- Cameron Oglesby
Is a monster lurking in your medicine chest?
Every day, some 750 older Americans are hospitalized for side effects of one or more medicines they’re taking.
That doesn’t mean the meds are unsafe. Before a prescription or over the counter medication can make it into your medicine chest, it must meet two FDA criteria: First, it must be efficacious, i.e., it must actually do some good. And second, it must be safe.
But safety doesn’t necessarily mean the same thing for everyone. That’s why there are warnings printed on the packaging. Some meds don’t work and play well with others, potentially creating serious side effects. And some work differently with different demographic groups, particularly older adults.
That’s because aging changes the way our bodies function. Lungs, kidneys and livers, for example, don’t work as efficiently as they used to. Your body metabolizes your meds less effectively, keeping them in your bloodstream and organs longer. So the more meds you take – and it’s not unusual for people in their 70s and 80s to be taking at least four or five of them – the more chance of harmful side effects like confusion, lightheadedness, even internal bleeding.
That’s why the American Geriatrics Society’s Health in Aging Foundation recommends that whatever else you take these drugs with, you take them with caution:
· Ibuprofen-based pain relievers (formally known as Non-Steroidal Anti-Inflammatory Drugs) can increase the risk of internal bleeding – particularly if you’re over 75, take oral steroids, or blood thinners like aspirin, Eliquis, Plavix, Pradaxa, Savaysa, Xarelto, or Coumadine. They can also raise your blood pressure, aggravate kidney problems, and make heart failure worse. So don’t take them regularly, and when you do, take them with extreme caution. If there’s no other alternative t NSAIDs, proton pimp inhibitors like Prilosec or Cycotec can reduce the risk of bleeding.
· Taking Digoxin (AKA Lanoxin) for heart failure or irregular heartbeats can be toxic to older people with moderate or severe kidney problems. For most, other meds are safer and more effective. If you have to take Lanoxin, limit dosage to 0.125 mg per day; higher doses provide much more toxicity than added benefit.
· Diabetes drugs including Diabeta, Micronase, and Diabinese can dangerously lower your blood sugar.
· Because older adults take longer to metabolize them, Muscle relaxants such as Flexeril, Robaxin, Soma, and others can leave you feeling groggy, and increase your risk of falls. If that’s not enough, they can also cause dry mouth, constipation, and problems urinating. Oh, and there’s little evidence that they work well.
· Tranquilizers like Valium, Xanax, or Librium and sleeping pills like Sonata, Ambien, and Lunesta can remain in your body for hours after wake-up time, leaving you confused and heightening your risk of falls.
· Similarly, OTC products with antihistamines (Benadryl, AllerChlor, Chlor-Trimeton, and Tylenol PM) can cause confusion, blurred vision, constipation, urinating problems, and dry mouth.
· So can antidepressants Elavil and Tofranil, anti-Parkinson drug Artane, and irritable bowel drug Bentyl.
· Older adults with dementia who have behavioral problems are often given antipsychotics such as Haldol, Risperdal, or Seroquel. But they can increase the risk of strokes or even death, cause tremors, and make falls more likely.
· Estrogen pills and patches may ease hot flashes and other menopause-related symptoms, but they can also increase cancer and blood clots.
Of course, different people’s bodies react to different medications in different ways. So before your start or add a new med, or if you have questions about one you’ve been taking, it’s important to discuss it with your doctor or pharmacist.
The same holds true of other aspects of your life as well. No two people think exactly alike, feel exactly alike, or have the exact same priorities, values, activities, interests, and lifestyles. That’s why, at Senior Insights, our thorough three-part needs assessment helps us get to know not just your medical condition, but you – and to custom-design a holistic senior care management plan accordingly.
If you agree that’s a healthier approach, please contact us.