The views expressed herein are those of the Ontario Pharmacists’ Association and do not necessarily reflect those of the Government of Ontario.

The Myths of Aging Aging will inevitably bring illness and disability The damage is already done so why bother protecting your health Getting old means losing your mental sharpness Getting old means being sad, lonely and unproductive Consumer Reports on Health, March 1999

Canadian seniors make up 12% of the population Seniors receive 28-40% of all medications prescribed Seniors are often taking several medications which can interact with each other and cause many side effects Aging makes seniors more sensitive to medication effects Why Am I at Risk?

Get the Most out of Your Medications Examples of medication problems: 

What are drugs? Prescription medicines Over-the-counter medicines Social drugs e.g. alcohol, caffeine in tea & chocolate, tobacco Traditional & Herbal Remedies Street drugs

ALL drugs change the way your body normally functions Used together, they may alter the effects of each other ALL drugs can be harmful if you don’t use them wisely

Drug Names Every drug has two names: BRAND name GENERIC / CHEMICAL name The Chemical name is most important and can be identified anywhere You should know or write down both names of all of your medications

Education Minimum 5 years university with focus on all aspects of drug use and development Ongoing quality assurance standards Communication Enhancing skills an important part of university and continuing education Confidentiality a legal and ethical requirement for all pharmacists Pharmacists – Drug Experts

How Can My Pharmacist Help? Answer my questions about my medications Help me choose the right non-prescription drug if I need one Put my drugs in an easy-to-open container Make a larger and easy-to-read label

Discuss how to take my medications appropriately Discuss side effects of medications Discuss drug and non-drug options to improve my health Discuss how to store my medications Refer me to the proper resource e.g. diabetes centres, support groups, physicians, dietitians, foot care etc.

Always make sure you understand…. the correct dose as prescribed the expected benefits of your medication the best time of day to take your medications whether to be taken with or without food what other medications (prescription or otherwise) or foods may interact all precautions (including alcohol) side effects to expect and others to be aware of If unsure of any of the above or know of any difficulty in taking medication as prescribed… ASK YOUR PHARMACIST

Storage of Medications Store in a cool, dry place away from sunlight and humidity The bathroom is NOT the best place The bedside is also NOT the best place Keep medicines out of the reach of children especially if your containers are “easy-open”

Most pills and capsules are NOT kept in the refrigerator Some medicines need to be kept in the container given to you by the pharmacist e.g. Nitroglycerin for chest pain Keep your medicines in the original container unless you use a special “pill box”

Expired Medication Who has the oldest medication? Never throw out medication in your garbage Return old medicines to your pharmacist Ask your pharmacist about sharps containers

Side Effects of Medication Side effects are extra ways that medicines affect your body Include headache, dizziness, rashes, stomach upset Ask your doctor or pharmacist about what side effects to expect from a new medication Report any side effects to your doctor and pharmacist

Over-the-Counter Medicines Do NOT require a prescription Can interact with your prescription medicines Can cause side effects or make a medical condition worse

ALWAYS check with your doctor or pharmacist first Over-the-counter medications should not be taken for long periods of time If you are not feeling better after 3-5 days, see your doctor

Herbals: Myths and Realities Myth: Herbal products are safe because they are “natural” Myth: Herbs are not drugs About 25% of modern prescription drugs are obtained from natural or botanical sources Myth: I don’t need to tell my doctor or pharmacist about the herbs I am taking

Fact: “Natural” doesn’t necessarily mean safe Fact: Herbs can interact with your medications and can worsen your medical conditions

Herbals: The Positives Available over-the-counter Some herbs have been proven effective Some of today’s useful medicines were originally herbs Psychological benefit

Herbals: The Negatives Lack of safety data, especially long- term Lack of quality control of exact ingredients, potency, purity Lack of studies to prove they work Lack of safety in pregnancy, lactation, and for use in children Use can delay more effective therapy Cost

Herbals: The Bottom Line Tell your doctor & pharmacist if you are taking herbal products and list them on your medication card

Daily or weekly pill boxes Let your pharmacist help you make a schedule that suits your lifestyle Keep a chart or a calendar (post it on the fridge) Set alarm clocks! Be creative! Compliance Aids

Safe Medication Card A list of all of your medicines Include herbals, over-the-counter medicines and vitamins For you, your doctor and other health professionals Keep it with you at all times (wallet, pocket, purse) Keeps you safe in a health emergency, when traveling and everyday!

