There is a higher likelihood of developing unfavourable drug side effects in older persons since they frequently have chronic health conditions that call for treatment with several medications. Moreover, older persons may react more strongly to some drugs.

The American Geriatrics Society’s Health in Aging Foundation advises older people to use caution when using the following types of medications. This includes some that can be purchased without a prescription. In order to help you make better-informed decisions about your medications and to reduce your chances of overmedication and serious drug reactions (over-the-counter).

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

Be wary of long-lasting NSAIDS such indomethacin and piroxicam (marketed under the brand name Feldene) (Indocin).

The issue: NSAIDs are prescribed to treat pain and inflammation. Older persons who take them run the risk of developing indigestion, stomach or colon bleeding, renal damage, high blood pressure, and worsening heart failure. They can also increase the risk of blood pressure and kidney damage. The quicker-acting ibuprofen (Motrin) and salsalate are preferable options if NSAIDs are required (Disalcid).

Use caution when combining NSAIDs with aspirin, clopidogrel (Plavix), dabigatran (Pradaxa), dipyridamole (Persantine), prasugrel (Effient), ticlopidine (Ticlid), or warfarin due to the increased risk of bleeding (Coumadin).

You might need to take a prescription medication like misoprostol (Cytotec) or a proton pump inhibitor like omeprazole to prevent stomach bleeding. Only if you regularly take NSAIDs, have a history of ulcers, or are 75 years of age or older. These drugs can help stop stomach bleeding (Prilosec).

Drugs that relax the muscles

Cyclobenzaprine (Flexeril), methocarbamol (Robaxin), carisoprodol (Soma), and other comparable drugs should be avoided.

The issue: These drugs may make you feel sleepy and dazed, raise your risk of falling, and result in constipation, dry mouth, and urine issues. However, there is little proof that they are effective.

Drugs that treat anxiety and sleeplessness

Avoid using benzodiazepines like diazepam (Valium), alprazolam (Xanax), or chlordiazepoxide (Librium, Limbitrol, Librax). Also, nonbenzodiazepine sleeping medications like zaleplon (Sonata) and zolpidem (Ambien).

The issue: Certain medications can make you more likely to fall and can also make you confused, especially in older folks. You may experience drowsiness and grogginess for a long time because it takes your body a long time to eliminate these medications from your body.

Medications for Anticholinergics

Be cautious of: medications including the antidepressants amitriptyline (Elavil) and imipramine (Tofranil). The anti-drug Parkinson’s trihexyphenidyl (Artane), the irritable bowel syndrome drug dicyclomine (Bentyl), the overactive bladder drug oxybutynin (Ditropan) and diphenhydramine, an antihistamine (Benadryl) often included in over-the-counter sleep medicines such as Tylenol PM.

Anticholinergic medications run the risk of causing low blood pressure, constipation, urinary issues, confusion, and other side effects.

Heart Medications

Digoxin (Lanoxin) in doses larger than 0.125 mg should be avoided.

Digoxin, a drug used to treat heart failure and irregular heartbeats, raises safety concerns because it can be harmful for older adults and those with impaired renal function.

Medications for diabetes

Glyburide (Diabeta, Micronase) and chlorpropamide should be used with caution (Diabinese).

These can result in extremely low blood sugar in elderly persons, which is a worry.

Opioids as painkillers

Meperidine (Demerol) and pentazocine should be avoided (Talwin).

The problem: These opioid analgesics, often called narcotic analgesics, can lead to confusion, falls, seizures, confusion, and even hallucinations, especially in elderly people.

Antipsychotic medication

Avoid anti-psychotic medications such haloperidol (Haldol), risperidone (Risperdal), and quetiapine unless you are being treated for schizophrenia, bipolar disorder, or some types of depression (Seroquel).

Antipsychotic medications raise the possibility of a stroke or possibly death; they also raise the possibility of tremors and falls.

Estrogen

Pay close attention to: Estrogen patches and pills, which are frequently prescribed to treat hot flashes and other menopause-related symptoms.

The issue: Estrogen can raise your chances of dementia, blood clots, and breast cancer. Female urine incontinence caused by oestrogens might also become worse.

Anticholinergics

These medications may be recommended by your doctor to help treat disorders like Parkinson’s disease, irritable bowel syndrome, and depression. Anticholinergics, however, can make people feel confused, have a dry mouth, and have hazy vision, especially in older people.

The likelihood of their causing urination issues is higher in older men. Antihistamines, tricyclic antidepressants, cimetidine, muscle relaxants, and several cold medicines are additional common pharmaceuticals with anticholinergic characteristics.

Ask your doctor the reason for any drug changes or new prescriptions that are made.

For instance, consider if it makes sense to continue taking the medicine that is causing the negative reaction if a new prescription is prescribed to lessen the adverse effects of one you are already taking.

When taking five or more medications already, it is extremely important to ask your doctor or pharmacist to verify any new prescriptions in a database of possible drug interactions.

Review your medication schedule.

Ask your doctor or other health care provider to examine the prescription drugs, dietary supplements, and vitamins you are taking once or twice a year. Check to see if you still need to take each one at the prescribed dosage.

Try to have the same pharmacy fill all of your medications if at all possible. Most pharmacies employ computer programmes that alert them to potential drug interactions.

Inform your medical professionals of any prior drug allergies you may have experienced.

REFERENCES:

• https://www.healthinaging.org/tools-and-tips/tip-sheet-ten-medications-older-adults-should-avoid-or-use-caution
• https://www.aarp.org/health/drugs-supplements/info-07-2011/medications-older-adults-should-use-with-caution.html
• https://www.webmd.com/healthy-aging/ss/slideshow-medications-seniors-should-use-with-caution

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