the medicine from leaking out
  • Eye preparations for Hospital use: Preparations for the eye should be sterile when issued. Eye drops in multiple- pplication containers include preservative but care should be taken to avoid contamination of the contents during use.

    Eye drops in multiple application containers for domiciliary use should not be used for more than 4 weeks after first opening (unless otherwise stated) Eye drops for use in hospital are normally discarded 1 week after first opening. Individual containers should be provided for each patient. Containers used before an operation should be discarded at the time of the operation and fresh containers supplied. A fresh supply should also be provided upon discharge from hospital: it may be acceptable in specialist ophthalmology units to issue on discharge eye drop bottles that have been in use for the patient for less than 36 hours. Eye drops used in out patient departments should be discarded at the end of each day. In clinics for eye diseases and in accident and emergency departments, where the dangers of infection are high, single application packs should be used, it should be discarded after single use. Diagnostic dyes (e.g. fluorescein) should be used only from single application packs. In eye surgery it is wise to single-application containers. Preparations used during intra-ocular procedures and others that may penetrate into the anterior chamber must be isotonic and without preservatives and buffered if necessary to a neutral pH. Large volume intravenous infusion preparations are suitable for this purpose. For all surgical procedures, a previously unopened container is used for each patient.

  • For ophthalmic (eye) drops: To prevent contamination, do not let the eye drop applicator tip touch any surface (including the eye) and keep the container tightly closed. How to apply: First, wash hands, Tilt you head back and, with the index finger, pull the lower eyelid away from the eye to form a pouch. Drop the medicine into the pouch and gently close your eyes. Do not blink. Keep your eyes closed for 1 or 2 minutes.
  • For ophthalmic (eye) drops: If you medicine is for glaucoma or inflammation of the eye: With the middle finger of the same hand, apply pressure to the inside corner of the eye (and continue to apply pressure for 1 or 2 minutes after the medicine has been placed in the eye). This will help prevent the medicine from being absorbed into the body and causing side effects. After applying the eye drops, wash you hands to remove any medicine that may be on them. The bottle may not be full; this is to provide proper drop control.
  • For ophthalmic (eye) ointments: To prevent contamination of the eye ointment. Do not let the applicator tip touch any surface (including the eye). After using, wipe the tip of the ointment tube with a clean tissue and keep the tube tightly closed.
  • How to apply: First, wash your hands. Pull the lower eyelid away from the eye to form a pouch. Squeeze a thin strip of ointment into the pouch. A 1-cum (approximately 1/3-inch) strip of ointment is usually enough unless otherwise directed. Gently close your eyes a keep them closed for 1 or 2 minutes. After applying the eye ointment, wash your hand to remove any medicine that may be on them.
  • For rectal cream or ointment: Bathe and dry the rectal area. Apply a small amount of cream or ointment and rub it in gently. If your health care provider wants you to insert the medicine into the rectum: First, attach the plastic applicator tip onto the opened tube. Insert the applicator tip into the rectum and gently squeeze the tube to deliver the cream. Remove the applicator tip from the tube and wash hot, soapy water. Replace the cap of the tube after use. Wash your hands after you have inserted the medicine.
  • For vaginal medicines: How to insert the medicine: First, wash your hands. Use the special applicator. Follow any special directions that are provided by the manufacturer. However, if you are pregnant, check with your health care provider before using the applicator to insert the medicine. Lie on you back with your knees drawn up. Using the applicator, insert the medicine into the vagina as far as you can without using force or causing discomfort. Release the medicine by pushing on the plunger. Wait several minutes before getting up. Wash the applicator and your hands with soap and warm water.
  • For inhalers: Medicines that come in inhalers usually come with patient directions. Read the directions carefully before using the medicine. If you do not understand the directions or if you are not sure how to use the inhaler, check with your health care provider. Since different types of inhalers may not be used the same way, it is very important to carefully follow the directions given to you.