July - August 2019

Pharmacist Letter

Medications in the Elderly

Taking medications should always be done with caution, weighing risks vs. benefits to ensure the best outcome possible. This is especially true as we age, our bodies do not process medications in the same manner. Below I will outline strategies, which can be utilized to prevent common mis-steps with medications in the ageing population.

Insist on starting low and going slow. As we age our body does not absorb, distribute, process, or excrete medications as well as our youth. It is important that you advocate for yourself when it is decided to start a new medication. Request that your provider starts at the lowest possible dose and increases at a slow rate when deemed necessary. This will allow you to better understand how the medication will affect you and prevent unwanted side effects.

Help your provider avoid the prescribing cascade. Medications are started to help treat a symptom. Those symptoms can be due to a disease or infection but also from another medication. It is very important to analyze any recently started medications and their common side effects to prevent your provider from adding medication on top of medication. In many cases the issue can be resolved with removing a medication or decreasing a dose. (example: have allergies > take Benadryl > causes urinary retention > get prescribed a new med which causes light headedness > patient falls and breaks hip > bad situation).

Frequent follow-up and monitoring. This is important with both new and chronic medications you may have been on for many years. When starting new medications there may be physical changes which may be expected (mild muscle pain, dry mouth) but there are some severe side effects, which cannot be detected without lab work (high potassium, blood too thin). This is why frequent follow-up and monitoring is very important to ensure safety and efficacy. Many medications are processed and or excreted by our kidneys. Kidney function declines as we age which allows the medication to linger in our system and cause increased side effects. Even if you have been on the same dose for 10 or 20 years the dose may need to be decreased because you are aging.

I cannot stress enough the importance of being your own advocate. Healthcare professionals are all human and humans make mistakes. Limiting these mistakes is of high importance to us all. One crucial way to limit mistakes is having an accurate and up to date medication and allergy list. This includes all over the counter and herbal medications one may be on. As your medication list grows the harder it will be to memorize, thus the importance of having a paper copy (or giving one to your loved one) and updating it frequently as changes are made.

Together we can be a healthier community.

God Bless – Joe Flynn, PharmD