Medicines react differently as we age
Aging is an inevitable process, and with it comes many different changes. One such change is how the human body reacts to medication. The blood simply doesn’t flow the same way anymore. Now drugs can take longer to exit the body, and may have a longer effect or react as stronger doses.
With that in mind, be cautious of polypharmacy, or the practice of administering many different medicines – especially concurrently – for treatment of the same disease.
“Polypharmacy is not necessarily a bad thing,” said John Bowman, associate professor of pharmacy practice at the Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy. “But regulation must occur if it is encountered. When a patient is taking one medication, a health care provider should always double check to make sure a new medication does not cause negative or unbearable side effects. The patient and their family should also do their part by letting health care providers know what medication is being used.”
Estimated health care expenditures in 2001 related to the use of potentially inappropriate medications was $7.2 billion, according to the Medical Expenditure Panel Survey. Avoiding the use of inappropriate and high-risk drugs is an important, simple and effective strategy in reducing medication-related problems and adverse drug events in older adults. A helpful source for patients to learn more about their medication is a list referred to as the Beers Criteria.
“Medications listed on the Beers Criteria are rated on a scale,” Bowman said. “Some are to be taken in moderation and with extra care. Others, on the other hand, should not be taken. The thing is that some of these medications are still being given, even if they cause various problems.”
Fifty-three medications or medication classes are on the Beers Criteria. The criteria are divided into three categories: potentially inappropriate medications and classes to avoid in older adults, those to avoid in older adults with certain diseases and syndromes, and medications to be used with caution in older adults, according to the Journal of American Geriatrics Society.
“If a medication is listed on the Beers Criteria, it should not be given, in most cases,” said Victoria Pho, Ph. D., assistant professor of pharmacy practice with the Texas A&M Rangel College of Pharmacy. “It may be prescribed because there is a lack of understanding about what harm these medications can cause, but sometimes it is prescribed because it works for the patient.”
A medicine listed on the Beers Criteria might be the only thing suitable for the patient that actually makes them feel like it is working.
There are many things that can be done to help elderly patients be more careful when taking medication.
“Put your medication in a bag and take it to your doctor or any pharmacist,” Bowman said. “Ask them to make sure none of the medications cause negative side effects with each other. Also, have them check the expiration dates—you will get rid of medications that have lost some of their power. You can make a list of your medications and when you need to take them. Educate yourself and your family. ”
Pho said one key point is to make sure that health care providers remember that the patient is always taken care of.
“It is important to remember that the patient is always the focus,” she said. “Never talk down to them or make them feel like they are unimportant in any way. Listen to them. They know their body better than anyone else. When you listen, you are teaching and practicing preventive care.”
Story by Art Niño, junior English major at Texas A&M University-Kingsville.