In the Fine Print - Safety First!

In the Fine Print - Safety First!
Sonal Parmar, PharmD, Community-University Health Care Center

The Institute of Medicine and the World Health Organization undertook initiatives to improve current patient safety standards. This was largely geared towards health systems to avoid the assumption that medication safety is the sole responsibility of patients. Pharmacists, as medication experts, pride themselves on ensuring every medication has an indication for which it is effective and can be safely and conveniently dispensed. 

As medication use becomes more accessible and inclusive of various disease states, its safety net lapses. An article by The New York Times has revealed gaps in medication safety after cannabis was legalized in eighteen states. The unintentional child exposure to THC products has risen significantly despite some states requiring adequate labeling and child-resistant packaging. Cannabis edibles in the form of lollipops, cookies, gummies, and candy have become increasingly popular yet risky amongst all age groups for overdose. Since its legalization, many people assume that cannabis products are harmless and disregard their potential addictive properties. Parents and guardians should lock away any/all medications rather than assume it’s out of reach of children.

Another safety warning, released by the Food and Drug Administration (FDA), revealed new risks associated with the use of oral disintegrating buprenorphine in the form of sublingual tablets and buccal films. They have been found to cause significant dental issues in patients with or without a history of dental problems such as tooth decay, cavities, oral infections, and loss of teeth. Despite the risk, FDA recommends against discontinuation given its benefit in opioid use disorder and pain. They advise patients to rinse their mouth with water after the medication has completely dissolved then swallow and wait out an hour before brushing their teeth. Healthcare workers should also counsel patients to have a dental visit soon after starting this medication so a tooth-decay preventative plan can be customized. 

The occurrence of any adverse events should be reported to the MedWatch Safety Information and Adverse Event Reporting Program. Medication safety requires a team-based approach to recognize, understand and develop a patient-centered plan to ensure safety is practiced beyond the patient’s appointment time. 

References:

  1. Caron C. More young kids are getting sick from cannabis edibles. The New York Times. Published January 14, 2022. Accessed January 31, 2022. https://www.nytimes.com/2022/01/14/well/family/marijuana-edibles-children.html
  2. U.S. Food and Drug Administration. MedWatch. Buprenorphine: Drug Safety Communication - FDA warns about dental problems with buprenorphine medicines dissolved in the mouth to treat opioid use disorder and pain. Published January 12, 2022. Accessed January 31, 2022. https://www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-dental-problems-buprenorphine-medicines-dissolved-mouth-treat-opioid-use-disorder