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Medication Madness!
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You’ve just come home from the hospital, complete with some shiny new stents, a low-salt diet, and a bag full of prescriptions. Who’s your new best friend? Your pharmacist.
Beta blockers, statins, ACE inhibitors, aspirin, anti-depressants. If there’s a common frustration that women with heart disease share, it’s the constant juggle of pharmaceuticals. Members of the WomenHeart Online Community chat back and forth on a daily basis about what they’re taking, when they’re taking it, what side effects they’re having, and if any of this stuff is really working anyway. What they’ve come to understand is that what works for one may not work for another, making every woman feel like a guinea pig in her own private laboratory.

Since visits to your cardiologist may often be several months apart, it makes sense to form a good working relationship with the health care professional who you see most often: your pharmacist. Whether you pick up your prescriptions at a big box retailer or your neighborhood drug store, a pharmacist is trained to do much more than just count pills into bottles. “A lot of people don’t realize that pharmacists are trained in kinetics, chemistry, and pharmacology,” says Karen Williams, a pharmacist with the US Department of Health and Human Service’s Office of Pharmacy Affairs. Her advice to patients: “Get to know your pharmacist by name.”

Williams asked two of her fourth-year pharmacy student interns, Lawrence Momodu and Jay Singh from Howard University, to take a look at the types of medications that women with heart disease are taking and create recommendations for smart medication management. Both students were surprised to find that many female heart patients were younger than they anticipated; “It changed our perception of the physiology of the patients,” said Momodu, “because you may be counseling women who are pregnant, breastfeeding, taking birth control medication, or just entering the early stages of menopause.” One-on-one consultation is key, stresses Singh, saying “We are getting close to having personalized medication for each individual, and we know that one statin may work better than another based on the genetic code of the patient. A pharmacist can talk about options with a patient, who can then go in to the doctor with a good list of questions.”

Trying to organize a dozen or more pills and supplements a day can be a huge challenge for anyone, particularly while coming to terms with a serious health concern. Not only that, but the kinetics of various medicines may require that you drink a glass of milk with a certain pill or take another at a specific time of day in order to regulate blood pressure. Williams and her students caution that medications should never be
stored in the hot humid environment of a bathroom medicine cabinet and that, if you carry pills in your purse, don’t leave it in the car for an extended period. “The temperature inside a car can range from below freezing all the way up to 120 degrees,” says Singh. “That can seriously compromise any medicine left inside the car and may render it absolutely useless. It will just pass through your body with no effect whatsoever.”

Additionally, Momodu suggests that patients need to ask their doctors very specific questions about their prescriptions, such as if there are new or off-labeled (generic) drugs that can be substituted, which will provide the same effect but at a lower cost. “It’s also really important to ask your doctor how long you will be taking this drug,” says Momodu. “Will it be for three months or the rest of your life? That way you can
anticipate both the physical and financial effects of the pharmaceuticals that are being prescribed for you.”

Williams also voiced the common issue that women tend to overlook their own health even when faced with life-threatening complications: “Women always put themselves last on the list — but don’t do it. You need to create as many resources as you can in order to stay healthy, and that’s why you want to have a real partnership with your pharmacist, who can really help you navigate the way all of your different medications
work together with your body.” Translation: make the pharmacist your friend. A gift of home-baked goodies might not be a bad idea.

Here are some common questions that your pharmacist can help answer:

• Do I need to take this medication with food?
• What do I do if I miss a dose?
• What are some of the expected side effects of this medication and what are the steps
to minimize them?
• When should I take this medication in relation to taking other medications?
• Can this tablet be broken or crushed or does it have to be taken whole?
• Can I drink grapefruit juice, eat grapefruit, consume dairy products, and take antacids
with this medication?
• Can I drink this medication and then lie down or do I need to remain upright?
• Can alcohol be consumed while taking this drug?
• Do I need to drink a full glass of water with this medication?
• Will this drug interact with my other medications or herbal supplements?
• How should this medication be stored?
• Are there any restrictions to working, operating heavy machinery or driving while
on this medication?

6 Tips to Avoid Medication Mistakes

The Institute for Safe Medication Practices

Grapefruit Juice and Medication Can Be a Dangerous Mix

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WomenHeart: The National Coalition for Women with Heart Disease is a nonprofit, 501(c)(3) patient advocacy organization with thousands of members nationwide, including women heart patients and their families, health care providers, advocates and consumers committed to helping women live longer, healthier lives. WomenHeart supports, educates and advocates on behalf of the nearly 48 million American women living with or at risk of heart disease. Our programs are made possible by donations, grants and corporate partnerships.

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WomenHeart: The National Coalition for Women with Heart Disease is a founding partner of The Heart Truth Red Dress campaign. The Heart Truth and Red Dress are trademarks of HHS.