Being careful when managing and handling medicines

When medicines are prescribed, they are intended to help. It is true, however, that medicines can also cause unwanted effects, which we also call “side-effects”.  

Do remember that information about side-effects are based on averages. Even a common side-effect doesn’t affect everyone who takes the medicine.

• Side-effects can occur at safe doses of a drug

• Are usually dose related i.e. the higher the dose, the higher the possibility of side effects

• Possible side effects are listed in the patient information leaflet (PIL)

• Can be a reason for patient’s to not take medication

• If a patient reports that they are experiencing a side effect and/or you notice a patient is showing signs of side effects, report this to a suitable person e.g. designated senior, manager. They will need to seek advice from a healthcare professional (HCP) such as a pharmacist or GP

• If the side effect is life threatening call 999.

An ADR is an unexpected harmful effect resulting from taking a medication and can be serious

• They often occur when medication is newly prescribed (but can happen at any time)

• Maybe serious e.g. anaphylaxis

• If a patient is experiencing a non-urgent ADR, contact a Healthcare Professional (HCP) e.g. pharmacy, GP, prescriber.

• If a patient is experiencing a serious ADR ring 999

A drug interaction can occur when two or more drugs react with each other. In addition, some medicines react with food, drinks and herbal products. For example, mixing alcohol with some drugs may cause you to feel tired or slow your reactions.

 Drug interactions may cause the drug to be more or less effective, or cause effects on the body that are not expected.

 It is important that you read medicine labels and follow any additional instructions or warnings. Failure to do so could cause the service user harm.

 If you suspect that a patient is experiencing a drug interaction contact a Healthcare professionals for advice or 999 if life threatening.

Some medicines contain a higher risk to those who handle them than other medicines, these are known as: 'Cytotoxic' and 'Non-cytotoxic Hazardous'.

'Cytotoxic' medicines contain chemicals which are toxic to cells.

The toxicity of the cytotoxic drugs means that they can present significant risks to those who handle them. Examples include: Methotrexate, Azathioprine.

'Non-cytotoxic Hazardous' medications are deemed to pose a potential risk in the event of occupational exposure. Examples include: Finasteride, Anastrazole.

Occupational exposure could occur when preventative measures are inadequate e.g. if you do not use Personal Protective Equipment (PPE). It is your employer's responsibility to provide appropriate PPE.

Exposure may be through skin contact, skin absorption, inhalation of aerosols or drug particles and ingestion resulting from the following activities: drug preparation, drug administration, handling patient waste, waste disposal and cleaning spills.

If you or your managers are unsure if you are managing medicines which fall into the high risk category, you can ask for advice from the supplying pharmacy.

How to order medicine to prevent unnecessary waste

• Check stock levels before ordering (only order what is needed and avoid stockpiling)

• Carry forward suitable items (i.e. medicine that is still in date and still prescribed to the patient)

• Do not routinely return/destroy stock each month simply to replace with new stock.

• If you are receiving medicines from the pharmacy that are not required e.g. you already have enough stock, the item has been discontinued, etc. inform the supplying pharmacy/prescriber.