Spinal Cord Injury Information

I sincerely hope the information presented will be useful and help you and yours cope with this devastating injury.

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SCI INFORMATION, Medical & Medications

This important section is devoted to the medical and medication information needed by the SCI, drugs and what they do, side effects, your prescription, autonomic dysreflexia, causes, symptoms, what to do, how to prevent this condition from occurring.

Medications

  The purpose of this page is to inform you about medications in general, not the specific details and types of medication but the things you should know about medicine, includes how they work, why they come in varied forms, and how to be a smart consumer. All of this will help you to work with your doctor, health care provider, and rehabilitation team to better plan your medications.

  The information you read about medications does not make you an expert in planning your own medication. Planning drug therapy is a science. Consumer guidelines cannot replace the medical knowledge that your rehabilitation team has.

  Each person is unique and may require different dosages or have varied responses to certain medications. Side effects will not always occur in every person who takes a given drug. Trust your medical staff to recommend what is best for you.

  The biggest part of the help you give is honesty. You will need to give your doctor a complete medical history and a list of your current medications, both prescription and over-the-counter. Your medical history tells your doctor what kinds of reactions, illnesses, and problems that you and your family have had. These are very important to them in understanding your past treatment and planning your future care.

  You must keep in mind that medications not only affect your body, but they also affect other medications as well. For example, if you are taking something as simple as aspirin. It may defeat the ability of some other drug to work. Certain over-the-counter drugs like cold remedies can affect your bladder and bowel medications.

  If you are pregnant or suspect that you may be, tell your doctor. Any time that you are taking medication, your baby is taking it too. Depending upon the type of medication, it can have serious results.

  The starting point of how drugs work is understanding that your body is mostly made of chemicals. Medicines are chemicals too. When you take drugs, they mix with the chemicals of your body and help you.

  In many cases, the drugs themselves do not cure the problem you are having. They may simply help strengthen your body so that it can fight the problem.

  Drugs work in two ways. One kind of drug works just the way it is, in the same form it was when you took it. Others work only after your body has broken them down into some other form so that they can mix with the chemicals and tissues in your body.

  Most drugs are not things your body would normally use, so you eventually get rid of them through urine, bowel movements, tears, sweat, or your lungs. Each drug takes a certain amount of time to go through your body. This affects the dosage you are given. For example, some drugs pass very quickly through your body. Others are meant to build up and have a lasting effect.

  The drugs you take come in many different forms. There are tablets, capsules. syrups, chewables, shots, or ointments, to mention a few. The form the drug comes in depends on how it is supposed to work in your body. Some examples of drug forms and how they are used are listed below.

  Chewable tablets - Fast-acting, often given to children.

  Swallowable tablets, capsules - Long-acting. They must be swallowed whole so that all the medicine is not released at once, but over time.

  Injections - For fast-acting effects or for drugs that cannot be taken orally and digested (like insulin).

  Syrups - Mostly cough medicines, they are usually thick, and may contain sugar.

  Suppository / enema - Medicines that are taken through the rectum. For those who cannot swallow medicine or for medications that may cause nausea.

  Ointment / creams / lotions - Mostly for skin conditions. An exception is nitroglycerin gel, sometimes used to treat autonomic dysreflexia.

  Suspensions - Contain large amounts of solid medication suspended in liquid. The solid tends to settle to the bottom, so you must be sure to shake the bottle before using in order to mix the contents.

  Most drugs are fairly free from side effects, but many drugs can produce unwanted effects in certain situations. Undesired effects are classified in three ways:

  Pharmacologic effects - These are the chemical side effects of the drug itself. They are predictable and controllable. In addition, many drugs do more than one thing in your body. The size of the dosage you are taking can make a big difference. In some cases, your body may just need time to adjust to the drug or its side effects. In most cases, the benefit of the drug far outshines the discomfort from the side effects.

  Allergic reactions - Allergic reactions come in many forms, showing up immediately or even as late as several weeks after the medication is taken. Skin reactions are the most common symptom. They range from redness and itching to swelling and sores.

  Allergic reactions have nothing to do with the action of the drug or the size of the dosage. They are often unpredictable in occurrence, except that people who have allergies such as hay fever tend to react more to medications.

