About Medication

There are several societal myths with regard to the use of medications to assist those who suffer from physical health and mental health problems. 

Myth 1 Physicians and other health care professionals are familiar with most if not all of the medications on the market, and there is extensive research to explain how the medication will affect the client who is using it. 

Myth 2 The medication a client is prescribed is based on a careful evaluation, utilizing previous research that establishes the correct therapeutic dose that will be needed to address the client s problem. 

The second premise is that medications simply may not react the same in all individuals, and some individuals respond better to certain types of medications than others. Variables of age, body size, body chemistry, habits, and diet can influence the way a specific medication affects the client. Consequently, while general guidelines for prescribing medications exist, prescribers must also remain flexible in individualizing dosing regimens for each client. 

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Mark TL, Kranzler H R, Song X, et al Physicians opinions about medications to treat alcoholism. Addiction 98 617—626, 2003... 

What do you tell her about medication use and breast-feeding ... 

Negative attitudes or false beliefs about medications... 

Horne, R., Graupner, L., Frost, S. et al (2004). Medicine in a multi-cultural society the effect of cultural background on beliefs about medications. Soc. Sci. Med., 59, 1307-13. 

Drug information itself is much more than a collection of facts about drugs. Drug information is both a body of data and information about medications and a set of skills and tools that provide pharmacy professionals with the ability to find, access, understand,... 

Outpatients taking warfarin should be questioned about medication adherence and symptoms related to bleeding and thromboembolic complications. Any changes in concurrent medications should be carefully explored. 

Aikens JE, Nease Jr DE et aL (2005) Adherence to maintenance-phase antidepressant medication as a function of patient beliefs about medication. Ann Fam Med 3 23-30 Blenkinsopp A, Bond C, Britten N (1997) From compliance to concordance. Achieving shared goals in medicine taking. Royal Pharmaceutical Society of Great Britain and Merck Sharpe Dome, London UK... 

Disulfoton and its breakdown products can be measured in the blood, urine, feces, liver, kidney, or body fat of exposed people. In cases of occupational or accidental exposure to disulfoton, the breakdown products are often measured in the urine. The breakdown products are relatively specific for disulfoton and a few other similar organophosphate pesticides and can be detected in urine for up to one week after people were last exposed. Because disulfoton inhibits cholinesterase in blood and in blood cells, inhibition of this enzyme activity may also suggest exposure to disulfoton. Cholinesterase activity in blood and in blood cells may remain inhibited for as long as 1-2 weeks after the last exposure. Because other organophosphate pesticides also inhibit cholinesterase activity in blood and blood cells, this test is not specific for disulfoton. The measurement of cholinesterase in blood and blood cells and the amount of disulfoton breakdown products in the urine cannot always predict how much disulfoton you were exposed to. Your doctor can send samples of your blood or urine to special laboratories that perform these tests. Chapters 2 and 6 provide more information about medical tests. 

Many readers will have read about medical applications, the MYCIN and INTERNIST programs. There are many systems being developed to diagnose equipment failures. Layout and planning of manufacturing facilities are obvious applications. Chemistry and molecular biology systems were among the earliest examples of expert systems and are now embodied in commercial systems. 

It is important to convey information about medications as directed according to the needs of each patient. Moreover the pharmacist must use appropriate, simple language and adjust according to the patient s age, personality and educational background. 

The Supreme Court has recognized a constitutional right to bodily integrity that includes the right of a person to make voluntary and informed decisions about medical treatment." The government s concept of compassionate coercion appears to turn upside-down the individual s right to informed consent. All fifty states have laws that protect informed consent. These laws require that before performing medical procedures or treatments, medical personnel must make certain disclosures to patients and obtain the patient s consent." ... 

Having good friends at work who were anxiously following her situation allowed Emily to be forthright about medications once she returned to her office I started telling people myself, Tm on Prozac [and it s] saving me. A lapsed Catholic had experienced a miracle. 

We started talking about medication and at this point I submitted to medication.. .. I finally submitted. That s the word I used. And I just realized that I had to do something because I was desperate, (male media consultant, aged 52)... 

In this chapter we have heard different accounts of the ways psychotropic drugs affect users senses of themselves. In some cases medication allowed people to realize their authentic selves or to function at a higher level. In this sense their narratives are success stories, even miracles. In other cases, by contrast, people described psychiatric drugs as masking or even devastating their authentic selves. As a result they were typically resistant to or ambivalent about medication. 

We have talked about medication as altering personality, taking a person with dysthymia and making her temperamentally hyperthymic, sunny, and social. 

In order to have a constructive, two-way conversation with doctors, patients must become well informed about medications. Too many years of unquestioning compliance led many to stress the importance of educating oneself... 

Medication management provides the opportunity to develop a relationship with the child and the family. Asking about medication benefits and side effects in the context of academics, sports, team activities, friends, and overall functioning gives youths an opportunity to talk about how the disorder and the medication are affecting their life, what is important in their life, and what they wish it could be like. Phone calls and e-mail can help with medication monitoring, but face-to-face contacts provide a more comprehensive treatment relationship. 

PSYCHOLOGY OF PSYCHOPHARMACOLOGY 419 TABLE 33.1 Children s Thinking About Medication... 

When thinking about medicating, it is the patient, not the drug, that should get our major attention. Such thinking needs to be done in the context of a therapeutic alliance, not the likelihood of reimbursement. Hence we recommend the following ... 

Other factors, such as the availability (or lack of availability) of community resources or the ingress of managed care policies that shape clinical behavior, might be invoked to explain possible changes in prescribing and help-seeking behaviors. In addition, studies of physician attitudes as well as parent and family attitudes about medications use and usefulness are... 

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