DONT MAKE ASSUMPTIONS
WHEN IT COMES TO DRUGS

I have often heard the warning “Don’t assume because it makes an ass- out of –u and –me” (ass-u-me) and have readily acknowledged and found practical value in following this advice. Sometimes I need to follow my own advice especially where drugs are concerned. It was all too easy, and dangerous, to fall into the assumption that because I knew about drugs and their interactions I was safe. That assumption almost landed me in an emergency room and could have cost me my life.

I have many decades of experience in treating chemical dependency and a good working knowledge of various drugs, both legal and illegal, and their interactions. Because of this background I considered myself somewhat of an expert in drug interactions. Even self-proclaimed experts can become vulnerable to the “assumption” trap. Please learn from my story.

Several weeks ago I had surgery from which I am still recuperating. On discharge from the hospital I was sent home with a prescription for “Percocet”, a combination of oxycodone and acetaminophen. Oxycodone is a narcotic pain reliever very similar to codeine. Acetaminophen is a less potent pain reliever but has the ability to increase the pain relieving effect of oxycodone. The combination of oxycodone and acetaminophen together is commonly used in the treatment of moderate to severe pain.

As with other narcotic medications I knew there were restrictions on who could use this drug. For example, it is generally not prescribed for those with liver or kidney problems, low blood pressure, or those with head injury, breathing problems, epilepsy, stomach/intestinal disorders, urinary/prostate problems, mental illness or a history or drug addiction or alcoholism. I also knew that Percocet can cause confusion, sleepiness, light-headedness, shallow breathing, slow heart rate itching and nausea. These side effects are similar to all drugs in the narcotic family. I even knew enough to take the drug with a full glass of water. What I didn’t do was review all of the possible drug interactions.

I took the drug as prescribed and it did relieve the pain. I experienced some nausea when first taking the drug and also experienced some itching but nothing I considered serious. I began to get concerned when on the 5th day post-surgery I still had not had a bowel movement. On the 6th day post-surgery I began to have difficulty urinating. I was still eating moderately and drinking fluids. By the morning of the 7th day following surgery I could not urinate at all. A bowel blockage had created severe constipation and the pressure of the blockage cut off my urine flow. In severe pain and as a last resort before calling the ambulance I endured two fleet enemas that helped loosen the blockage enough for me to expel it which in turn relieved the pressure on my urinary tract allowing me to empty my bladder. I came very close to rupturing my bladder.

What I didn’t realize in taking the drug Percocet was that in addition to drinking a full glass of water with the medication was that the drug itself can cause constipation and that you should increase fiber intake and also drink 6-8 glasses of water daily while taking this medication.

The point I make in this article is that even experts can get into difficulty when making assumptions. Fortunately, I was able to overcome this lack of information without serious consequences.

I thought for a bit about what resources we have available to help prevent what happened to me from happening again and also what advice I could give to others. Most pharmacies today provide an educational flyer attached to each prescription received. Please read this document and if you are the patient, as I was, have your family read the information provided on what the drug is, what it does, and what the side effects of taking the drug are anticipated to be. Other resources can be found on the Internet. If you haven’t visited these resources lately you may be surprised at how much information is available to you. I have reviewed a few of these sites below:

drugs.com - This site provides a wide range of drug information of interest to consumers. The site advertises itself as a resource for over 24,000 prescription drugs, over the counter and natural products. On the first line of the site you can enter the name of the drug you are looking for and the site immediately takes you to information on that drug. If you don’t know the full name but the first few letters there is also an alphabetical search index to help you find/identify the drug. There are additional tabs at the top of the page for drugs and medications, diseases and conditions, pharmaceutical news and articles, pill identifier, drug interaction checker, medical encyclopedia, medical dictionary and a community forum. The site has a pharmaceutical news section, a hyperlink listing of the top 100 drugs along with a list of the top 10 searches used on their site. It also provides a list of the newest approved drugs and what they can be used for. All in all, this is a very easy to use and comprehensive drug resource.

rxlist.com - RX List is another easy to use web site that contains a lot of information both for consumers and professionals. At the top of the web page there are tabs for the Home page, Drugs A-Z, Pill Identifier and Diseases & Conditions. There also follows a link for their Message Boards and another link for Alternative Medicines. The body of the web page consists of a Feature Medication Topic Article (in this case Raltegraver – a new HIV drug; another topic title called Rx Consumer includes a series of news articles of current interest; a hyperlinked listing of the top 200 drugs followed by listings of new drugs and another list of updated drugs. The site has a link to another fine web site called WebMD along with several articles (and videos) from that site. The left panel includes a useful dictionary of medical procedures and terms. RX List is also an excellent and easy to use resource for drug information.

healthatoz.com – Health from A to Z is another interesting site that is unique in that it allows you to check the drug interactions between different drugs when taken together. It also includes a symptom checker and a personal wellness center. There is even a chat room where you can talk with a nurse.

I hope you find the above sites helpful. Please remember never to “assume” with prescription drugs and to read all the information on all of the drugs you may be taking. And please don’t forget to drink lots of water. Until next time – stay well.

              - By Don Doherty, MA, Ed.S.

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