Stop! You’re taking your medicine the WRONG WAY

Sniffing after using nasal spray. Keeping your eyes open after using drops. Cutting HRT patches in half . . .

Taking tablets and medications at the right time and in the correct way is often far from easy. Some must be taken on an empty stomach, others after a meal, some only at night or never with fruit juice.

is it any wonder, then, that many people take their medication incorrectly?

a report from government watchdog the national institute for Health and Care Excellence (niCE), first published in 2009 and updated in March, suggests up to half of medications prescribed for long-term conditions are not taken correctly.

Yet these mistakes can mean the difference between life and death.

a study just published in the journal allergy asked 158 mothers of children with severe allergies to use an EpiPen.

This device, which resembles a thick marker pen, is jabbed against the leg in a life-threatening allergic reaction called anaphylaxis, which causes the throat to swell and makes breathing impossible.

The pen injects adrenaline into the muscle of the leg, where it is quickly absorbed into the body and widens airways.

The mothers in the study had been taught how to use an EpiPen at a hospital allergy clinic six weeks earlier. However, in the study conducted at imperial College London and published in July, less than half used it correctly. Some tried to inject the wrong end into the leg, while others forgot to remove the safety cap.

Dr Robert Boyle, an allergy specialist who conducted the study, described the findings as ‘pretty disappointing’.

He recommended that parents request a practice ‘trainer’ pen from their specialist or pharmacist.

Yet EpiPens are not the only medications or devices that are often used incorrectly. Here we reveal common mistakes and how to avoid them.

NOT CLOSING YOUR EYES AFTER USING DROPS

THE biggest mistake most people make when applying eye drops is not closing their tear ducts, says Professor Francesca Cordeiro, a consultant ophthalmologist at the Western Eye Hospital, London.

‘Pressing the inside corner of the eye with your finger — ideally for at least two minutes — after inserting each drop closes the tear duct and prevents the drop escaping down the duct and into the throat. if you can taste your drops, they’ve hit the throat, which means you’ve lost most of the dose.’ This is particularly important for medicated eye drops such as antibiotics or treatments for glaucoma.

‘Studies have shown that up to 70 per cent of the side-effects with glaucoma eye drops, such as breathlessness, dizziness and fatigue, could be prevented if people press the corner of the eye, as it prevents medication being absorbed into the rest of the body,’ says Professor Cordeiro.

When inserting eye drops, she recommends pulling down the lower eyelid to create a well, and inserting the drop into this area, rather than trying to drop it on the eyeball.

‘Close the eyes immediately after — rather than blink — and this will help spread the drops around. Then press the inside corner of the eye.’

She also recommends waiting two to three minutes between putting each drop in the eye, as ‘using more than one at a time results in drops rolling down the cheeks,’ she says.

EATING FOOD WITH IBUPROFEN

ManY people reach for ibuprofen when they are struck with a headache or back pain. The advice is to take the painkiller with food to reduce the risk of the drug damaging the stomach lining.

But this is a mistake if it’s a oneoff, according to Professor ingvar Bjarnason, a gastroenterologist from king’s College Hospital in London, as this means the drug takes 45 minutes longer to work.

and though there is a risk of stomach damage with long-term ibuprofen use, research published by Professor Bjarnason in the J o ur nal of Pharmacy a nd Pharmacology found the risk from occasional one-off use to be ‘very, very small’. He explains: ‘if someone takes ibuprofen for a headache, they need their symptoms to be eased as quickly as possible. if you take it on an empty stomach, you’ll feel the effects in 15 minutes.’

SNIFFING AFTER A NASAL SPRAY

PEOPLE mistakenly sniff after squirting nasal spray into a nostril, says Dr Sophie Farooque, an allergy consultant from imperial College Healthcare nHS Trust, in London.

‘This draws the spray out of the nose to the back of your throat and you basically end up eating it. This is one of the most common reasons nasal sprays don’t work. instead, just breathe normally after each squirt.’

a second error, she says, is to close one nostril. ‘if you do this, you’ll be pushing the middle bony bit of the nose — the septum — across into the nostril and you won’t get as much spray where it’s needed.’

