常見的用藥迷思

General Misconceptions of Medication Use

10.6317/LTC.201112_15(3).0002

陳淑梅(Shu-Mei Chen)；李建立(Eric Kin-Lap Lee)；曾碧萊(Pi-Lai Tseng)

用藥迷思 ； 交互作用 ； 適應症 ； 藥物不良反應 ； misconceptions of medication use ； interaction ； indication ； adverse drug reactions

長期照護雜誌

15卷3期（2011 / 12 / 01）

181 - 194

繁體中文

本文介紹民眾常見之用藥錯誤觀念，並說明原因，如：（一）不能因為擔心藥物傷胃，藥物皆飯後服用，需依照藥物個別吸收特性，以及與食物之相互影響之各種考量，採取適當服用方法，於使用藥物前，應詳讀各藥品藥袋用法及注意事項之說明。（二）不同保健食品、中草藥可能與個別藥物有交互作用，而增加副作用或影響療效，如：warfarin之服用需注意與中草藥及保健食品之影響，提供政府或醫院之「食品與藥物交互作用資訊」、「中西藥交互作用資訊」之網站網址，以利相關查詢。（三）醫療機構藥袋所列印的適應症，若無列印患者所認知的適應症，患者常疑惑醫師藥品開立錯誤或藥師拿錯藥，建議對適應症有疑惑者應先諮詢藥師或醫師，切勿自行停藥而延誤治療。（四）感染或慢性疾病不能因病情改善或無效而自行停藥，需就診告知醫師病情。（五）治療中若發生嚴重副作用需立即停藥就醫；若有長期用藥因副作用要自行停藥，需先告知醫師。（六）藥物需依指示儲存，不可所有藥物都放置冰箱儲存。（七）老年人因生理正常老化或疾病原因，影響藥物動力學及藥效學，較易產生副作用，照顧者需了解並觀察治療情形，以利藥物劑量調整，確保用藥安全並獲得良好療效。

This article addresses common misconceptions by the public and gives underlying reasons. Examples like: (1) we can not assume drugs may hurt the stomach, so every drug should be taken after meals. We need to evaluate the absorption characteristics of the drug or interactions between drug and food. Patients should be instructed of proper usage and watch the information listed on prescription bag. (2) Interactions between dietary supplements, herbal medicines and drugs may occur and increase the likelihood of adverse event and compromising the therapeutic effectiveness. Yet, warfarin makes the case of interaction with herbal medicines and food supplements that substantially affect its treatment effect. Here we give two official websites on ”Food-Drug Interaction Information Resources”, “Herb-Drug Interaction Information Resources” for readers as references. (3) Patients sometimes get confused when their diagnosis is different from the indication listed for the drug prepared in the prescription bag after dispensing from the hospital pharmacy. This doubt may leads to argument on wrong physician prescribing or wrong dispensing. Suggestion has given that patient should ask for counseling before stopping any medication. (4) It’s inappropriate for patients automatically discontinue medications for their infectious disease or chronic medical treatments. (5) Patients are advised to stop their treatment and seek for assistance when severe adverse drug events occurred. Medications taken regularly and continuously are mandatory for the treatment of their chronic diseases. Consequently, physicians should be informed of any cases of drug discontinuation. (6) Medications should be stored at proper conditions, it is not appropriate to store all pills in a refrigerator. (7) Older person are vulnerable to adverse drug effects in line with aging and disease circumstances, which affect the pharmacokinetics and therefore its effectiveness. Healthcare providers should give scrutiny on treatment outcomes and adjust dosage accordingly. All efforts are made to ensure safety and patient’s good outcomes.