"Take two tablets every four to six hours, up to four times daily."
These are the standard dosing instructions we see on drugstore bottles of aspirin, acetominophen, and ibuprofen. "Take two [at the time]" is such a common instruction for medications that it's almost become a cultural joke. But if you go over to the drug manufacturer's site, or to a site like drugs.com, you'll find another story that may cause you to question the first. That story is the drug's activity curve.
Most drugs have an activity curve that has an initial lag between dosing and the time it gets into your bloodstream and starts to do something. Then it has a relatively sharp rise until it hits its peak activity, where it stays for a short period of time before gradually tapering off and leaving a long asymptotic tail. In short, most drugs -- even extended-release drugs -- tend to work best closer to the time you take them, and less well (if at all) by the time you're supposed to take the next dose.
For those of us who are sensitive to the effects of pharmaceuticals, combining that curve with two-at-once dosing could take us on a roller coaster ride through highs and lows of drug activity -- just like some of you experience with your blood glucose levels and insulin. Taking a lower dose more frequently may be less convenient, but better for maintaining a steady level of medication. It is the theory behind splitting one's Lantus dose, changing 2q6 (two tablets every 6 hours) to 1q3 (one tablet every 3 hours), and as we split the time increments even more finely, migrating to intravenous drips and insulin pumps.
While we trust our doctors to give us the appropriate administration instructions for our discrete-dose medications, sometimes we need to argue that those instructions might not be right for us, and that an alternate dosing method may be better. If you're finding huge peaks and short tails, you might want to discuss the idea of taking smaller doses, more frequently. [Note: I am not suggesting that anybody change a prescription dosing or dose administration plan without your doctor's approval. The activity peaks and valleys may have specific therapeutic value.]
Medications are not the only place where incorrect or suboptimal directions can cause us grief.
In a previous post, I mentioned that I had decided to make my Sunday ride a round-trip to my STARFLEET meeting. The route, nominally fifteen miles, is relatively flat (though there are spots where it does not feel that way!), had a definite end-point/rest stop, and if things utterly failed, I'd have friends to help, and a public-transit option to get home.
As usual, I plotted my course in MapMyRide and printed out the maps and directions, and made sure I understood the basic path I'd be taking before I set out.
And once again, I've learned why the pros "pre-ride" their races, whether on their bicycles or in the team car, and don't just rely on maps...
(To be continued in part 2)
