Old age ain’t for sissies–at least, that’s what some seniors tell us. It’s even harder when the medicines that are prescribed to help overcome ailments end up causing more harm than good.
A new study in the Archives of Internal Medicine (Feb 9, 2004) suggests that older Americans often get prescriptions that are inappropriate. Although the problem has been recognized for years, no progress has been made in reducing the likelihood that an older person will get a potentially dangerous combination of drugs.
The new study concludes that inappropriate drugs were prescribed at up to 16 million doctor visits in the year 2000. Such errors can lead to symptoms of depression, fatigue, confusion or even dementia. Sometimes the downward spiral leads an older person to be admitted to a nursing home, or it ends in disability and death.
Family members have shared stories of overmedication with us. One person wrote: “My mother is 70. She has no thyroid so she is taking Synthroid. She is also on clonidine, aldactone, donepezil, lorazepam and Provera. She is a walking drug store and sleeps 18 out of 24 hours. She has a list of side effects a mile long.
“She was diagnosed with dementia and high blood pressure. Now she is even worse. Poor mom and miserable dad!”
Sedation and dizziness are among the possible side effects this woman could be experiencing. But if you think her list is long, consider this report: “My father-in-law is taking 16 different drugs. They include: naproxen, Ascriptin, verapamil, amitriptyline, nitroglycerin, Pepcid, prednisone, lovastatin, Lasix, Tylenol PM, Detrol, terazosin, Flonase, omeprazole, diazepam and Centrum Silver. He doesn’t have much energy, and complains of muscle aches, weakness and back pain. Are all these medicines compatible?”
It is little wonder that this gentleman is feeling weak and spaced out. Several of his medications are suspect. Amitriptyline, diazepam and diphenhydramine (in Tylenol PM) are considered risky for older individuals.
As people age, kidney and liver function becomes less vigorous and it becomes more difficult to metabolize some medicines. The nervous system may also become more sensitive to side effects such as confusion or unsteadiness.
Our Guide to Drugs and Older People lists a number of medicines that are generally not appropriate for seniors and provides a Drug Safety Questionnaire. Anyone who would like a copy, please send $2 in check or money order with a long (no. 10) stamped, self-addressed envelope: Graedons’ People’s Pharmacy, No. O-85, P. O. Box 52027, Durham, NC 27717-2027.
A senior citizen with numerous medical problems may see several different doctors, and not all of them may be aware of every drug the patient takes. Shopping for the best price from many different pharmacies can make it hard for a pharmacist to detect potential interactions.
If the patient is forgetful, a family member may be the only one who is aware of the entire list of medicines being taken. The patient’s physician or pharmacist should review them periodically.
Many people know that they must be extra vigilant about any medicines their children are taking. Their elderly parents also need advocates.
The People's Perspective on Medicine