Medication Safety and Management of Side Effects Unwanted or unexpected reactions to a medication or treatment.

Accidental or emergency situations

It is possible for both accidental and emergency situations to occur when taking medications. For example, missing a dose, taking an extra dose, or experiencing an overdose Taking a drug (or a mixture of drugs) in quantities that are much greater than are recommended. Symptoms of an overdose can be fatal or life threatening. or withdrawal A set of symptoms that occurs when someone stops using a drug or medication that they’ve become dependent on. Physical symptoms include sweating, nausea and shaking. Emotional symptoms include anxiety and irritability. . We have included some information below on what to do if you experience any of these situations.

Missed Medication Dose

A missed dose can occur, but it is important to know what to do if this happens. Follow the steps below in case of a missed medication dose:

• Check the medication label or information sheet included with the medication for specific instructions on next steps (if you do not have an information sheet, we suggest contacting your pharmacy)
• Consult with your pharmacist or another healthcare provider for guidance
• Be aware that different actions may be recommended based on the time passed since the missed dose. For example, one recommendation may be to take the missed dose as soon as possible, if the missed dose is not too close to the time of your next scheduled dose. However, another recommendation may be to skip the dose, as opposed to doubling up to make up for a missed dose, to avoid an overdose Taking a drug (or a mixture of drugs) in quantities that are much greater than are recommended. Symptoms of an overdose can be fatal or life threatening. .

Overdose

An overdose Taking a drug (or a mixture of drugs) in quantities that are much greater than are recommended. Symptoms of an overdose can be fatal or life threatening. is when more than the recommended amount of medication is taken. It may cause serious harm.

Symptoms of medication overdose Taking a drug (or a mixture of drugs) in quantities that are much greater than are recommended. Symptoms of an overdose can be fatal or life threatening. may appear differently in different people, and signs may look different depending on the medication. The most concerning signs come from overdose Taking a drug (or a mixture of drugs) in quantities that are much greater than are recommended. Symptoms of an overdose can be fatal or life threatening. of medications that impact the central nervous system (brain and spinal cord injury function) which include:

• Difficulty with mobility, talking, or staying awake
• Lips or nails turning blue or grey
• Making choking, gurgling, or snoring sounds
• Vomiting
• Smaller pupils than usual
• Skin that feels cold and clammy
• Dizziness or confusion
• Unable to breathe or weak/slow breathing
• Chest pain
• Unable to wake up even if shaken

It is important that you and any support persons are aware of the steps to follow in the event of an overdose Taking a drug (or a mixture of drugs) in quantities that are much greater than are recommended. Symptoms of an overdose can be fatal or life threatening. . If an overdose Taking a drug (or a mixture of drugs) in quantities that are much greater than are recommended. Symptoms of an overdose can be fatal or life threatening. is suspected, a support person can follow the steps below:

1. Try to wake the individual up (yell their name, shake their shoulders, rub their chest)
2. Put the individual on their side (if possible)
3. Call 911
4. Check for breathing, perform CPR or chest compressions
5. If no improvements are seen within 2-3 minutes, repeat steps 3 and 4
6. Stay with the individual

Opioid Overdose

An opioid overdose When you take too much of an opioid medication it make cause serious symptoms like difficulty breathing, loss of consciousness and even death. occurs when more than the recommended amounts of opioids Class of pain-relieving medication that work by blocking pain signals in the brain. Examples include drugs like morphine, oxycodone, and fentanyl. are taken, taking opioids Class of pain-relieving medication that work by blocking pain signals in the brain. Examples include drugs like morphine, oxycodone, and fentanyl. with alcohol or other sedatives, taking an opioid your body isn’t used to, or other underlying health conditions. Opioid overdose When you take too much of an opioid medication it make cause serious symptoms like difficulty breathing, loss of consciousness and even death. can cause serious harm as these medications affect the part of the brain that controls your breathing and overdosing causes breathing to slow. 

