NEW YORK (MainStreet) Cynthia MacGregor developed a dry cough and blamed the blood pressure drug Lisinopril. Her nurse agreed and her doctor prescribed another drug to control her blood pressure, Losartan, but that drug made the 69-year-old dizzy and short of breath. With her blood pressure under control with three other drugs, she came off of that drug, too.
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Changes in the body associated with aging cause an increased risk of drug side effects in seniors. The elderly also often take multiple medications, which increases drug-drug interactions. According to the American Geriatrics Society, every year one in three adults age 65 and older has at least one adverse reaction to a medication or medications.
There's a major problem the elderly have as part of the normal aging process.
"The body cannot break down the medications effectively, due to body mass and protein levels, so medications may not be absorbed efficiently," says Mardy Chizek, a registered nurse and president of Charism Eldercare Services. "And once the medication is broken down the body may not be able to excrete it so it accumulates, leading to adverse consequences."
"Older adults often -- but not always -- require different dosing of medications," says geriatrician Leslie Kernisan. "older adults tend to take more medications and hence are at higher risk for problems due to medications interacting."
Further, the side effects of a medication or medications can mimic the symptoms of a disease "rather than appear as medication related," Chizek says. "Because of the number of medications seniors use, it may be difficult to identify the problematic medication or medications if there is an adverse drug reaction."
Compounding matters, side effects from medication may lead to complaints that result in more medication to deal with the new side effects, Chizek says.
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Steps can be taken by caregivers and patients to address the dangers of polypharmacy. Among other strategies, Chizek and others suggest bringing all medications, not just a list, to doctor appointments. This includes medication applied on the skin or taken by other routes, over-the-counter medication and any natural or herbal remedies.
Chizek also suggests getting a medication review to get a better understanding of side effects and dosing, if a drug is necessary and if there are safer alternatives available.
However, the solution may not be as easy as discontinuing a prescription.
"While the clinical team understands these issues, it may be difficult to find the best solution for medication-related problems because of the need for these treatments and consequences of discontinuing them," Chizek says.
--Written for MainStreet by S.Z. Berg, author of College on the Cheap