Older Adults and Medication Management
Our hair may become gray, our laugh lines more apparent and we may not have the energy we once did but aging is not lost youth but a new stage of opportunity, adventures, and strength.
Did you know…sometimes what we think is normal aging could be the effects or side effects of medications?
Many improvements in the health and function of older people during the past several decades can be attributed to the benefits of medications. Vaccines help prevent many infectious diseases such as influenza and pneumonia that once killed many older people. Antibiotics are often effective in treating serious infections, including pneumonia. Medications to control pain and other symptoms enable millions of people with arthritis to continue to function and medications to control blood sugar levels enable millions of people with diabetes to lead normal lives.
However, drugs can have effects that are not intended. Starting in late middle age the risk of side effects related to the use of medication increases. Older people are more than twice as susceptible to the side effects of drugs as younger people. Side effects are also likely to be more severe, affecting quality of life and resulting in more visits to the doctor and hospital.
Many older adults may take five or more medications each day…
Older adults use more medications than any other age group.
Sometimes, one of the medications being prescribed may cause new symptoms, or make symptoms you already have get worse. This could potentially lead to what is called a “prescribing cascade.” This is when a side effect of a medication is mistaken for a new medical condition, so your healthcare provider uses a new medicine to treat the side effect of the other medication. This can lead to being prescribed even more medications and having even more side effects.
Multiple medications can lead to interactions and have the potential for harmful side effects. For example, chronic medical conditions such as arthritis, diabetes, cardiovascular disease, and high blood pressure are more common in older adults and often require more complex management.
Medications may stay in the body longer…
Changes in body weight may have an effect on the amount of medicine you need to take and how long it stays in your body. Our circulatory system may slow down as we age and may affect how fast medications get to the liver and kidneys. The kidneys and the liver may not metabolize medications as well as they use to and affect the way medications breakdown and are removed from our bodies. This means the medication could stay in our bodies longer and cause more severe side effects if doses are not monitored.
Increased sensitivity to many medications is more common as we age…
In older adults some medications can even affect balance and your thought process. Some of these include:
Anticholinergics – medications that are used to treat overactive bladder, allergies, vertigo, nausea, nerve pain, or depression, even Benadryl (over the counter medication).
Sedatives and tranquilizers – medications prescribed for anxiety or as a sleep aid, such as Ativan and Ambien. These medications can increase fall risk or can provoke confusion.
If any of these concerns are happening with someone you support, consider making an appointment with a Geriatrician.
Geriatricians specialize in the unique health needs of the elderly, including chronic diseases, memory impairment, adverse effects of medications, immobility, and balance issues.
Some helpful tips:
- Get all prescriptions from the same pharmacy, preferably one that provides comprehensive services (including checking for possible drug interactions) and that maintains a complete medication profile for each person.
- Bring all medications being taken to medical appointments if requested to do so.
- Periodically discuss the list of medications being taken and the list of disorders with the doctor, nurse, or pharmacist to make sure the medications are correct and should be continued.
- Review the list of medications with the doctor, nurse, or pharmacist every time a medication is changed (doctors and pharmacists can check for interactions between medications).
- Make sure the doctor and pharmacist know about all over-the-counter drugs and supplements being taken, including vitamins, minerals, and medicinal herbs.
- Consult with your doctor before taking any new medications, including over-the-counter drugs and supplements.
- Always review the possible side effects for each medication being prescribed.
- Report to the doctor or pharmacist any symptoms that might be related to the use of a drug (such as new or unexpected symptoms).
- If the schedule of taking medications is too complex to follow, ask the doctor or pharmacist about simplifying it.
- If seeing more than one doctor, it is very important to make sure each doctor knows all the medications being taken.
Medicines can treat disease and reduce symptoms of the many conditions that are experienced by adults as they age but the combined effect of aging and poly-pharmacy places older persons at increased risk for adverse medication events. While medicines help us, they can also pose risks if not used carefully. For more information about medication and their side effects, please see resource, Merck Manuals https://www.merckmanuals.com/home/drugs/adverse-drug-reactions/overview-of-adverse-drug-reactions.
