Pharmacology - Questions to Ask When Taking a Drug History

Q1. What medicines are you currently taking?

A: Ask the patient to list all medicines they currently use or explain what each medicine is for.

Why is this useful?

It helps identify the patient’s current medications.

Q2. What types of medicines should you specifically ask about?

A: Ask specifically about:

• Oral contraceptives.
• Over-the-counter (OTC) medicines.
• Herbal preparations.
• Medicines prescribed or recommended by alternative practitioners.

Why is this useful?

Patients may not automatically consider these products to be medicines, so asking directly helps create a complete medication list.

Q3. Why should you ask to see the patient’s actual tablets or medicines?

A: Seeing the medicines can help identify them when the patient cannot remember their names.

With experience, some commonly used medicines can be recognized by their appearance. Examples include:

• Sildenafil, which may be recognized as a blue tablet.
• Amoxicillin, which may appear as maroon-and-gold capsules.

Q4. Why should you ask about medicines taken during the last few days or weeks, even if they have been stopped?

A: Recently discontinued medicines may still explain current symptoms because some adverse effects can appear or persist after treatment has stopped.

Examples include:

• Lung disease associated with amiodarone.
• Adrenal insufficiency following withdrawal of glucocorticoids.

Q5. Why should you ask why a medicine was originally prescribed?

A: Knowing the indication can help:

• Identify the underlying diagnosis.
• Determine whether treatment is still necessary.
• Decide whether therapy should be continued, changed, or stopped.

Examples:

• A patient may describe an unknown medicine simply as a “water tablet” or “blood pressure tablet.”
• A beta-blocker for hypertension may require continuing treatment.
• A medicine used for hyperthyroidism may have been intended only for short-term therapy.

Q6. What should you ask about the dosage regimen?

A: Determine:

• The dose taken each time.
• How frequently it is taken.
• The time of day it is taken.

Why is this useful?

This can show whether adverse effects are related to the medicine or its dosing schedule. It can also help determine whether another regimen might be safer or more effective.

Example:

If one dose of furosemide works effectively but another dose taken 6–8 hours later provides little additional benefit, the regimen may need reassessment. If a nighttime diuretic dose causes nocturia, changing the timing may improve tolerability.

Q7. Why should you ask about the route of administration?

A: The route can help identify the medicine and clarify exactly how the patient uses it.

Examples include:

• Sublingual glyceryl trinitrate (GTN).
• Inhaled salbutamol.

Q8. Why is the duration of treatment important?

A: Knowing how long a medicine has been used can help determine whether an adverse reaction is related to it.

Some adverse reactions occur soon after starting treatment, while others develop only after long-term use.

Examples:

• Penicillin allergy may occur relatively soon after administration.
• Adverse effects from corticosteroids or amiodarone may occur during prolonged treatment.

Q9. Why should you ask whether the medicine has produced beneficial effects?

A: The response to treatment helps determine whether therapy should be continued or modified.

• If the medicine is effective → treatment may be continued.
• If it is ineffective → consider changing the regimen, increasing the dose when appropriate, or changing the medicine.

Examples:

• Triptans for migraine: correct timing of administration can affect effectiveness.
• Bronchodilators: poor response may be related to incorrect inhaler technique.

Q10. Why should you ask about unwanted or adverse effects?

A: Adverse effects may help identify drug-related problems and determine whether treatment needs to be modified.

Examples include:

• Cough caused by ACE inhibitors.
• Bruising associated with anticoagulants.

Q11. Why should you ask about other medicines being taken at the same time?

A: Taking several medicines together can result in drug interactions, which may increase toxicity or reduce treatment effectiveness.

Example:

Warfarin is affected by many drug interactions, and some medicines, such as erythromycin, can precipitate clinically important interactions.

Q12. What should you ask about drug allergies?

A: Start by asking:

“Are you allergic to any medicines?”

If necessary, ask specifically about particular medicines, such as:

“Are you allergic to penicillin?”

If the answer is yes, ask:

“What reaction did you experience?”

Q13. Why is it important to ask what happened during a reported drug allergy?

A: This helps distinguish a true drug allergy from an adverse effect or intolerance.

For example, a patient may report being “allergic” to penicillin when the previous reaction was actually diarrhoea, which is generally an adverse effect rather than an allergic reaction.

Q14. What is the purpose of identifying a genuine drug allergy?

A: Recognizing a true allergy allows the responsible medicine, or related medicines when appropriate, to be avoided in the future, reducing the risk of another allergic reaction.