Medications at Home…a Closer Look
It so happens that when this blog was assigned, an interesting medication teaching opportunity came up with a relative of mine. She has diabetes type 2 which is controlled by diet and exercise only; her doctor has not yet prescribed any single medication for her blood sugar control. If/when we are together and eat, I always chat with her about her blood glucose number. It so happens that on that particular day we were visiting, and she was telling me about the lunch she had at a new restaurant up the street. When I asked about her blood sugar level, she said that it was 275! When I asked her what she was going to do about it, she replied that she was going to take her cholesterol medication for it! I gave her a glass of water to drink and asked to if she wanted to take a short walk (to help lower her blood sugar). My plan was to chat with her on the walk about her medication and to retest her BGC when we returned. (By the way, it later went down to 135 to my relief).
I initially thought that she was confused about the difference between cholesterol medication and blood sugar control medications. She told me that when she tests her blood sugar and found it high, she has been taking a dose of her cholesterol medication, believing that her BGC level would decrease. I assumed she was referring to a statin and asked her to show me her medication packaging. I was surprised with my findings…
Her medication is named Welchol. It is a bile acid sequestrant, and considered an alternative to taking a statin to reduce/control high cholesterol levels. It works in the bowel to help remove bile acids from the body, then the body’s cholesterol to make more bile acids, which causes blood cholesterol levels to decrease. Ingenious!
Further intrigued, I went to the manufacturer’s website to investigate this interesting drug and saw…large banners that Welchol helps to lower blood sugar levels! Then I realized that is why/how my relative came to the conclusion that Welchol would symptomatically reduce her blood sugar levels. I read the “for patients” information section and found that this medication mostly works “in addition to” blood sugar lowering drugs, such as metformin and insulin. There was absolutely no mention of it helping to reduce blood sugar levels on its own.
Later, I pulled up several websites on Welchol to review with her. She was not aware that Welchol was not lowering her blood sugar. She also thought that she was supposed to take the Welchol symptomatically. Directions say to take it every day with food and to not miss a dose. She was also unaware of the potential side effects, so I reviewed those with her as well. I encouraged her to also chat with her doctor if she had any other questions and to keep on top of her blood sugar regimen.
I felt bad that I had not reviewed her medication with her before. We do, after all, educate patients at the hospital clinicals…why not educate out family too? I had just assumed that her provider had educated her, or that she had received information at the pharmacy. I should not have assumed, and decided from hereon that I would spend some quality time chatting with other family members about their medications (with their permission of course!). I also decided to take my own “medicine” so to speak, and to review the details, side effects, etc. for a medication that I am taking as well. Although I read the entire attachment that came with the one medication I take, it was a year ago and I decided that it would serve me well to have a review, just in case.
This was a great assignment…it reminds us to not take anything for granted, especially our medications. We have a responsibility to understand them and I am renewing my dedication 
References:
Deglin, Judith Hopfer, and April Hazard Vallerand. Davis’s Drug Guide for Nurses. 11th ed. Philadelphia, Penn.: F.A. Davis, 2009. Print.
“FDA Expands Advice on Statin Risks.” FDA Expands Advice on Statin Risks. U.S. Food and Drug Administration, 14 Jan. 2014. Web. 12 Oct. 2015.
Shah, R. V., and A. B. Goldfine. “Statins and Risk of New-Onset Diabetes Mellitus”” Circulation (2014): E838. Print.