Symptoms of an opioid overdose When you take too much of an opioid medication it make cause serious symptoms like difficulty breathing, loss of consciousness and even death. may include:

• Difficulty with mobility (stumbling, difficulty navigating) and talking (slurred speech)
• Lips or nails turning blue or grey
• Slow, weak or no breathing
• Very small pupils (significant size difference than usual pupils)
• Dizziness or confusion
• Extreme drowsiness
• Choking, gurgling or snoring sounds (may indicate challenges breathing)
• Unable to wake up even if shaken

It is important that you and any support persons are aware of the steps to follow in the event of an opioid overdose When you take too much of an opioid medication it make cause serious symptoms like difficulty breathing, loss of consciousness and even death. . If an opioid overdose When you take too much of an opioid medication it make cause serious symptoms like difficulty breathing, loss of consciousness and even death. is suspected, your support person can follow the steps below:

1. Try to wake the individual up (yell their name, shake their shoulders, rub their chest)
2. Put the individual on their side (if possible)
3. Call 911
4. Administer naloxone A medication that can quickly reverse the effects of an opioid overdose. (spray into nose or inject into thigh), if available
   • Note: naloxone A medication that can quickly reverse the effects of an opioid overdose. is a medication that rapidly and temporarily reverses the effects of an opioid overdose When you take too much of an opioid medication it make cause serious symptoms like difficulty breathing, loss of consciousness and even death.
   • If naloxone A medication that can quickly reverse the effects of an opioid overdose. if not available, continue with Step 5
5. Check for breathing, perform CPR or chest compressions
6. If no improvements are seen within 2-3 minutes, repeat steps 3 and 4
7. Stay with the individual

Medication Withdrawal

General Medication Withdrawal

Withdrawal A set of symptoms that occurs when someone stops using a drug or medication that they’ve become dependent on. Physical symptoms include sweating, nausea and shaking. Emotional symptoms include anxiety and irritability. can occur when the body has become dependent on a medicine and there is a sudden stop of the medication or a decrease in dose. It is important not to suddenly stop a medication, it should be done after consultation with a healthcare provider. See Module 2 for more information.

Symptoms of withdrawal A set of symptoms that occurs when someone stops using a drug or medication that they’ve become dependent on. Physical symptoms include sweating, nausea and shaking. Emotional symptoms include anxiety and irritability. will differ depending on the medication and may not present the same in all people, but common signs include:

• Nausea and vomiting
• Muscle aches or pain
• Trembling and tremors (shaking)
• Seizures
• Sweating
• Change of mood and irritability
• Paranoia (unusual suspicion and/or mistrust)

Withdrawal from Opioids

If you are experiencing withdrawal A set of symptoms that occurs when someone stops using a drug or medication that they’ve become dependent on. Physical symptoms include sweating, nausea and shaking. Emotional symptoms include anxiety and irritability. from opioid medications, below are some general guidelines to consider:

• Seek assistance from your healthcare provider to determine best treatment method
• Use Medication-Assisted Treatment
  • Common medications to help manage withdrawal A set of symptoms that occurs when someone stops using a drug or medication that they’ve become dependent on. Physical symptoms include sweating, nausea and shaking. Emotional symptoms include anxiety and irritability. symptoms include methadone, buprenorphine, and naltrexone
  • Medications must be taken under the supervision of health care providers
• Inpatient or outpatient treatment depending on the severity of the withdrawal A set of symptoms that occurs when someone stops using a drug or medication that they’ve become dependent on. Physical symptoms include sweating, nausea and shaking. Emotional symptoms include anxiety and irritability. symptoms
• Ensure proper sleep, hydration and nutrition to support the physical demands of withdrawal A set of symptoms that occurs when someone stops using a drug or medication that they’ve become dependent on. Physical symptoms include sweating, nausea and shaking. Emotional symptoms include anxiety and irritability. symptoms
• Ensure you get enough rest as adequate sleep is needed for recovery
• Seek emotional support by building a support system (e.g. friends, family or a support group)
• Seek therapy and counseling

Practice gradual tapering of opioid medications to reduce the intensity of withdrawal A set of symptoms that occurs when someone stops using a drug or medication that they’ve become dependent on. Physical symptoms include sweating, nausea and shaking. Emotional symptoms include anxiety and irritability. symptoms