Researchers have estimated that medications cause 17 million visits to emergency rooms and 8.7 million hospitalizations each year [Johnson, J.A. and Bootman,, J. L. “Drug-Related Morbidity and Mortality: A Cost-of-Illness Model.” Archives of Internal Medicine, 1995; 155:1949-1956.] It has been estimated that the drugs that are supposed to relieve our symptoms or cure us, may be responsible for as many as 300,000 deaths annually.

Given that medicines are one of the leading causes of death in America, it becomes imperative for physicians, pharmacists and patients to be aware of those drugs that are most likely to cause mischief. A new article in the New England Journal of Medicine [“Emergency Hospitalizations for Adverse Drug Events in Older Americans”] throws some light on this problem.

Dr. Daniel Budnitz and his colleagues at the Centers for Disease Control and Prevention (CDC) analyzed data from 58 hospitals that participated in an adverse drug-event surveillance project. The researchers were looking for medications that led to emergency hospitalizations. They found that blood thinners were especially problematic. Roughly one-third of all the admissions were from warfarin (Coumadin). Oral anti-platelet drugs (such as aspirin, clopidogrel [Plavix], dipyridamole, prasugrel [Effient], and ticlopidine [Ticlid]) added another 14%. Insulin and oral diabetes medications were also high on the list. Of course no one should ever stop a medication without discussing the ramifications with the prescriber. Sometimes a medication is so essential it has to be taken regardless of the risks. When that happens, though, it is essential to know the symptoms and side effects of problems and be extra vigilant so you can catch them before they lead to hospitalization.

High-risk drugs that should rarely, if ever, be prescribed to older people also contributed substantially to hospitalizations. It astonishes us that these drugs, found on a list called the “Beers-criteria of potentially inappropriate medications,” are prescribed at all to senior citizens. Sadly, many primary care physicians are unaware of the Beers list or problem drugs.

We have prepared a Top 10 List of Potentially Problematic Pills in our new book, Top Screwups Doctors Make and How to Avoid Them. Here is our list:

  • Anticoagulants
  • Digoxin
  • Anti-inflammatory drugs (NSAIDs)
  • Acetaminophen
  • Narcotic analgesics
  • Corticosteroids
  • Anti-arrhythmics
  • Atypical Antipsychotics
  • Antidepressants
  • Quinolone-type antibiotics

To learn which drugs are on the Beers list and for more details, brand names and a list of other problem pills, check out book, Top Screwups Doctors Make and How to Avoid Them.

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  1. John M.

    You fail to point out the fact that brand-name companies outsource their manufacture of drugs to the same manufacturers as the generics. What is needed is a very simple law: Make illegal the importation of drugs originating in any country with slipshod standards. The whole Indian and Chinese government are up for sale to the biggest briber. They should be out of the supply chain permanently. Read the subtext.

  2. GHH

    I am appalled at the lack of knowledge by physicians on this subject.
    My late husband took a number of drugs, separately as macular degeneration required that he take vitamins separately as a multi-vitamin had too much “stuff” in it. He also had atrial fibrillation for which he took warfarin for many years, which you mentioned this morning. This was monitored quite closely as he had to have blood taken quite often to check on the bleeding capacity.
    After so many years, Pradaxa came on the market. He wanted to try it so he didn’t have to get “stuck” all of the time. He was told that this drug did not need monitoring, so his doctors did not do it anymore. After a few months of this, he had a stroke – at least that’s what it seemed to be when he went for his morning walk, and died.
    His immune system was compromised, according to one of his doctors. The artery leading to his heart was said to be blocked which never would have happened had he stayed on the coumadin (warfarin) which was checked every few weeks.
    I fault the doctors for not checking this more carefully.

  3. Marie

    LP –
    I totally agree with your lines:
    “We’re becoming a drug dependent country. I’d gamble to say that if you picked a random American walking down a street in New York City that they would either be on an something for depression, anxiety, insomnia, high blood pressure, or cholesterol”.
    The situation is exactly the same here in Sweden – and in many other countries.
    Almost all interesting websites (this one, for instance) and books I have “found” originate in the U.S. I am so glad that I can read them without problem.
    I think Joe and Theresa Graedon’s book – Top Screw Ups That Doctors Make – and how to avoid them – is an excellent book.
    I have also read many other interesting books for instance:
    Are your prescriptions killing you? (Armon B. Neel and Bill Hogan)
    The Risks of Prescription Drugs (edited by Donald W. Light)
    It`s important to read many different books to make it easier to decide to take/ or not to take a certain kind of drug for the rest of your life.
    There are also many u-tubeclips on different subjects.

