Studies have shown that, About 40% of the people have had the experience of taking the wrong medicine, sometimes taking the wrong medicine is not because the doctor prescribed the wrong medicine or bought the wrong medicine, but often because the patient himself was negligent. In 2012 alone, I came into contact with many cases of drug errors in my work. Here, I sum up 7 problems that everyone must pay attention to before taking drugs.
First, pay attention to distinguish tablets with the same color, shape and size or similar ones.
Once, I was on the night shift, A patient called, Said he just mistook chlorpheniramine tablets for prednisone tablets, Twelve tablets were taken by mistake, Ask what to do. Chlorpheniramine is 4 milligrams per tablet, Twelve tablets are 48 milligrams, The maximum dose of chlorpheniramine should not exceed 24 mg per day. This is very dangerous, so I suggested that she immediately see the emergency. Domestic chlorpheniramine and prednisone are small white round tablets, do not pay attention to the distinction is easy to confuse. Therefore, before taking the medicine must carefully check the drug name and dosage on the drug package, at the same time do not let the tablets leave the original package, in order to assist in confirming the drug name.
Second, for the same drug with different concentrations, attention should be paid to distinguishing the dosage.
There was a mother who mistook a Tylenol drop for a suspension, Give the baby the dosage of the suspension, Causing the baby to overdose, It had to be sent to the emergency department for observation. The drug concentration of the suspension was 32 mg/ml, The drop is 100 mg/ml. Parents should pay special attention to the drug concentration. In June 2012, The FDA asked Tylenol manufacturers to unify the two concentrations to 32 mg/ml, Since then, only one concentration of Tylenol has been sold in the U.S. Market. For the sake of drug safety, our hospital has only sold one concentration of Tylenol since 2012. However, there are still two concentrations of Tylenol sold in Chinese hospitals and pharmacies. Parents must carefully check the dosage before feeding their babies.
Third, a special person is responsible for taking medicine for the baby.
Sometimes, the wrong dose is also related to multiple people feeding medicine. Once, an old lady came to the pharmacy panting and asked me, “what should I do?” “
My grandson took too much medicine, It turns out that when the old lady came to the pharmacy the day before yesterday to get medicine, I understand how to give my grandson medicine, At that time, the pharmacist was afraid that she forgot to hand-write a description of taking the medicine. When she got home, After feeding the medicine to the baby, he went out. The baby’s grandfather saw the medicine and thought that the baby had not taken it, so he fed the baby again. Fortunately, the repeated administration did not reach the poisoning dose. Here remind all parents, must be fixed by a family member responsible for taking the medicine to the baby, in order to avoid excessive poisoning caused by repeated administration.
Fourth, when multiple drugs are used at the same time, the name and usage of the drugs should be carefully checked.
A doctor prescribed a solution of budesonide and salbutamol for the baby to be atomized. Budesonide needs to be used every 12 hours. Salbutamol needs to be used every 4 hours. The baby’s mother mistook budesonide for salbutamol, As a result, budesonide is atomized every 4 hours, while salbutamol is atomized every 12 hours. It took one day to find out the mistake. As a result, the baby uses budesonide in excess and salbutamol in insufficient dosage. Therefore, we remind everyone to carefully check the name and usage of the drug before taking it, especially when multiple drugs are used at the same time.
Fifth, carefully check the names of drugs with similar packaging.
It is more common to use the wrong medicine because of similar packaging. Such as the silicone gel used to smooth the scar, Just like the packaging of eye ointment, They are all tubular. A new mother who had a caesarean section bought home some medicine for calming abdominal scars. The old man in the family mistook it for eye ointment, It was smeared into the eyes of the newborn. Many years ago, Clinically, nurses have also pushed oral enteral nutrient solution into patients’ blood vessels as intravenous infusion. Just because the bottle containing oral liquid looks like the medicine bottle for infusion. After this incident, The pharmaceutical factory changed the bottle cap of oral liquid to iron cover, and the infusion needle could not be inserted into the bottle. Of course, there are still many different drugs with similar packaging at present, so we should check them carefully before taking drugs.
Sixth, medication is strictly in accordance with the requirements of the instructions.