The symptoms — whether a blocked or runny nose due to allergy or a cold — will be due to inflammation in this fleshy part of your nose as well as increased mucus production, which is why you need to direct the spray to the soft part of your nostril, on the outer side, rather than the septum. Hold the bottle in your right hand and spray it into your left nostril, towards the outside edge, while looking down as if reading a book. Then switch hands and do the opposite nostril.

Dr Farooque adds that using a salt water spray (available from chemists) before will make it more effective. This helps clear mucus, enabling the spray to reach the lining.

Furthermore, many people give up too soon on steroid sprays, prescribed for conditions such as allergy, says Dr Farooque. They can take up to two weeks to work.

With decongestant sprays, such as those used for colds (these work by shrinking the swollen blood vessels in the nasal lining), use them for the shortest time possible (between three to seven days) or you can get rebound nasal congestion — and your blocked nose can get worse.

NOT RUBBING IN PAIN RELIEF GEL

gELS and creams, such as ibuprofen gel, are a popular choice to ease joint pain or muscle sprains and strains. They work by reducing inflammation, but many people use them incorrectly, says Sultan Dajani, a pharmacist in Bishopstoke, Hampshire and spokesperson for the Royal Pharmaceutical Society.

‘People tend to leave them on the skin without rubbing in. But you need to rub the area to increase blood circulation, which enables the medication to be absorbed.’

CUTTING UP A STICK-ON PATCH

anOTHER common pain relief option that goes directly on to the skin is a patch. These are available over the counter as well as on prescription. a common mistake with these, and HRT and nicotine patches, is to cut them up.

‘This destroys the mechanism the patch uses to deliver drugs into the skin, meaning a person could get too much or too little of the medication,’ says Mr Dajani. This is because some patches slowly release the medicine through a special layer — cutting the patch damages this layer, so it’s all released at once.

QUICK PUFFS ON YOUR INHALER

MOST people with asthma are prescribed inhalers, yet one in three is using them incorrectly, potentially making their condition worse, says Sue kropf, a nurse manager from charity asthma Uk.

‘Many people use their inhalers too quickly and if you take a quick breath, most of the medicine will just hit the back of the throat — very little will actually reach the lungs.’

instead, she says, breathe in for five seconds. ‘as you start to breathe in, push down on the inhaler. Continue breathing in for five seconds, then hold your breath for ten seconds to give the medicine enough time to get into the lungs.’

This applies to reliever inhalers ( usually blue) and preventer inhalers (usually brown).

and leave at least 30 seconds between each puff on a reliever inhaler, as this enables the device to prime for the next use (otherwise there may be no medication in the second dose).

Tell-tale signs of bad inhaler technique include seeing ‘smoke’ coming out of the nose or mouth (this vapour is the drug) or being able to taste the medicine.

BEING SCARED OF ANGINA SPRAY

FOR people with angina, a type of spray called a glyceryl trinitrate nitrate is often prescribed — this helps widen blood vessels and ease the pain of an angina ‘attack’.

However, many people mistakenly think these sprays, which are squirted under the tongue, are only f or use i n emergencies, says Dr Richard Bogle, a cardiologist from Epsom and St Helier University Hospitals nHS Trust.

‘But this is wrong. There is no danger from taking the spray, and they should be using it when they get angina or before any activity that provokes angina. Otherwise they are suffering unnecessarily.’

if the pain doesn’t ease after five minutes of a second dose of the spray (with the sprays taken five minutes apart), call an ambulance, as it may be a sign of a heart attack.

USING EAR DROPS BEFORE BED

‘a LOT of the time people pop a couple of drops in their ear and carry on with what they’re doing,’ says pharmacist Sultan Dajani.

‘But the drop will come straight out or not reach far enough into the ear canal. instead, tilt your head to one side for one to two minutes afterward to make sure the drops reach deep inside the ear.’

avoid inserting them before bed, as they will just roll out when you lie down.