Did you know the average person in the U.S. takes one prescription medication for each decade they've been alive? For a person in their 60's or 70's that's at least a half dozen medications even if they're in relatively good health. Add into the mix any herbal remedies or supplements and you've got a tricky, and possibly a risky, pharmaceutical situation.

You should know and understand all of the medications you are prescribed and how they might interact with other substances. A number of medications are used to treat a variety of ailments. Propranolol for example, is used to treat hypertension and heart attacks. But it is also given to patients suffering migraine headaches, glaucoma and even certain psychiatric issues such as post-traumatic stress disorder.

Since all medications have side effects and interact differently with each other (including supplements), it's critically important that your doctor and your pharmacist know everything you're putting into and on your body. If it's not specifically food, it should be on a list. A list for your doctors, your pharmacist - and you. That list should include everything, including the dosage and how often you take them. • Prescription medications • Non-prescription medications •Topical medications •Vitamins and supplements •Herbal remedies •Powders •Suppositories/enemas Why such detail? Apart from concern about drug interactions, the rise in popularity of herbal medicine has medical professionals concerned. It's not that herbal remedies are intrinsically dangerous, but with so many sales online, it's difficult to know exactly what you're buying. And, even if your herbal meds come from reputable producers, there can be hazards of interactions. In addition, some patients are reluctant to reveal non-pharmaceutical substances to their doctors and pharmacists that haven't been prescribed. Let's take red yeast rice extract for example. Red yeast rice extract has been sold as a natural cholesterol-lowering agent in over-the-counter supplements. There has been legal and industrial dispute as to whether red yeast rice is a drug or a dietary supplement, involving the manufacturer, the U.S. Food and Drug Administration (FDA) and the pharmaceutical industry. Red yeast contains statin-like drugs. Statins can harm the liver. Taking red yeast along with pharmaceutical statins, or with other herbs and supplements might increase the risk of liver damage. Where do you need to keep this list?

Apart from you doctors and pharmacist, it's best to have this list in a variety of places, most importantly with you at all times. If, for some reason you become temporarily incapacitated, the list will speak for you, when you cannot. This is probably most important for older people who suffer a higher percentage of falls and stroke. I recommend that seniors also have that list with family members, as well as a list in the home that can be accessed quickly by emergency personnel. Emergency responders will often look in the refrigerator for clues as to what an unresponsive patient may be taking. This is actually a good place to store the list in an old prescription container. I also recommend that patients not seek emergency treatment without having the list. Having to take precious time to discern your medications in the emergency room could be a life and death situation. Finally, update your list frequently. Always make a note if you have started or stopped taking any medications. Record any drug allergies, side effects or sensitivities you have. AARP, Inc., formerly the American Association of Retired Persons is among many organizations that can provide standard medical information lists that can help healthcare professionals in minimizing adverse drug interactions, as well as provide you with the highest quality of care.

Rebecca Culbertson is a Registered Pharmacist with St. Mary's Medical Center and a former president of the Missouri Pharmacy Association. She can be reached at 816-228-5900.