Malcom Randall Department of Veterans Affairs Medical Center
Division Of General Internal Medicine
The Division of General Internal Medicine at Saint Louis University is a team of primary care physicians, hospitalists and advanced practice nurses dedicated to providing top-notch, patient-centered medical care to the St. Louis area.
As generalists, we care for the widest variety of diseases and medical problems of any medical specialty. We are trained and experienced in diagnosing the unusual as well as managing complex patients with multiple diseases and conditions. As general internists, patients are our top priority and it shows in the care we provide.
Our faculty is routinely listed in St. Louis Magazine's annual Best Doctors issue, which names the top physicians in the metro area as chosen by other doctors. Physicians on this list also appear in the national ranking, "Best Doctors in America."
EducationWe take pride in teaching residents and students to practice evidence-based, patient-centered medicine. As a result of our emphasis on education, we have developed many of the top teachers at the Saint Louis University School of Medicine.
ProvidersOur faculty members are leaders at the highest levels within SLUCare, the academic medical practice of Saint Louis University, as well as national leaders in medical ethics, medical education, hospital medicine and primary care.
We see patients at SSM Health Saint Louis University Hospital, VA Saint Louis Health Care System - John Cochran Division, the Doctors Office Building Clinic and the Des Peres Clinic.
Within the Division of General Internal Medicine at the Saint Louis University School of Medicine there are two types of providers:
Stop Using The Medicine Cabinet. Oh, And Now Clean It Out
Jan. 24, 2024 – If old bottles of prescription medicines and over-the-counter pain relievers are gathering dust behind your bathroom mirror, you're not alone. But it's important to take stock of what medications you have, what you can get rid of, and figure out how to store and discard your pills with care.
Let's start with the basics: Despite its name, you shouldn't keep your pills in the bathroom medicine cabinet. There are two major reasons why, experts say.
The first is that medicine cabinets are usually in bathrooms. That comes with a lot of humidity and high temperatures. According to the CDC, storing medications in places were temperatures often change and humidity is high has been shown to make medicines degrade more quickly.
The second reason to move your pills is that often, anyone you share your home with can easily get to your medicine cabinet. If you're trying to keep medications out of the hands of young children, people struggling with substance use, or teens with mental health issues, even a kitchen cabinet may not be the best place to keep pills. And studiesshow that most household medications aren't stored properly.
When Suzanne Robotti was a child, her younger sister loved to climb. One day, she walked into the kitchen to see that her then-5-year-old sister had climbed on top of the counter and found the baby aspirin.
Robotti, founder of the MedShadow Foundation, a drug safety organization, and the consumer representative appointed to the FDA's Drug Safety and Risk Management Committee, tattled, and her mother rushed her sister to the hospital.
"They had to pump her stomach because she had indeed eaten an entire bottle of baby aspirin, which could have seriously damaged her kidneys and liver," she said.
"It sounds crazy, but there are people who keep their medicines under lock and key, the same way you would a gun. They're just as dangerous as a gun in the wrong hands."
When Do Medicines Actually Expire?
Most pill bottles have an expiration or "use-by" date of about a year after you receive them. This isn't the case across the board, especially not for all prescription medications.
"It's kind of like that milk that you get; it's probably good a little past the expiration date," said Maryann Amirshahi, MD, a toxicologist, emergency medicine doctor, and co-director of the National Capital Poison Center.
"There's nothing magical about the day that it expires. But that being said, you don't want to let it sit there for much longer than that," she said.
Whether or not the medication is past its prime by the date on the packaging has a lot to do with how it has been stored. It also depends on what type of situation you find yourself in, said Joe Graedon, a pharmacologist and co-host of "The People's Pharmacy" national call-in radio show.
"If you're in a situation that is not that critical – maybe you need a sleeping aid or an allergy medication – and you've got a medicine that is a week, month, or even a couple of months out of date, it probably didn't go bad," he said.
But if you find yourself in a situation where the medication absolutely has to work – for example, if you have an infection and need an antibiotic, or someone needs an EpiPen – then you shouldn't risk it.
There's a scenario that Amirshahi sees a lot on the job, both at Poison Control and in the emergency room. Patients will say that they had an antibiotic lying around the house from a previous infection, so they decided to take it for their current ailment.
Here's why that's a problem: When you are prescribed an antibiotic, you're supposed to finish it to make sure you completely get rid of the infection and avoid resistance, Amirshahi said. There are also different antibiotics used for different infections; a prescription you previously had for a urinary tract infection is not the same one you would get for a sinus infection. Lastly, the old antibiotic might be well past its expiration date, making it far less effective.
What Do I Do With My Old Meds?
For many medications, simply tossing the bottle in the garbage isn't the best course of action. The best way to dispose of old prescriptions is to take advantage of take-back programs offered across the country. The FDA has a resource that helps you find local Drug Enforcement Administration-registered take-back locations. Many pharmacies will also take old drugs and dispose of them safely.
If that doesn't work for you, Amirshahi has another solution.
"With most medications, you can actually put them in cat litter or coffee grounds before throwing them away – something gross – so that people won't be tempted to take them," she said. "You want to make them completely unpalatable."
Whatever you do, don't flush medications down the toilet. Research has shown that doing this leads to an increased concentration of drugs in the water supply and damages aquatic wildlife.
JAMA Internal Medicine
JAMA Internal Medicine (formerly Archives of Internal Medicine) is a peer-reviewed medical journal published twice a month by the American Medical Association. The Archives of Internal Medicine was established in 1908 and covers all aspects of internal medicine, including cardiovascular disease, geriatrics, infectious disease, gastroenterology, endocrinology, allergy, and immunology. The editor in chief is Rita F. Redberg (University of California San Francisco School of Medicine). According to the Journal Citation Reports, the journal's 2009 impact factor is 9.813, ranking it 8th out of 133 journals in the category "Medicine, General & Internal".
Publisher American Medical Association Website http://archinte.Ama-assn.Org/Some content from Wikipedia, licensed under CC BY-SA
Comments
Post a Comment