The older we get, the more prescription medicines we seem to need – sometimes too many.
According to the Centers for Disease Control, 68 percent of adults 65 and older take three or more prescription drugs, and 42 percent take five or more. And from 2006 to 2014, the rate of emergency department visits by older adults for adverse drug effects has doubled.
Sometimes, the increase in prescriptions can result from newer or better medications, particularly antidepressive and cardioprotective ones. But all too often, it’s from lack of medical coordination. “I think the issue is that a lot of times people see more than one specialist,” says Dr. Lee Lindquist, a geriatrician and associate professor at Northwestern University’s Feinber School of Medicine, “and they may be given more than one medicine [by each].”
That’s why not just care, but a coordinated care plan is so important. It’s why our three-part needs assessment includes a thorough review of your health and medications. And why, when we accompany you to doctor appointments, we make sure that all of your doctors and family members know about all your medications and all your doctors’ recommendations.
And sometimes, the problem isn’t how many medicines, but which kind. With older adults taking more meds, there’s more risk of side effects and adverse drug reactions. So whether you take your meds when you wake up, during the day, or at bedtime; whether you take them with or without food; it’s very important to take them with caution – particularly these:
NSAIDs (NonSteroidal Anti-Inflamatory Drugs such as ibuprofen) can reduce pain and inflammation, but also increase blood pressure and the risk of stomach bleeding. They can affect your kidneys and make heart failure worse. If you’re over 75, if you take oral steroids, blood thinners (even as mild as low-dose aspirin), or if you have kidney problems or heart failure, you should avoid NSAIDs. If there’s absolutely no alternative, a proton pump inhibitor, such as omeprazole (Prilosec) or misoprostol (Cytotec) can reduce the risk of bleeding.
If your doctor prescribed Digoxin (Lanoxin) for irregular heartbeats or heart failure, be aware that it can be toxic in older adults, particularly those with moderate or severe kidney problems. Ask your doctor about other medications which are safer and more effective. Avoid any dosage higher than 0.125 mg per day; higher doses increase toxicity with no added benefit.
Avoid Diabetes drugs such as Glyburide (Diabeta, Micronase) and chlorpropamide (Diabinese), which can cause dangerously low blood sugar.
Muscle Relaxants such as cyclobenzaprine (Flexeril), methocarbanol (Robaxin), carisprodol (Soma), and others can leave you groggy, confused, and more susceptible to falls, constipation, dry mouth, and urination problems.
Anxiety Medications including diazepam (Valium), alprazolam Xanax), and chlordiazepoxide (Librium) can cause confusion and increase your risk of falls. So can Sleeping Pills including zalephon (Sonata), zolpidem (Ambien), and eszopiclone (Lunesta). What’s more, because your body needs more time to get these drugs out of your system, you’ll be feeling them not only the morning after, but through the rest of the day as well.
Certain Antidepressants such as amitriptyline (Elavil) and imipramine (Tofranil), Anti-Parkinson drug trihexyphenidyl (Artane), and Irritable Bowel Syndrome drug dicyclomine (Bentyl) can cause urinating problems in men and confusion, constipation, dry mouth, and blurry vision in men and women alike.
Pain Reliever meperidine (Demerol) can heighten the risk of seizures and can cause confusion.
Over-The-Counter products with antihistamines such as Benadryl, AllerChlor, Chlor-Trimeton for colds, coughs and allergies, and sleeping pills like Tylenol PM, can cause confusion, blurry vision, constipation, urinating problems, and dry mouth.
Doctors often prescribe Antipsychotics such as haloperidol (Haldol), risperidone (Risperdal) and quetiapine (Seroquel) to treat behavioral problems in older adults with dementia. But they can increase the risk of stroke or even death, cause tremors, and increase the risk of falls. Unless you’re being treated for psychosis, use them with caution.
Estrogen pills and patches, prescribed for hot flashes and other menopausal symptoms, can increase risks of breast cancer and blood clots.
For senior care that’s coordinated to custom-fit your needs, please call or contact us to arrange a comprehensive consultation.