Thursday, February 28, 2008


Actor’s drug overdose can serve as a lesson for all

With the death of actor Heath Ledger in February due to a cocktail of pain killers, sleeping pills and anti-anxiety medications, the topic of medication interactions is on many minds.

And we see its implications at Backus Hospital all the time.

About 28 percent of all emergency department visits and 10 percent of all hospitalizations are due to problems with medications.

It is also estimated that 1 in 4 hospitalizations of senior citizens are related to medication issues. The culprit is often multiple drugs prescribed by multiple physicians who are unaware of a patient’s other medications.

Ledger’s autopsy revealed the actor was taking six drugs that all could suppress the respiratory system. The cocktail of drugs created a perfect storm to kill the 28-year-old, the autopsy showed.

It is unclear if Ledger used more then one pharmacy for his prescriptions, which can be a problem. A pharmacy can only check for drug interactions between the prescriptions they fill. There is no way to track a patient’s prescriptions outside their own store or chain.

Even when the same pharmacy is used, patients often forget to tell the pharmacist of any over-the-counter drugs or supplements they are taking. A lot of people think because it’s a natural supplement it’s completely safe and it’s the same thing with over-the-counter drugs.

That is not the case. The two most popular over-the-counter drugs, acetaminophen and ibuprofen, can cause serious problems, such as liver failure with acetaminophen and intestinal bleeding with ibuprofen, if taken inappropriately. Many natural or herbal products have powerful drug interactions.

Patients should also never assume because medications are for very different ailments that they cannot affect one another. Drug interactions occur between all kinds of medications. It is not just side effects and drug interactions that cause trouble, taking multiple drugs without alerting a pharmacist can cause other problems, too.

There can be a lot of waste and duplication of therapies. Having multiple doctors prescribe multiple drugs for the same conditions can lead to wasted money and an increased risk of problems. Having all your prescriptions filled at a single pharmacy allows the pharmacist to evaluate all your prescriptions and supplements for duplication of therapy and drug interactions.

People who are on multiple medications should carry a list with them of what medications they are on, the dosage, how many times a day they take it and why they were prescribed it. This list should be shared with all healthcare providers whenever a medication is prescribed or filled.

Backus Hospital offers a pocket medication card you can use to help you with this at Simply scroll down the left side of the page and click on “personal pocket medication card.”

Michael Smith is a pharmacist and Clinical Coordinator in the Department of Pharmacy Services at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. E-mail Smith and all of the Healthy Living columnists at

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