Patients need to tell doctors which medications they are taking

Ginseng (left) is used for general well-being, dementia and poor circulation. It can also increase a person’s bleeding potential especially when used with NSAIDS (above right) like Advil, Motrin or Aleve.

One of the tenants for health care providers is that we should “first do no harm.” At the recent European Society of Cardiology (ESC) 2018 Congress held in Munich,“first do no harm” was a very hot topic. This was especially so when health care providers spoke of medical treatment in the elderly.

When considering all of the medical problems someone elderly or any person may have, there are occasions when it is not prudent to prescribe another pill. One of the most prominent conditions to watch for overprescribing is the treatment of arthritis. Health care providers know that the medications we use for the treatment of arthritis are effective and provide relief from the pain and stiffness caused by the disease. However, we must think about the possible side effects of some arthritis medications and whether a possible cure is worth the side effects. Let me explain.

People typically take nonsteroidal anti-inflammatory medications (NSAIDS) for the treatment of arthritis. These over the counter NSAIDS include popular medications such as Advil, Motrin, Nuprin and their generic brother and sister medications. When these stop working people look for the prescription strength NSAIDS and their brother and sister counterparts.

The problem here is that the NSAIDS can increase one’s blood pressure and possibly lead to heart failure. This resultant conditions may lead to additional medications being prescribed to lower blood pressure or controlling heart failure. The unintended possible side effects of these medications can be edema or fluid retention and the consumption of more medications.
NSAIDS can also result in increased stomach bleeding in people 70 years of age or older. Health care providers should limit their usage of NSAIDS in that population.

Hopefully your health care provider will not give NSAIDS to those who should not have them. What though, is a health care provider to do when they are unaware that their beloved patient is taking these over the counter medications as well as supplements?

So many people do not tell their health care providers what they are taking outside of the medications they are prescribed. It is well known with the billion dollar supplement and vitamin industry selling consumers their FDA unregulated products, many patients consume these but neglect to inform their health care provider.

For example, St. John’s wort is a commonly used over the counter supplement for depression and to ease the nerves. However, St. John’s wort may adversely affect your heart medications, blood pressure medications, cholesterol medications and medications to prevent blood clots.

Supplements such as Ginseng and Gingko biloba are used for general well-being, dementia and poor circulation. However, these can increase bleeding potential especially when used with NSAIDS.
Health care providers are responsible for not over prescribing medications. You, as patients, are responsible for informing physicians regarding the over the counter medications you are consuming so we can truly follow our creed to “first do no harm.”

Dr. Veita Bland is a board-certified Greensboro physician and hypertension specialist. Dr. Bland’s radio show, “It’s a Matter of Your Health,” can be heard live on Wednesdays, 5:30 p.m. on N.C. A&T State University’s WNAA, 90.1 FM. Listeners may call in and ask questions. The show is replayed on Sirius 142 at 5 p.m. on Wednesdays. Email Dr. Bland at hrefideas@blandclinicpa.com.