  4. J.J.

    Just want to say thank you for idea of Listerine for underarm odor prevention. When my partner was in an accident last year and broke both shoulders, her arms were bound to her body. She got a terrible yeast infection (Ny-Stop – the miracle powder!). After that cleared up, she began to have terrible underarm odor. I remembered reading about Listerine here and gave it a try. Viola! The odor stays away pretty much all day now. Thank you, People’s Pharmacy!!

  5. LP

    BMT, your comment is just a testament to how much more interested doctors and pharmacies are in making money off of a product than someone’s physical well-being. People are naive to think that doctors don’t receive monetary benefits from pushing particular drugs; and look at how many advertisements there are today on TV for medications. We’re becoming a drug dependent country.
    I’d gamble to say that if you picked a random American walking down a street in New York City that they would either be on an something for depression, anxiety, insomnia, high blood pressure, or cholesterol. Maybe even a combination of things.
    Unfortunately many people do not read the side effects of a medication before they take it because they assume that because the doctor prescribed it that they must somehow be at a less risk of developing problems.
    Yes, doctors have years of schooling, but no one knows your body better than you do. Don’t blindly trust anything a doctor has to tell you. Do your research. Read up on the long term effects of something before you take it.

  6. Tawny

    I really enjoyed reading the article and appreciate all the information you have shared. I have my daughter that is severally disable who can not communicate but shows great potential in becoming a great contribution to society. that I have to look out for. and I take her care very serious and appreciate anything any one is will to teach me for her sake. She has been my biggest accomplishment and still a working progress. Thank you for the info. and coming from a very over protect mom who LOVES HER KIDS SO MUCH.

  7. BMT

    In August through September I was in 2 different emergency rooms with very low potassium in blood. Was admitted to hospital for five days and then into sub-acute rehab nursing care. Since discharge was back at another emergency room with same problem.
    Then saw a doctor twice at a Family Practice which has a geriatric physician on staff. During all of this I had prescriptions filled at two different pharmacies. They were for potassium chloride. I am eighty and take Vasotec for blood pressure, a diuretic and a low dose of prednisone.
    I kept feeling worse and finally stopped the Rx for potassium. Have experienced slow improvement and
    am eating high potassium foods.
    THEN, when I purchased the new book, Top Screwups Doctors Make and How to Avoid Them… I found that my
    PROBLEM was Screwup #9… and also, 2 different pharmacists had also “Screwed Up.” It was sad to realize that Vasotec and potassium drugs may cause fatal interactions in the elderly.
    3 ERs, 2 Pharmacists, 1 SubAcute Rehab, and 1 doctor–2 times. Am I too old to go to Med School?
    Thank You for vigilance and for the book.

  8. edwin a

    In your report about dangerous prescription drugs you list Wafarin as the number one problem drug. I have been on this medication for seven years and although I do find it to be a nuisance I have never had a reason to think of it as dangerous. Please enlighten me as to why this is especially problematic, so that I can be more alert to its dangers.
    Thank you
    Ed A.
    The tricky problem with anticoagulants in general is that you the tight rope between preventing a blood clot on the one hand and “thinning” the blood too much, which could lead to excessive bleeding. That is why you have to have your blood monitored regularly to make sure you are in the sweet spot. Think of it a bit like the story of Goldilocks and the Three Bears. Not too hot…not too cold. It has to be just right.
    Many medications can interact with warfarin to affect blood levels and effectiveness. And as you probably know, so can certain foods.
    Botton line is that warfarin saves lives, but it must be used carefully with appropriate medical monitoring. Our book, Dangerous Drug Interactions, tells much more about this interaction and how to detect trouble.

  9. Jan S.

    I do take a lot of pills but the one that really brought me misery was MetroGel cream for rosacea. I didn’t see the side effect of cold sores and for a year had terrible, awful cold sores that were painful and unsightly. They lasted at least 2 weeks and nothing helped. I still had them after stopping that cream, but Lysine has helped. That medication has given me a life-long problem; always read the side effects!

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