Antidiarrheal montmorillonite powder is lime-like powder. When eating it, will you choose to pour the powder directly into your mouth and send it with water in order to save trouble? One of our patients did, And choked, Almost suffocated. Pills don’t save trouble, The correct method of taking montmorillonite powder in the instructions is: Take a cup and pour the powder into it. Add 50 ml of warm boiled water and flush it completely, Then drink it. When I posted this on Weibo, A netizen left me a message, Said thought of a joke, said to nurse the child, directly feed the milk powder into the mouth, then drink water, and then grab the child up and down and left and right. The joke is very easy for everyone, but once the actual medication or feeding mistake occurs, it is not so easy, so everyone must not take the medicine without water or with less water for the sake of saving trouble.
Seventh, the medicine should be kept out of the reach of the baby.
On one occasion, I just replied to a mother on Weibo what to do if the baby took eczema cream by mistake. Another mother asked the baby what to do if he took hip cream by mistake. Speaking of these things, It really shouldn’t be put out of the reach of the baby. Apart from external ointment, External eye drops, nasal drops, ear drops and other drugs should also be stored away from the baby. We adults know that external drugs cannot be taken, but babies will not put them in their mouths because these are external drugs, so after applying the ointment, they should carefully put it away and never put it in the baby carriage or the baby bed.
Eighth, foreign drugs may not be safer and more effective.
Many people are superstitious about foreign drugs, I think foreign drugs are more effective in treating diseases, Especially when relatives and friends have difficult and complicated diseases or rare diseases, If there are no drugs available in the country to treat these diseases, They are flocking to new drugs from abroad and buying them abroad through the Internet. This kind of behavior is called “sea panning”. In view of this behavior of the common people, I suggest that everyone should be cautious in purchasing [new] drugs from foreign countries, whether it is new drugs for difficult and rare diseases or drugs for common diseases.
Drugs approved for listing abroad do not necessarily have Asian race test data, Some drugs may have different therapeutic effects and doses among different races. The cardiovascular drug propranolol (trade name: Propranolol, for example, If you want to reduce the patient’s heart rate by 20%, The required plasma drug concentration, The yellow race is about half as low as the white race. In other words, At the same dose, Americans use it just right, while Chinese people may have adverse reactions due to excessive amounts. When these drugs are clinically tested in China, these differences will be reflected in the instructions through labels. If foreign new drugs that have not yet been listed in China are used, it is likely that due to lack of such data, reasonable dosage cannot be obtained.
Drugs for common diseases, Foreign ones are not necessarily better, There may also be potential safety hazards. For example, some parents listen to the deception of online sellers, I bought the so-called “Universal Ointment” [Little Bee] Lithospermum Ointment, The baby has diaper rash, mosquito bag, eczema and other skin problems to apply it. But in fact, this ointment is just an ordinary outdoor ointment abroad. The effect is equivalent to that of China’s cooling oil, which is limited to people over 2 years old and cannot be used on skin with wounds. Once used on skin with wounds for a long time, there is a risk of liver damage and it is not as safe as [edible ointment] advertised by online sellers.
Moreover, it is still difficult for many Chinese people to read foreign language instructions to obtain corresponding medication instructions. The instructions are an important reference for medication. If you can’t read the instructions, It is difficult to specify the time, dosage, adverse reactions and matters needing attention of medication. Not to mention that most people lack the corresponding foreign language reading ability, Even if I can understand these foreign languages, if I do not have a professional medical background, I may not be able to understand the real meaning of some professional terms. In reality, I have met many people who do not understand the Chinese instructions of drugs correctly. For example, [taking at once] refers to [taking drugs at one time], and many people understand it as [taking drugs at every meal], resulting in taking them three times a day.
Many parents said to me, “We are also forced to search online.” If Chinese drugs can be truly safe and at ease, who is willing to go all the way to find drugs? ] I can especially understand the helpless mood of parents, but I still want to say that sometimes the so-called drugs you find back are really not drugs. For example, homeopathy products.
Author: Ji Lianmei
The article was reprinted by Clove Garden authorized by the author, and the original text was published on WeChat Public Number [Ji Lianmei Pharmacist] with slight changes.