Additional Pharmacy Services Refill reminders Filling of pill boxes Trial prescriptions Home health care products Home visits Help patients manage diabetes, asthma, high blood pressure, etc. Medication Review (MedsCheck Program)

MedsCheck Program New in 2007 One-on-one consultation with a pharmacist Once/year for initial consult; once/year for a follow-up under specific circumstances Using 3 or more medications on a regular basis Cost covered by Ministry of Health and Long-Term Care

Who will benefit? Trouble managing medications or remembering to take them Multiple physicians/specialists Complicated medication schedule Significant changes to medication routine in the last 3 months Taking medications which must be carefully monitored (e.g. warfarin) Recently released from hospital MedsCheck Program

What should I expect? 20 to 30 minutes private consultation By appointment Resulting in comprehensive medication list to share with doctor and other health care providers Bring all medication containers –Rx and OTC from all pharmacies –Herbal and natural products –Ointments and eye drops

I want to take control of my medications I want to understand my medications and how they affect my body and how I feel I want to stay healthy and be safe taking my medication Why Me?

The Do’s & Don’ts of Safe Medication Use DON’T expect a prescription every time you visit your Doctor DON’T share your medicines DO use a Medication Card/MedsCheck list to keep a list of all of your medications and conditions in your wallet DO tell your Doctor and Pharmacist about ALL the drugs you use (even OTC and herbals)

DO visit the same pharmacy for all of your medication needs and visit only one family Doctor If you do visit any other health care professionals, tell your Doctor DO beware of interactions (food, drug, alcohol) DO participate in your health care and talk to health care professionals about non-drug options

DO check with your Pharmacist or Doctor before you buy or use an over-the- counter product DON’T use medication that is expired and bring your expired medications to your Pharmacist for disposal DO keep your medications in the original bottle unless using a pill box or compliance aid

ASK YOUR PHARMACIST Any questions? Medication cards Presentation questionnaire Pharmacists and patients working together to get the most from your medications!

Special thanks to the Ontario Seniors’ Secretariat for their support of this program.

Tips for Snowbirds Bring your medication record with you all drugs (both names), phone numbers for pharmacy, doctors, etc. Be careful of storage Vacation Supply requirements for Ontario Drug Benefit Some medications may make you more sensitive to the sun: Ask your pharmacist!

Colds are caused by viruses and will go away on their own in ~ 7 days ALWAYS check with your Pharmacist or Doctor before you use any over-the-counter medication Colds & Infections

You should not expect a prescription every time you go to the Doctor If you have a bacterial infection, the Doctor will write you a prescription for an antibiotic DO NOT STOP taking the antibiotics even if you feel better

Like colds, influenza is caused by a virus and has similar symptoms Usually involves the whole body, lasts longer (~10 days) and is more intense High fever, chills, sore throat, congestion, cough, headache, muscle soreness, stomach upset Antibiotics are not effective Influenza : “The Flu”

Flu season is generally from late December to early March Transmission is via air or direct contact (e.g. hand shaking) People over 65 years, nursing home residents, and people with heart or lung problems or diabetes are especially at risk for serious consequences Everyone should get a “flu shot” to prevent spread of the disease Influenza : “The Flu”

Vaccination of dead influenza viruses that cause the body to make antibodies to fight against the viruses Should be given early in the flu season (October to November) Takes about 2 weeks to take effect Influenza Vaccine

Sample Medication Record