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Medications that Seniors Should Use With Caution.

Medications that Seniors Should Use With Caution.

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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.

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How to Deal With Side Effects of Medicine?

How to Deal With Side Effects of Medicine?

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Prescription medications treat our illnesses, lessen our suffering when we are hurt, and help us avoid or manage chronic disorders. However, even when they perform as intended, they may produce unwanted side effects.

If a medicine is crucial to controlling a medical condition, don’t let that cause you to instantly rule it out. But you also shouldn’t take unfavourable responses at face value.

Know What to anticipate

According to Jim Owen, a doctor of pharmacy and vice president of practise and science affairs at the American Pharmacists Association, side effects can occur with practically any medication. They frequently occur with everything from birth control pills to chemotherapy medications that treat cancer.

For instance, many prescription medicines travel through your digestive system and result in stomach issues including nausea, diarrhoea, or constipation.

Others, including blood pressure or diabetic medications, muscle relaxants, and antidepressants, may make you feel lightheaded. Some might give you a groggy, downcast, or agitated feeling. Some might result in weight gain. Also, some may interfere with your ability (or desire) to have sex or with sleeping.

Risk of Developing Side Effects

Each of us is special. However, some of us are more susceptible to experience adverse effects than others due to certain personal circumstances. Age is the most important of these variables. The extremely young and the extremely old are ALWAYS more prone to adverse effects.

Little adults are not children. Babies’ bodies process medications differently from adults’ bodies in terms of absorption, metabolism, and elimination. Younger children typically have a slower rate of stomach absorption of medication but a greater rate of intramuscular (IM) absorption. They have a greater liver to bodyweight ratio and a higher body water to lipid ratio in the early stages of life. Their kidney function is also immature, as are their liver enzymes.

Additionally, their blood-brain barrier, a layer of cells that prevents drugs from passing from the bloodstream to the brain, has a higher permeability. Studies have found that older persons often use more medications and are twice as likely to visit the ED. This is due to a drug-related adverse event and seven times more likely to be hospitalised. They are more likely to be on drugs like warfarin, insulin, digoxin, and anti-seizure medications that have a razor-thin line between being beneficial and harmful.

Their bodies typically contain more fat and less water, which may lengthen the duration of some medications’ effects. Liver metabolism and kidney excretion are often slowed down. Additionally, due to the fact that their brains are more susceptible to the sedative effects of medications. Also, pre-existing conditions like dizziness, eye, and ear issues may be made worse, they are at an increased risk of falling.

Individual factors that also increase risk

The likelihood of side effects is significantly influenced by a number of additional factors. Examples that stand out include:

Genetics: The study of how your genes affect how you react to medications is known as pharmacogenetics, and genetic factors account for 20–95% of patient variability. Testing for differences in liver enzymes is becoming more common in this area of pharmacology, which is developing quickly.

For instance, the conversion of codeine to one of its active metabolites, morphine, requires metabolism through CYP2D6. In the 5–10% of patients who have poor metabolizers, very little codeine is metabolised to morphine, which leads to insufficient pain alleviation. A increased risk of toxic effects, such as respiratory depression, results from 1-2% of people having ultra-rapid metabolizers.

Kidney operation. If your kidneys aren’t working properly, taking medications that are excreted through the kidneys increases your risk of experiencing negative effects. When kidney function is compromised, some other medications may become less effective.

Gender: Compared to men, women have less activity of some hepatic enzymes, a higher body fat to water ratio, and less kidney clearance of medicines. According to studies, women are more likely than men to experience drug-induced liver damage, gastrointestinal side effects, allergic skin reactions, and long QT syndrome.

Ask for assistance

Tell your doctor about typical side effects when they prescribe a new medication. Together, you, your doctor, and your pharmacist should share information so that everyone is informed, advises Owen. You should be aware of the side effects that can be avoided, those that will go away on their own, and those that are significant.

Any unusual symptoms you experience after starting a medication should be discussed as soon as possible with your doctor or pharmacist. According to Liu, this includes changes in your sexual life, which many patients are ashamed of or frightened to discuss.

Your doctor may advise you to continue with your existing plan for a little while longer because some side effects fade with time as your body becomes adjusted to a new medication. In some circumstances, you might be able to reduce your dosage, try a different medication, or incorporate another into your regimen, such as an anti-nausea treatment.

