Top Drugs for Older Adults To Avoid Realfarmacycom

With most adults middle aged and over taking an average of four prescription medications every day (1), things can get complicated. But there are a few experts in older adult health that have come forward with helpful advice.

Why Older Adults Have A Greater Health Risk From Prescription Medications

So, why does age matter? Over time, your liver, which is the primary organ for metabolizing drugs can become less and less efficient. However, it’s important to note that everyone has their own natural metabolism speed- and it can be difficult for doctors to pinpoint a 100% safe dosage of a prescription drug. Someone with a fast drug metabolism may process their medications so quickly that they aren’t as effective as they are expected to be; someone with a slow drug metabolism may absorb too much of a medication before it’s excreted from the body: even toxic levels (2).

Kirby Lee, a pharmacist and associate professor of clinical pharmacy at the University of California at San Francisco explains:

“As your body ages, it absorbs medications differently. They can be metabolized differently by your liver and excreted differently by your kidneys, so you may be more sensitive to some medications.Prescribing medications for people 65 and older can be more challenging, because some drugs can be more toxic or cause more side effects than when you were younger.”

“As your body ages, it absorbs medications differently. They can be metabolized differently by your liver and excreted differently by your kidneys, so you may be more sensitive to some medications.Prescribing medications for people 65 and older can be more challenging, because some drugs can be more toxic or cause more side effects than when you were younger.”

To make matters even more complicated, changes to your diet can impact your drug metabolism in unexpected ways; doctors aren’t able to predict how your body might respond to a particular dosage of a medication. And unfortunately, specialists in the field are few and far between:

“Only about 7,500 physicians in the U.S. specialize in the care of older adults, according to the American Geriatrics Society. With 46 million Americans age 65 and older today, that works out to about one geriatrician per 6,100 patients.”(3)

“Only about 7,500 physicians in the U.S. specialize in the care of older adults, according to the American Geriatrics Society. With 46 million Americans age 65 and older today, that works out to about one geriatrician per 6,100 patients.”(3)

Which Medications are More Dangerous for People Over 60?

In 1991, American geriatrician, Mark Beers, M.D. developed his signature list of medication types that posed a unique risk to seniors. This list is now known as the Beers Criteria, and is widely circulated and updated by American geriatricians as newer prescription drugs are created.

The criteria is meant to help both older patients and their doctors have increased awareness about which medications may have greater health risks than their intended benefits, thanks to their physiological makeup and their effect on the aging metabolic system. While it isn’t meant to overrule a physician’s recommendations, it’s important to be aware of your body’s unique needs and to ask questions and raise concerns for your medical care provider and pharmacist.

The Beers Criteria: Download Printable List

You can find a complete pocket-sized printable .pdf of the Beers Criteria here!

A few highlights from the list include:

  1. Benzodiazepines such as diazepam (Valium), lorazepam (Ativan), alpraxolam (Xanax) and chlordiazepoxide (Librium). Side effects include confusion and risk of falling.
  2. Non-Benzodiazepines such as Zolpidem (Ambien), zaleplon (Sonata) and eszopiclone (Lunesta). Side effects include addiction, disturbed sleep, and sleep walking.
  3. Anticholinergics such as Diphenhydramine (Benadryl), acetaminophen with diphenhydramine (Tylenol PM) and muscle relaxants containing diphenhydramine. Side effects include confusion, constipation, dry mouth, blurry vision or urine retention in older adults, and eventually dementia.
  4. NSAIDs such as Aspirin, naproxen, and ibuprofen. Side effects include kidney damage and stomach damage.
  5. Blood Pressure medications including alpha-blockers: Doxazosin, Prazosin, Terazosin. Side effects include risk of falling and fatigue.
  6. Antipsychotics sometimes prescribed for anxiety or depression. Side effects include addiction.

Patricia Corrigan’s Story

Patricia Corrigan is a journalist and the author of 19 books. She recently shared her personal encounter with a bad reaction to a prescription medication (3):

One recent weekend, I experienced a relapse while on doxycycline, an antibiotic prescribed for a bacterial sinus infection. The doctor on call I spoke with prescribed a stronger antibiotic for me, levofloxacin (Levaquin), one I’d taken successfully a decade ago.

After four days on the new drug, a throbbing Achilles tendon awakened me in the wee hours. I hobbled to the computer and learned the drug is not recommended for people 60 and older. I am 68. Later that morning, I called my internist, who advised me to stop taking it and start helping the tendon to heal — no easy task, and one with no quick fix.

I can’t be angry with the physician who neglected to take my age into consideration, because I share in the blame.

When I picked up the prescription, I waved off a consultation with the pharmacist, saying I’d taken this antibiotic before. Then, after reading just a sentence or two of the lengthy list provided to me of possible side effects, I tossed the paper into a recycling bin.

Patricia’s story highlights the importance of taking your health into your own hands and learning to be aware of your body’s changing behavior.

References:

  1. https://assets.aarp.org/rgcenter/health/rx_midlife_plus.pdf
  2. http://www.merckmanuals.com/en-ca/professional/clinical-pharmacology/pharmacokinetics/drug-metabolism
  3. http://www.nextavenue.org/unexpected-drug-side-effects-familiar-drugs-older-adults/

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Source: Real Farmacy