Medicine Tips for Seniors

What special risks do medications pose for seniors?

As people grow older, new drug prescriptions are almost as inevitable as gray hair and reading glasses. Two-thirds of all seniors take at least one medication each day, and 25 percent take three or more.

Many seniors owe their lives -- or at least their lifestyles -- to medications, but the remedies can also carry serious risks.

As a senior, you're especially vulnerable to the effects of prescription drugs. Not only do people in your age group take more drugs than any other group, you're also more sensitive to the effects of medication.

Each year, in fact, more than 9 million American suffer side effects or have a negative reaction to medication. Fortunately, a few simple steps can help you take the danger out of your drugs.

How can I find out about possible dangers from my medication?

The first step to staying safe is understanding the risks. Read the warning labels on all over-the-counter medications, and ask your doctor about the side effects of all your prescriptions.

You should know that two common medications, the sedative diazepam (Valium) and the painkiller propoxyphene (Darvon), are now considered to be inappropriate for people over 65. Unfortunately, some doctors still give these prescriptions to seniors, often with disastrous results. If your doctor suggests such a medication, ask him or her for a safer alternative.

You should also ask your doctor if your medications can clash with each other. Drug interactions are a serious concern for seniors; according to the Council on Family Health, almost 40 percent of all drug reactions reported each year involve people over 60.

For instance, combining aspirin with the blood-thinner warfarin, used to treat heart disease, will increase the risk of bleeding stomach ulcers thirteenfold.

Make sure your doctor knows about every prescription and nonprescription drug you are taking, including herbal remedies and nutritional supplements -- and even your daily multivitamin.

How can I take my medications safely?

1) Follow your doctor's directions exactly.

This sounds pretty basic, but the Food and Drug Administration reports that 40 percent to 75 percent of all older adults take their medications at the wrong times or in the wrong amounts.

Make you sure you understand how and when to take all your medications. Have your physician write down the directions, if necessary, to be sure you will remember them.

2) If you have trouble reading labels, ask for large-print type on your prescription labels.

A magnifying glass and a bright light can also help. Don't reach for your medicines in the dark -- it's too easy to mix them up.

3) Develop a system for keeping track of your medications.

For instance, you can start your day by sorting your medications into separate dishes, one for morning pills and one for evening pills. (Your physician may have pill-sorting trays that he or she can recommend.)

You can also try turning your medicine bottle upside down every time you take a pill. It's an easy reminder that you've already taken that medicine.

4) Always keep taking a drug until your doctor says it's time to quit.

Stopping when you "feel better" can lead to unforeseen complications.

5) Check the expiration dates on your medicine bottles and throw out anything that's past its prime.

6) Don't take anyone else's prescription medicine or give yours to others.

7) Store your medicines in a cool, dark, and dry place.

(The medicine cabinet in your bathroom is not a good choice. Try a dresser drawer instead.)

8) Contact your doctor if you experience any side effects

-- including dizziness, constipation, nausea, sleep changes, diarrhea, incontinence, blurred vision, mood changes, or a rash -- after taking a drug.

9) Obtain a copy of your complete medical record to give to any new doctor or specialist you see.

Be sure to remind them about any medications, chronic conditions, and allergies to medications of which you're aware.

10) If you have trouble taking your medicines at the same time each day, buy a timer that will go off at set times.

Further Resources

You can order the pamphlet "Taking Your Medicines Wisely: A Guide for the Elderly" from the National Institute on Drug Abuse at 5600 Fishers Lane, Rockville, Maryland 10857.

You can also call The Council on Family Health at 212-598-3617 for copies of "How to Prevent Drug Interactions" and "Ten Guides to Proper Medicine Use."

References

W.B. Dalziel, M.D., et al. "The Top Ten Problem Drugs for the Elderly." CPJ/RPC, July 1996.

"Andreas E. Stuck et al. "Inappropriate Medication Use in Community-Residing Older Persons." Archives of Internal Medicine, October 10, 1994.

Mark H. Beers et al. "Explicit Criteria for Determining Inappropriate Medication Use in Nursing Home Residents." Nursing Home Medication Use, September 1991.

General Accounting Office. "Prescription Drugs and the Elderly: Many Still Receive Potentially Harmful Drugs Despite Recent Improvements." GAO/HEHS-95-152, July 1995.

Reviewed by Peter Pompei, MD, a geriatrics specialist and associate professor of medicine at Stanford University School of Medicine.

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