People’s Pharmacy: How to counteract coffee’s bladder irritation

Q. When I read your article about irritable bladder, I didn’t see any mention of coffee ingestion. I used to drink two large cups of very strong coffee every morning. Then I came down with bladder irritation, and now I can’t drink coffee at all.

A. Many people with this condition, also known as bladder pain syndrome or interstitial cystitis, have trouble with acidic beverages such as citrus juices, coffee, tea or carbonated beverages (BJU International, June 2012).

On the other hand, they might find that their symptoms improve when they take sodium bicarbonate (baking soda) or calcium glycerophosphate (Prelief). These compounds can help neutralize acid in food.

Q. Do you have any remedies for low blood pressure?

A. Doctors usually worry far more about high blood pressure, but low blood pressure can cause symptoms such as dizziness, brain fog, fatigue, blurred vision, nausea and fainting. Some people experience these symptoms when they stand up suddenly (orthostatic hypotension).

There is growing recognition of a condition called postural orthostatic tachycardia syndrome, in which low blood pressure makes the heart race. Doctors are reporting that POTS might be part of a post-COVID-19 syndrome (Immunologic Research, March 30).

Doctors often recommend nondrug approaches to treat low blood pressure. They include eating more salt, drinking more fluids and wearing compression hose to keep blood from pooling in the legs. In severe cases, physicians might prescribe midodrine (ProAmatine, Orvaten). This drug squeezes blood vessels to raise blood pressure. Patients must not lie down after taking it, as the drug can cause low blood pressure in such a situation.

Q. I worked as a certified pharmacy technician for 14 years. It was frightening how many times we received prescriptions from doctors that were for the wrong dose, the wrong medication, even the wrong patient. Fortunately, our pharmacists called the doctor if there was any doubt or question. They probably saved many lives.

A. Thank you for sharing this scary story. For years, pharmacists had to decipher doctors’ handwritten prescriptions. Illegible writing contributed to serious dispensing errors.

Now, electronic prescribing is supposed to eliminate those kinds of mistakes. But computers introduce other types of problems. E-prescribing can make it possible for physicians to choose the wrong drug, patient or pharmacy from the drop-down menu (Integrated Pharmacy Research and Practice, May 20, 2015). Incorrect directions might carry over from previous prescriptions. Sometimes, e-prescriptions don’t specify the dose or frequency correctly.

Alert fatigue is another source of potential trouble. Physicians and pharmacists can become overwhelmed by numerous computerized red flags warning of potential drug interactions or adverse reactions. This “cry wolf” phenomenon can lead even a conscientious health professional to ignore important cautions.

That’s why patients need to double-check their prescriptions. After all, they are the ones who will pay the price if someone makes a mistake. To assist them, we have written several chapters about how to avoid prescribing and dispensing errors in our book “Top Screwups.” It can be found in the books section of the store at peoplespharmacy.com.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them in care of King Features, 628 Virginia Drive, Orlando, FL 32803, or email them via their website peoplespharmacy.com.