Children are not just small adults. Drugs that are safe and effective for grown-ups, such as antidepressants or cough syrup, may not work well for kids. Pediatricians have worked hard to tailor children’s health care to their special requirements.
Older People May Take Too Many Meds:
It’s time we considered the other end of the life span as well. Too often, drugs prescribed for older people don’t take aging organs and altered body chemistry into account. The results can be dire, especially if the person is on several drugs that may interact.
One reader described his father-in-law’s health problems:
“At 89, he was hospitalized for a prostate operation and bladder infection. On discharge, he was sent to rehab for a week to regain his strength. But he severely strained his Achilles tendons when the staff exercised him too hard. They were unaware that Cipro, the antibiotic he was taking for the bladder infection, can weaken the Achilles tendon, especially in the elderly.
“Back home, he continued to get infections. The high dose of antibiotic he was prescribed took away his appetite and he lost weight steadily. One day, he awoke feeling very dizzy and was once again taken to the ER. The doctors ran tests on everything from his heart to his brain. All were negative. He was put on a powerful intravenous antibiotic, because he still had signs of a urinary tract infection.
“Next day he awoke disoriented and barely able to move. Fearing a stroke, the medical staff ordered more tests, which showed nothing.
“I asked the doctor if he knew that the patient had been on antibiotics almost continuously from December to June. Did he know the man had lost 10 percent of his body weight and felt miserable? With impaired kidney function dating back decades, he was in nearly complete renal failure when admitted to the hospital. Was it possible his problems were due to an accumulation of antibiotic or an interaction between his medications?
“The doctor acknowledged that elderly patients are often prescribed one medication on top of another, then given more medicine to deal with the side effects of the first drugs. There is often too little consideration for the fact that as we age we don’t process or excrete drugs as well as we did when we were younger.
“My father-in-law was receiving a dose of the antibiotic Levaquin on the highest end of the normal range for a young person. For someone like him, who had a history of kidney impairment and was 89 years old, it was probably more than his body could handle.”
The story has a happy ending. Once the medications were discontinued, he recovered and went home much improved. But his case is not unique. Older people frequently take multiple medications for a variety of conditions. Unless someone is vigilant there is a real risk of interactions or overdose.
Staying Out of the Hospital:
One study has demonstrated that older people taking inappropriate medications are more likely to be admitted to the hospital (Drug Safety, Jan., 2016). Avoiding potentially serious side effects and interactions can be difficult, but it can really benefit an older person’s overall well-being.
We have prepared a Guide to Drugs and Older People that discusses these issues in greater detail and provides a drug safety checklist for patients.