  Reactions of this kind are a strong reason why your medical history needs to be complete. There may be less chance that a reaction will occur if your doctor knows about your past experiences with medications.

  If you do experience some kind of reaction to your medication, stop using it and call the SCI clinic or your doctor immediately.

  Anaphylaxis - A severe, immediate response to a drug. It is a life-threatening situation of decreased blood pressure and breath spasms. CALL 911.

  Drug interaction - This refers to the effect two or more drugs have on each other. Sometimes, one drug helps another work. Other times, one stops the other. Occasionally, both keep on working, but their actions combined create yet another action.

  Alcohol is likely the drug most often combined with other drugs. For example, alcohol more than doubles the effect of tranquilizers. 

  Keep in mind that cough syrups contain enough alcohol to have the same effect.

  Again, the best policy is to tell your doctor about any drug you take on a regular basis. Even if it’s just aspirin, it could make a big difference.

  The foremost difference between over-the-counter medications and prescription medications is that medicines sold over the counter have a wider margin of safety. This means that they have fewer and milder side effects and little or no chance of addiction.

  This does not mean that over-the-counter medications are harmless. Used unwisely or along with other drugs you are taking, they can affect your health a great deal. So tell your doctor if you are using any over-the-counter medicines, as well as any prescription medications.

Prescriptions are all roughly the same. For the most part, they include:

• Your name and address.

• "Rx"—the symbol marking the area where the actual prescription is written.

• The name and strength of the drug.

• The quantity to be prepared.

• The directions of how to take the drug. (These are abbreviated on the prescription but will be written out for you on the drug container.)

• Refill information.

• The date.

• The prescriber’s name, address, and registration number.

• The prescriber’s signature.

  In most cases, your doctor will be able to give a drug order to the pharmacy over the phone. However, this cannot be done with prescriptions for controlled substances. These include such drugs as narcotics and stimulants. They can only be obtained with a written prescription taken to the pharmacy. Refills for your prescriptions are convenient to get with refill order forms.

  These forms contain almost the same information as your original prescription, except that this one keeps a running tab on how many refills you have used and are still allowed. As long as you still have refills on your original prescription, you will get an updated refill order form for your next refill. If you have used your last refill, you will get a form for reordering the whole prescription. This form only works with your doctor’s signature.

  Refill laws limit the number of refills you can have written onto a prescription. Drugs are put into different categories that tell how many refills they may have. There is a maximum of five refills for a six-month period. Your pharmacist may choose not to refill your prescription and will then consult with your doctor about this.

  As a consumer, you are most likely fairly wise to advertising in general. Many of us have been burned enough times to make us cautious of the "miracle" this or the "better than ever" that. You should be the same way when it comes to the medications you buy.

  Some new drugs are old drugs with new instructions for usage. Others may be just some old drugs that have been mixed with each other. It is not often that a new drug on the market is really brand new. To help you tell how new a drug is, the FDA uses a rating system.

  This system consists of a number and a letter on the label of the drug. The numbers, from 1 to 6, tell how new and unique the drug is. A #1 drug is the newest, most unique one. The letters are A, B, or C. An "A" is a major breakthrough. A "B" is a modest but definite improvement on the drug. A "C" is a drug with little or no real gain.

  So you see, there are ways to protect yourself from wasting your money on questionable new drugs. Be aware of all the information about a drug, not just what one source says. In most cases, it is a good idea to rely on your doctor’s judgement about what you should take. Do not be fooled by advertising. Read it carefully, and if you still have questions, ask your doctor or your health care provider.

  In the hospital, you have many people around you to ensure that you take your medication safely. They tell you how much to take and when to take it. They will also tell you about what you are taking and how it works.

  At home, you will be typically the only one responsible for your medicine chest. You are responsible for taking your medication on time and in the proper dosage. Be aware of any changes that may occur while you are taking your medications and let your doctor know about them.

  Being responsible also means that you have to keep yourself informed about what you are taking. Read the labels of everything you take. If you still have questions, ask your pharmacist. This applies to both your prescription and over-the-counter medications.

  Pay attention to the details. The more aware you are, the safer your drug therapy will be, and the more effectively your drugs will work for you.