While medicines can help you stay healthy, inappropriate prescriptions and drug interactions can lead to dangerous, and even life threatening side effects.
How many bottles are in your medicine chest? If you’re in your 60s or beyond, chances are you take at least one drug — and probably a cocktail of them — to lower your blood pressure, ward off a heart attack, manage thyroid disease, ease depression, or slow the progress of other health conditions.
In a 2016 survey of adults ages 62 to 85, more than a third of respondents reported taking at least five prescription drugs. Nearly 40 percent took over-the-counter medicines, and almost 65 percent were on dietary supplements. While medicines can help you stay healthy, they also come with risks. Inappropriate prescriptions and drug interactions can lead to dangerous, and even life threatening side effects.
Here’s what you need to know about medication safety for seniors.
Inappropriate drug prescribing
About one out of every five drugs prescribed to seniors is inappropriate for them, and therefore more likely to cause side effects, according to a 2012 study in PLos One. Diphenhydramine (Benadryl, Dramamine, Nytrol) and amitriptyline (Elavil) were two of the most commonly prescribed inappropriate drugs with a high risk of side effects, the researchers found.
A drug you take to treat one disease could make another condition worse. A more recent PLoS One study found that about 20 percent of older adults take medicines that counteract each other. “More than 9 million older adults in the U.S. are being prescribed medications that may be causing them more harm than benefit,” said Jonathan Lorgunpai, study co-author and medical student at the Yale School of Medicine. “Not only is this potentially harmful for individual patients, it is also very wasteful for our healthcare system.”
As you get older, your body no longer metabolizes medicines in the same way. Your kidneys and liver don’t remove medications from your body as efficiently as they once did. This means one dose doesn’t have a chance to clear your system before you take the next dose. As medicines build up in your body, they increase your risk for side effects like falls, confusion, kidney failure, and GI bleeding.
An estimated 100,000 Americans age 65 and older are hospitalized each year for adverse drug reactions, according to a 2011 study in The New England Journal of Medicine. Most of these reactions are blamed on a handful of drugs, including diuretics, NSAID pain relievers, clot preventing drugs, and diabetes medicines.
The more medicines you take, the more likely some of them won’t get along. “Older adults are the largest consumer of prescription drugs,” said Stacy Tessler Lindau, MD, assistant professor of medicine at the University of Chicago Medical Center. “We find that they commonly combine these prescription medications with over-the-counter medications and dietary supplements, which can increase their vulnerability to medication side-effects and drug-drug interactions.”
For example, taking an anti-clotting drug like clopidogrel (Plavix) or warfarin (Coumadin) with aspirin or naproxen (Naprosyn) increases your risk for bleeding. A statin drug plus the cholesterol drug niacin (Niaspan, Niacor) can cause muscle damage. Aspirin and other NSAIDs can slow the rate at which your body removes immune-suppressing drugs like cyclosporine and heart medicines such as digoxin.
How to avoid drug side effects and interactions
Seeing multiple doctors to manage several conditions can increase your risk of getting inappropriate prescriptions or having drug interactions. To prevent these issues, keep a running list of all the medicines you take, and share it with every doctor you see, and your pharmacist (you should also use only one pharmacy). “Patients need to inform their providers about all medications they use – prescription and nonprescription – and should ask their physician or pharmacist about interactions any time they start a new drug, on their own or following the doctor’s recommendation,” said Lindau.
Whenever you get a new prescription, ask the doctor what side effects it can cause, and what to do if you experience those side effects. Don’t just read the package insert, which can be confusing to anyone without a medical degree. Also ask your doctor to explain how to take the medicine. Some drugs shouldn’t be taken at the same time, or with certain supplements or foods.
Once a year, go over your entire list of medications with your primary care doctor and pharmacist. Find out if you can wean off any of your medicines. If you ever develop side effects while taking a medicine, let your doctor know right away.
April 06, 2017
Janet O’Dell, RN