Medicine mix-ups

Which number

Triple Zero or the Poisons line

Healthdirect is clear about the order: in a medical emergency, the call is to Triple Zero (000) for an ambulance, not to the Poisons Information Centre. The Poisons Information Centre’s own medicines page gives only its own number, so the Triple Zero advice on this page is healthdirect’s.

If you go for medical help after something has been swallowed, healthdirect suggests taking the container with you, or a photo of it.

Causes

Why mix-ups happen more with age

The NSW Poisons Information Centre lists medication errors among the ways poisonings happen, “especially in elderly people with multiple treatments”. Healthdirect puts it more broadly: older people are more likely to have problems with their medicines. Someone with a few chronic, or ongoing, conditions may be prescribed several medicines, and taking 5 or more is called polypharmacy.

Healthdirect also names health conditions that affect older people and can make medicines harder to take. These include:

• poor eyesight, which can make the instructions hard to read
• arthritis, which can make medicine packs hard to open
• memory loss, which can make it hard to remember to take a medicine
• conditions that make swallowing medicines harder

The centre’s advice

The Poisons Information Centre’s medicine safety tips

The NSW Poisons Information Centre opens its page on medicines with a warning: the wrong medicine, or too much of one, can be dangerous and even life-threatening, and taking different medicines together can increase the risk of harm. Its safety tips follow, here in plain words and in its order.

1. Whenever you take a medicine, follow your doctor’s or pharmacist’s instructions.

2. Before you drink alcohol, check whether the medicines you take are safe to mix with it. Some combinations can be dangerous.

3. If anyone, you included, has taken too much of a medicine, call the Poisons Information Centre on 13 11 26, even when there are no symptoms.

4. Take medicines you no longer need, or that are past their expiry date, to your local pharmacy, or dispose of them through Return of Unwanted Medicines.

Extra care

Medicines the centre singles out

The same page says some medicines are more dangerous than others, and names:

• opioids, such as codeine, fentanyl and oxycodone; mixing them with alcohol, or with other medicines such as antidepressants, can raise the chance of harm
• paracetamol, which it calls one of the most common causes of hospital admission for an accidental overdose
• sedating medicines, such as sleeping tablets, antipsychotics and some ADHD medicines

Medicine lists and reviews

Keeping track of what is taken

Healthdirect suggests keeping an up-to-date list of your medicines to share with the people who look after your health, and talking to your doctor or pharmacist when you have questions. It is firm on one point: never stop taking a medicine without talking to your doctor.

It suggests that, ideally, medicines are checked every 6 to 12 months, and that you can ask for a review at any time. You may be able to have a Home Medicines Review, where a pharmacist visits you at home; it needs a referral from a doctor and is free of charge. Healthdirect also notes that some medicines can raise the chance of delirium, a sudden change in thinking or behaviour. Medicines and the risk of falling are covered in After a fall.

The call

Calling the Poisons Information Centre

The NSW Poisons Information Centre says a call to 13 11 26 is answered by a pharmacist or medical scientist trained as a Specialist in Poisons Information, who works out the risk in your case and tells you what to do next. It adds that most accidental poisonings can be watched at home, and that where it is needed the centre can refer you to hospital or a GP, or organise an ambulance.