MEDICATION

What is the purpose of Medications?

Medications are taken to help your body adjust to the changes that have occurred since your spinal cord was injured. In order to give you the best possible care, your doctor must be told your complete medical and surgical history. This includes:

* What over-the-counter and prescribed medications you are taking right now
* Any allergies to medications you might have.
* Always notify your doctor if you are pregnant. Medications you take will affect your baby too.

How Do Medications Work?

Medications contain chemicals that interact with your body to:
* Replace chemicals that may be low in your body;
* Help body systems that aren't working right;
* Maintain chemical balance throughout your body.

Drugs also interact with each other. One drug can stop another from working properly or can make another drug have a greater effect than is needed.
* Your doctor always needs to know all the medications you are taking to be sure they work well together.
* Check with your doctor about drinking beer, wine, or liquor, because alcohol affects the way many drugs
* Take the medications your doctor has ordered exactly as they are prescribed. Always check with him/her if you feel you need to increase or decrease the dose.

Know Your Medications

Medications come in different forms. They vary in size, shape, or color and have distinct markings on them. They are available as tablets, capsules, ointments, or liquids.
* Know the names of your medications
* Know what they look like
* Know the dosages and times they should be taken
* Know WHY you are taking them
* Know any side effects they might cause.

You alone are responsible for all this information so you can be independent in caring for yourself. If someone else is giving it to you, personally verify each medication before you take it.

Side Effects

Most medications can cause side effects in your body. These usually are not a problem because they can be controlled by regulating the amount of drug you take and when you take it. Notify your doctor if you notice any discomfort from your medicines.

Drug Allergies

An unpredictable side effect can cause an allergic or anaphylactic reaction. Some reactions occur immediately and some are delayed several days. Know what to look for and what to do:

  • The most common symptom is a skin reaction such as itching or rash.
  • Call your doctor right away.
  • If you have difficulty breathing or any other severe reaction to any medicine, call the ambulance immediately and be seen in the Emergency Room.

How Do You Know When To Take Your Medication?

Medication is usually scheduled for two, three, or four times each day. The schedule will be written on the prescription bottle or on the envelope containing your pills. Most medications are spaced at least 4 hours apart. Taking them more often is unwise, but feel free to consult your doctor about how best to fit medications into your personal daily schedule. Learn how long you should continue the medication. Be prepared to renew your medication long before your supply runs out.

Common Drugs For Spinal Cord Injured Persons

For Spasticity

BACLOFEN (Lioresal)
Dosage: 15 to 200 mg daily by mouth
Purpose: 1. To relax skeletal muscle to decrease spasticity. 2. To relax the external sphincter to allow the passage of urine when the bladder contracts

Cautions: 1. It must not be discontinued abruptly; dosage must be decreased gradually down to zero. (If, for some reason, you suddenly cannot take it by mouth, intravenous (IV) valium will be used go wean you slowly.) 2. If discontinued abruptly, this drug can cause hallucinations, increased spasticity, abdominal cramping and tiredness. 3. Avoid drinking alcohol.

CLONIDINE (Catapres)
Dosage: .05 to 0.4 mg by mouth per day

Purpose: 1. To lower high blood pressure 2. To reduce spasticity

Cautions: 1. With prolonged use, get routine eye exams. 2. Can cause increased constipation (in which case, your bowel medication will be adjusted to help relieve this effect). 3. This drug can cause lowered blood pressure.

DANTRIUM
Dosage: 25 to l00 mg four times a day

Purpose: 1. To relax skeletal muscle to reduce spasticity due to injury to the spinal cord or brain.

Cautions: 1. This drug can cause muscle weakness or liver damage (blood level tests must be done to check the health of the liver). 2. Avoid alcohol or over-the-counter medications.

DIAZEPAM (Valium)
Dosage: 1 to 5 mg two to four times a day

Purpose: 1. To relax skeletal muscle to reduce spasticity 2. To decrease anxiety

Cautions: 1. This drug can cause addiction, tiredness, or decrease in alertness. 2. Avoid alcohol.

For Bladder

MINIPRESS
Dosage: 0.1 to 0.4 mg a day

Purpose: 1. To relax internal sphincter to allow urine to pass 2. To prevent repeated autonomic dysreflexia

Cautions: 1. This drug can cause dizziness when sitting up due to lowered blood pressure. Sitting up slowly will help reduce this feeling

PROBANTHINE
Dosage: 7.5 to 15 mg four times a day

Purpose: 1. To relax bladder wall muscle so it can store more urine without leakage

Cautions: 1. Store in tight container protected from light. 2. This drug can cause constipation or urinary retention. 3. Avoid drinking alcohol.

DITROPAN
Dosage: 5 mg three to four times a day

Purpose: 1. To relax smooth muscle in urinary tract and bladder so to reduce spasms and allow bladder to store more urine

Cautions: 1. This drug can cause constipation or urinary retention.

