Project Inform Perspectives 43 - April, 2007

So, you take care of your mind, body, and whatever else is in need of maintenance, and you time your meds by the bleep of the atomic clock and never miss a dose. Good for you. Who would think that going to the hospital for your face-lift or appendectomy or brain transplant could be a threat to all of that hard work and discipline.

Blessedly, few people living with HIV/AIDS need to be hospitalized these days compared to the bad old days. A by-product of this success is that most interns (doctors in training), pharmacists, and nurses who work in hospitals don’t have much experience with HIV meds. They may have heard something about “cocktails” and AZT and how easy things are now, but they may not know how drugs are combined or realize the importance of taking every dose on time or that it’s not okay to skip one drug out of your combination.

So guess who gets to be the expert? You! Yes, you are a medical expert when it comes to your therapy, and it is up to you to make sure things don’t get messed up.

The intern who takes your history just graduated from medical school six months ago and she’s really busy and you’re only the second person she’s seen on HIV meds and it took her a while to enter your orders and the pharmacy is all the way downstairs and they don’t know if they have that one med and now it’s midnight and you totally fell asleep and didn’t get your meds. (You can view a PDF of the wallet card.

So what can you do?

• Most importantly, know what meds you’re on, how much you take (the number of milligrams and the number of pills), and how often and when you take them. It’s scary how many people are admitted to the hospital and can only recall that there’s “a blue pill with a D on it that I used to take, but now I think it’s a pink one.”
• Write down your meds and allergies on a wallet card like the one with this article. (You can also print the wallet card from the PDF of this issue at www.tpan.com.) If you don’t have a list handy, do not hesitate to call your pharmacy or doctor’s office. Either one can speak to the hospital doctor and help you keep your therapy on track.
• Take a 2-day supply of meds with you to the hospital. Even though all meds that you take in the hospital should come from the pharmacy, they may not have a supply of new or seldomly used drugs. It can also take a while to get your orders processed and filled. Bring each drug separately in a labeled bottle from the pharmacy. Showing an unlabeled pillbox to your nurse is just going to add to the confusion.
• Most hospital pharmacies don’t stock Fuzeon, so definitely bring enough to last your entire stay in the hospital. Remember to take charge of your meds, don’t be afraid to speak up to get them, and enjoy your stay in the hospital. It’s the most you will ever pay for bad food.

Jim Schniepp is an HIV specialty pharmacist currently working at Rush University Medical Center in Chicago.

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