Factors Related to Drugs

influences brought on by drugs include:

  • Medication’s dosage: The danger of side effects increases with dosage.
  • The phrase used is: For instance, compared to oral steroids, which have a more systemic effect, inhaled steroids target the lungs specifically and cause less side effects.
  • How the medication is transported, metabolised, and removed
  • Concurrent use of additional pharmaceuticals.

REFERENES:

  • https://www.webmd.com/a-to-z-guides/features/manage-drug-side-efects
  • https://www.healthlinkbc.ca/health-topics/dealing-medicine-side-effects-and-interactions
  • https://www.drugs.com/article/drug-side-effects.html

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How to make smart medicines choices for ourself?

How to make smart medicines choices for ourself?

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IIn primary, secondary, and tertiary care settings, medications are a crucial component of patient management. Medication safety is still an issue both within and outside of hospitals, since roughly 9% of prescriptions contain errors1 and patients frequently take their prescribed medications inappropriately or not at all.

By 2036, when one in four people will be 65 or older, as the baby boomer generation reaches their senior years, the population that requires the majority of drugs is anticipated to have doubled. This tendency is prevalent in many industrialised nations, where efforts are being made in social and health policy to reduce unnecessary morbidity that results in the need for healthcare and loss of independence.

Apps and other digital tools have been included into healthcare systems recently to help with drug management. However, these new smart technologies could provide new difficulties for patients, nurses, pharmacists, and prescribers. Patients must take their drugs as directed, report any side effects, and the healthcare system and employees must make sure that the right prescriptions are written. Human factors are just as crucial as the role of technology in achieving better patient outcomes.

As a follow-up event to the International Forum on Quality and Safety in Health Care Europe 2021, a roundtable discussion was conducted in July 2021 to talk about the difficulties and potential directions in smart drug management.

What should you ask to the doctor?

A treatment that is good for you depends on a variety of things. Ask your doctor the following queries:

Why do I require this medication?

Eva Waite, MD, assistant professor of internal medicine at Mount Sinai Hospital in New York City, asserts that understanding the purpose of taking a drug increases the likelihood that you will really take it.

Your health may suffer if you skip a dose of a medication. For instance, not taking your blood pressure medication can result in heart disease or a stroke.

What negative impacts are there?

Learn what to anticipate. You can use it to determine which meds suit your lifestyle the best. Together, you can try to choose the medications that have the fewest adverse effects or that you find most tolerable, advises Waite.

For instance, some medications may cause you to feel as though you need to use the restroom more frequently. This might not be a huge concern for some individuals. You may need to locate a medication that manages your disease without this adverse effect if, however, your profession requires you to spend a lot of time in a car.

How frequently should I take it?

Talk to your doctor if it’s a struggle for you to remember to take your medication multiple times per day.

According to Waite, many drugs are available in combinations. This means that you might be able to take only one pill that contains all three blood pressure medications rather than three separate ones.

What is the price?

Even with health insurance, prescription medicines can be expensive. That shouldn’t deter you from taking them.

If you let your doctor know that the expense is a concern, he or she will frequently be able to recommend a less expensive option, according to Filer. “Your doctor may occasionally change the dosage of a drug so that you only need to take it once day rather than twice. The price may also change as a result of this.”

Discuss the medications you are taking.

Write down all of the medications you currently take before your appointment. The list should be with you. Include any supplements you take as well, advises Waite. This comprises supplements made of vitamins, minerals, and herbs. You can prevent negative interactions by using the knowledge.

She cites ginkgo biloba as an illustration. “Your doctor would want to know that you are taking it before adding a blood thinner that can increase your risk of bleeding, too,” she says.

How well your treatment plan is implemented can be greatly influenced by your connection with your doctor. Never stop taking a medicine without first talking to them about it.

Every problem you could have while taking a drug has a solution, according to Waite. Simply inform your doctor of them so you may work on a solution together.

REFERENCES:

  • https://www.webmd.com/a-to-z-guides/features/how-choose-medication
  • https://informatics.bmj.com/content/29/1/e100540
  • https://www.sciencedirect.com/science/article/pii/S2314728818300230

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