For several years now, internal medicine doctors have been discussing the zombie apocalypse.
I know what you’re thinking. You may be envisioning the arrival of hordes of the undead. That’s not quite what I had in mind. I am talking about zombie medications. Let me explain.
Think of a zombie medication as a drug whose original purpose has long since “died,” but it somehow seems to live on in your medicine cabinet, your bag of drug bottles or on your prescription list. Zombie medications are dangerous – potentially lethal – and require a strategy to fight back.
So I’m going to share with you my list of five steps to avoid a zombie medication apocalypse.
Step 1: Get rid of old antibiotics. These medications are usually prescribed for a specific short-term purpose. Antibiotics should always be taken for their intended duration, which usually means until you run out of pills. However, if you do stop early, the leftover portion should be discarded. Saving them for a later time, such as to treat a self-diagnosed infection, not only risks misdiagnosis and improper treatment, but a short course of antibiotics can promote growth of resistant bacteria.Step 2: Do not save prescription painkillers. Like antibiotics, medications such as opioids are usually prescribed for a short-term indication, such as pain after surgery or a broken bone. Prescription pain medications are potent drugs with potentially dangerous side effects and the risk for abuse. They are also controlled substances and cannot be safely or legally shared with others. These medications should not be simply thrown in the trash. You can check with your local pharmacy or local law enforcement to learn about “take back” programs for safe disposal of these drugs.Step 3: Remove expired or canceled medications from your supply. If you take prescription medications for a chronic condition, it is not unusual for bottles of old drugs to accumulate in your cabinet. This is a frequent source of confusion and could lead to dangerous consequences if these medications are accidentally taken along with newer ones. Side effects, drug interactions and other problems often arise because of the combination.Step 4: Pay attention to the dose change. Doctors frequently change the dose of a medication. Dose titration, or increase, is commonly necessary to achieve targets for things such as blood pressure and blood sugar. Dose tapering, or decrease, is often undertaken to reduce medication side effects when they occur. A serious problem results from patients taking both the old dose and the new one, effectively increasing their total dose. Clarify your current dose with your doctor or pharmacist and throw away the older dose of your medication.Step 5: Beware the zombie prescription. Sometimes you may have an active prescription for a medication that has been discontinued. This may occur if you change your pharmacy or if the discontinuation is not effectively communicated from your doctor’s office to the pharmacy. If you visit multiple prescribers, this problem can be compounded. Failure to recognize it can lead to the “zombie” prescription living on long after it was supposedly killed. I always recommend that you keep an active list of your current medications and double check this list with your pharmacist and with any doctor that you visit.Don’t fall victim to the zombie medication apocalypse. Be prepared!
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.