Keeping track of meds is part of my post-transplant plan
Even over-the-counter drugs come with side effects and other risks
What medications do you take regularly, and what are they for? Do you know the possible side effects?
When I was diagnosed with idiopathic pulmonary fibrosis (IPF) in January 2017, I didn’t take many medications. I took a blood pressure medication, an over-the-counter (OTC) allergy pill, and occasionally a nasal spray for seasonal allergies. Life was simpler then.
I like to think I stay on top of what I take and am aware of the side effects. But somehow, I missed one. It came to my attention in an unusual way.
I’m a trainer for Narcan (naloxone), which is used in emergencies to reverse the effects of an opioid overdose. Instructors, including me, often like to provide examples of opioids, especially ones you may find in your home. During a recent training session, the instructor doing the presentation cited the antidiarrheal Imodium A-D (loperamide).
Wait, what?
It turns out Imodium A-D does present an overdose risk when taken in large quantities, and that treatment with Narcan is appropriate.
Doing my due diligence
Following my bilateral lung transplant in July 2021, the number of pills I took daily increased. Since then, I’ve developed a routine to ensure I understand each medication I’m taking.
Three rows taken from my medication record as an example of how I manage my meds. (Courtesy of Sam Kirton)
The table to the right is taken from the medication record I’ve kept since my lung transplant. It indicates the name of the medication, the dosage, the action (reason for taking), the number of times each day I take the medication, and the approximate time of day I take it.
The number and letter combination depicted in the medication column in green is how I’ve labeled my pill bottles. Instead of searching through a bin of prescription bottles, I can look for the number I’ve written in permanent marker on the cap to easily locate the proper medication.
The dose column indicates how much of the medication I should take. The numbers in red correspond to footnotes, where I’ve noted changes in medications, including which doctor made the adjustment, and when. There have been 122 changes to my medications since I received my lung transplant.
I write out the number of times per day I take a medication. The first one on the list, Prograf (tacrolimus), is split into two rows because my dosages may differ between morning and evening. I currently take 0.5 mg each morning, but I take my evening dose only every other day.
With each new medication, I take the time to review the data sheet supplied by the pharmacist or review the information online. For me, the online version is easier to read than the printed one.
To find this information, I conduct a search on the internet. The Prograf website, for example, provides a patient information document that explains how and when to take the medication, its possible side effects, and drug interactions. The site also shares ways to report adverse side effects to the U.S. Food and Drug Administration.
Going forward, I’ll apply the same due diligence to my OTC medications. Many IPF patients, even post-transplant, use OTC products such as Imodium A-D regularly. I’d never thought about the risk of overdosing on that drug. Sharing this information helps all of us make every breath count.
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Note: Pulmonary Fibrosis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Pulmonary Fibrosis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to pulmonary fibrosis.
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Comments
Anita Clos
Sam, you are filled with great advice! Thank you for sharing your technique. I set mine up in a weekly pill box that holds am and pm meds. Then I set my iPhone alarm for 9a and 9p everyday. Even if my phone is silenced the alarm rings through. The trick is, of course, to be where my phone is! But your plan is a good back up to mine in a more limited variation. Thank you! Again.
Rev Daniel J Lemke
I'd read the caution on the Imodium A-D package, and on the generic version that I usually buy. If memory serves me correctly (HA!), the max is 4 of those tiny caplets per day. I had no idea that Naloxone would be appropriate for overdose of loperamide, even though I have naloxone in my meds case. I am trained as a mental health first aider, so I knew I might come upon overdose patients, and wanted to be prepared. I think I should check the expiration date on my package, though.