URECHOLINE
Dosage: 25 to 50 mg three to four times a day

Purpose: 1. To help bladder wall muscle contract to push out urine

Cautions: 1. Take with food or milk to decrease stomach upset. 2. This drug can cause dizziness when sitting up due to lowered blood pressure (sitting up slowly will help reduce this effect), sweating, or changes in bowel function.

For Bowel Program

DULCOLAX (firm, cone-shaped suppository)
Dosage: 1 suppository per rectum

Purpose: 1. To irritate the nerve endings in the bowel wall, causing COLON to contract.

Cautions: 1. Remove any stool in the rectum space where you will be putting the suppository. 2. Be sure suppository is placed against bowel wall otherwise it will not work. 3. This drug can cause mild cramping or leakage of mucous from bowel (this mucous is the normal way your body eases the passage of stool from the bowel).

GLYCERINE (soft, pencil-shaped suppository)
Dosage: 1 suppository per rectum

Purpose: 1. To irritate the nerve endings of the bowel wall, causing it to contract -- bowel secretes mucous to act as a lubricant and to ease the passage of stool

Cautions: 1. Remove any stool in the rectum space where you will be putting the suppository. 2. Be sure suppository is placed against bowel wall, otherwise it will not work

DOCUSATE SODIUM
Dosage: 1 to 4 tablets by mouth daily

Purpose: 1. To act as a surface agent helping to keep stools soft for easy natural passage

Cautions: None

MYLICON
Dosages: 40 to 80 mg by mouth 30 min. before meals Purpose: 1. To prevent buildup of gas in the digestive tract

Cautions: 1. Take tablets by chewing them.

PERICOLACE
Dosage: 1 to 2 tablets by mouth daily

Purpose: 1. To provide a stool softener with a stimulant to move the BOWEL

Cautions: None

METAMUCIL
Dosage: Sprinkle amount of powder suggested on label into 8 ounces of water, milk, or fruit juice 6 to 8 hours before planned bowel program

Purpose: 1. To create a gel-like mass that stretches the bowel causing it to squeeze and move the mass along the COLON and out of the body

Cautions: 1. Stir and drink right away. 2. After drinking mixture described above, drink one more glass of plain water.

SENEKOT
Dosages: Amount of tablets or granules as suggested on label 6 to 8 hours before bowel program

Purpose: 1. To increase movement of the whole digestive tract to move stool into the lower bowel

Cautions: None

DULCOLAX TABLETS
Dosage: 1 to 2 tablets by mouth 10 hours prior to suppository

Purpose: 1. To irritate the nerve endings in the bowel wall, causing it to squeeze hard

Cautions: 1. Be certain to time taking of Dulcolax tablet with placement of suppository as stated above. 2. This drug can cause cramping.

For Neurogenic Pain

ELAVIL Same as Norpramin NORPRAMIN
Dosage: 1O to 150 mg per day

Purpose: 1. To treat neurogenic pain 2. In high doses, to treat depression

Cautions: 1. Avoid alcohol. 2. This drug can cause drowsiness.

TEGRETOL
Dosage: l00 to 800 mg per day

Purpose: 1. To control neurogenic pain 2. To control seizures

Cautions: 1. Must have routine blood work done, because Tegretol can cause anemia in some people. 2. This drug can cause dizziness or drowsiness.

For Miscellaneous Complications

COUMADIN (Deep Vein Thrombosis & Pulmonary Embolis)
Dosage: Based on blood level tests.

Purpose: 1. To thin the blood and prevent clots

Cautions: 1. Take on an empty stomach at the same time each day. 2. Use a soft toothbrush as gums may bleed. 3. Report any sign of bleeding to your doctor. 4. This drug can cause bruising to occur easily.

CIMETIDINE (Tagamet) (Stomach Problems)
Dosage: 300 mg at bedtime

Purpose: To prevent or treat stomach ulcers by lowering the secretion of acid in the stomach Cautions: None

RANITIDINE (Zantac)
Dosage: 150 mg by mouth two times a day

Purpose & Cautions: Same as CIMETIDINE

DIDRONEL
(Excess Bone Growth, known as Heterotopic Ossification)
Dosage: 10 to 20 mg/kg a day

Purpose: 1. To prevent calcium from being added to areas of heterotopic ossification (See Complications Chapter)

Cautions: None

INVERSINE (For Sweating)
Dosage: 2.5 mg twice a day

Purpose: 1. To treat severe sweating that comes with spinal cord injury 2. To treat moderate to severe high blood pressure

Cautions: 1. This drug can cause lowered blood pressure.

ANTIBIOTICS (For Infections)
Dosage: Read the label Purpose: 1. To kill bacteria that causes infections

Cautions: 1. Take only by doctor's orders. 2. Take all that is prescribed even if the signs and symptoms are no longer present. This is to destroy all the bacteria involved. 3. Wounds and urine will be tested once in a while to make sure that the correct antibiotic has been used to treat the infection.