Seniors are likely to take many medications and supplements, whether prescribed by their doctors or purchased over the counter. In many cases those medications are necessary and helpful, even life saving.
However, many medications have potentially harmful side effects, particularly in older patients, whose metabolism may be less efficient in detoxifying drugs and clearing them from the body. In addition, many drugs interact with each other or with certain foods.
The result is that older people taking multiple medications run a significant risk of potentially harmful reactions. These can range from minor episodes of dizziness, drowsiness, or digestive upsets to potentially fatal reactions.
Studies have shown that in the U.S., the U.K., and other developed countries, the majority of people over the age of 60 take three or more prescription medications every day, and ten percent take seven or more medications daily.
"The more drugs a patient takes, the greater the risk of drug interactions and adverse effects," conclude the authors of a major new study from Germany, "Potentially Inappropriate Medications in the Elderly: The Priscus List."
Some simple steps seniors can take
In an excellent summary, Consumer Reports lists some common-sense steps that anyone taking multiple medications should take:
-- Schedule a medication review with a health care provider. Come prepared with a complete list of the prescription medications, over-the-counter remedies, vitamins and other supplements you are taking (or bring the whole batch with you). Your goal is to know what each drug is for, if you should still be taking it, and if it's safe to take it along with all your other medications.
-- Make sure that all of your doctors know all of the medications and supplements you are taking.
-- After starting any new medication, be alert for any side effects. Ask for a medication consult from your physician or pharmacist, read the literature that comes with the medication, and note any changes you experience.
Medications That May Lead to Interactions in Seniors
The German study mentioned above identified 83 drugs that are particularly risky for elderly patients, in 18 different classes. Many of those medications have also been identified as risky in other studies. The original article and full list can be found ataerzteblatt.de (link above).
Some of the most frequently prescribed medications include the following, listed under their generic names:
-- NSAIDS: indometacin, ketoprofen, piroxicam
-- Opiods: meperidine
-- Heart rhythm drugs: quinidine, flecainide, digoxin
-- Antibiotics: nitrofurantoin
-- Antihistamines: hydroxyzine, clemastine, chlorpheniramine
-- Urinary spasm medications: oxybutinine,solifenacine
-- Blood thinners: ticlopidine, prasugrel
-- Antidepressants: amitriptyline, doxepine, imipramine, clomipraine, trimipramine
-- SSRIs: fluoxitine
-- MAO inhibitors: tranylcypromine
-- Anti-nausea medications: dimenhydrinate
-- Cardiovascular medications: clonidine, doxazosine, prazosine, terazosine, methyldopa, reserpine, nifedipine (non sustained-release)
-- Nervous system medications: thioridazine, fluphenazine, levomepromazine, perphenazine, haloperidol, olanzapine, clozapine
-- Muscle relaxants: baclofen, tetrazapam
-- Sedatives: chlordiazepoxide, diazapam, flurazapam, bromazapam, prazepam, nitrazapam, alprazolam, temazepam, lorazepam, zolpidem, zopiclone, zaleplone, doxylamine, chloral hydrate
-- Anti-dementia medications: pentoxifylline, naftidrofuryl, nicergoline, piracetam
-- Anti-epileptics: phenobarbital
It is important to remember that any of the medications listed above may be necessary, effective and safe. However, especially for the elderly, their use, especially with other medications needs to be carefully monitored.
Reference: "Potentially Inappropriate Medications in the Elderly: The PRISCUS List," (DOI: 10.3238/arztebl.2010.0543)
Robert Adler - Robert Adler is a science and technology reporter and book author. He divides his time between Santa Rosa, California and Oaxaca, ...
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