March 29th, 2023 | Senior Health
The typical person in their later sixties and older takes several medications for chronic conditions. These may be drugs to regulate blood sugar, thyroid, blood pressure, cholesterol, allergies, mood, or any of hundreds of other mild-to-serious conditions. Your comprehensive blood panel is your and your doctor's way of monitoring the effect of the drugs prescribed, as well as whether they're working or not or if they may be interacting with one another. And, besides, you're changing.
How do we know you're changing? You're aging. Your liver and kidneys break down and eliminate drugs from your body, and your liver and kidneys are aging. You may lose muscle and gain fat, affecting how drugs work. All of this can complicate the effectiveness of meds and, especially important, create harmful side effects.
So, consider these medication tips – after you see your doctor.
1. Take Medicine as Prescribed — with Regular Discussions with Your Health Care Provider
On that all-important visit with your doctor, be involved. The doctor or nurse should ask you if your meds have changed or if you've stopped or started either prescribed medicine or over-the-counter drugs or supplements. They all count! If you're taking something prescribed by another doctor that's not on your primary's list – speak up.
Take only prescription meds your health care provider has prescribed. None of this, "Here, try one of mine" from your golf partner. Taking someone else's medicine can be very dangerous. This is particularly true of pain medication, which could worsen your condition or cause addiction. You probably know opioids are highly addictive but are not the only ones.
The interaction of drugs is unpredictable. Your doctor has the proper outlook on your entire series of medications. Please don't stop taking or skip prescribed medications because you think you don't need them anymore, feel they've stopped working, or think they're causing a side effect. Consult your doctor about any side effects.
Take side effects seriously. In the United States, 125,000 people die annually from incorrectly taking their medications!
Talk to your pharmacist or health care provider about ways to help you take the proper dosage on time every time. It's typical to forget to take your meds. But it's not okay. Many antibiotics must be taken after the infection stops or after you stop feeling the symptom. Hence the instructions to take every dose until they're gone.
If you're a family member or caregiver reading this, please provide the person under your care with prefilled pillboxes and automated reminders attached to pill bottles, or subscribe to a pill packaging service that sorts, packages, and delivers by individual dose.
2. Store Your Meds Safely and Keep Current
Keep all medicine up and away from children, wherever you store them. Around 10,000 children are accidentally poisoned by prescription meds every year, and a child dies every 12 days from such poisoning. If you have questions about safely storing your medicines, contact your pharmacist or health care provider.
Store meds in a safe, cool, dry place. A high drawer reserved for medications in a dresser or cabinet is good. Be careful that meds that need to be cooled are stored in the fridge, but give them a shelf where children can't reach them. There will be storage instructions on the bottle. Due to fluctuating heat and humidity, a bathroom medicine cabinet may be the worst place. Even if meds are not expired, improper storage can render them ineffective or unsafe.
Remember we talked about how you're changing as you age? So is your medication. If you have an old bottle of aspirin that's been haunting the top shelf of a kitchen cabinet for a couple of decades, don't use it. Some meds lose their effectiveness, but others can degrade into toxicity. Check the expiration dates.
There are proper ways to dispose of unused medications. Throwing them in the trash is not one of them. Discarded drugs can end up in the water supply and may be eaten by wildlife or pets. See any disposal instructions that may be on the side of the bottle. Many pharmacies have disposal sites where you can drop the old drugs. You can search for "medication disposal sites" or see the FDA's webpage that instructs you on the options of disposing of meds.
3. Be Aware of Potential Medication Interactions and Side Effects, Even Unexpected Interactions
Grapefruit juice is always good for you. Here's something you may need to learn about grapefruit juice. The grapefruit has these beneficial enzymes that naturally protect it from the effects of insects and other harmful stressors. Unfortunately, these same enzymes inhibit the breakdown of certain medications in the human stomach, making some drugs ineffective or even toxic. So, what's good for the grapefruit is only sometimes suitable for the patient. Don't let this stop you from enjoying your morning grapefruit. Ask your doctor because this has been studied, and there's a list of drugs more likely to interact. And we only bring this up to illustrate how seemingly harmless or good-for-you foods and supplements can seriously interact with your medication. Ask your doctor about any potential adverse interactions.
Prescription drugs can affect each other dramatically. For example, nitroglycerin, which treats angina, should not be taken with many erectile dysfunction medications, including Viagra and Cialis, because serious interactions can occur. Your pharmacist can also advise you about potential medication interactions and side effects.
You may also have a medical condition that makes a particular medication risky. Again, your healthcare provider armed with your health record, a physical exam, and blood work is the best call here. Even herbal supplements you get off the shelf at the grocery store, though you're free to take them without a prescription, can interact. It may surprise you, but 40 percent of the drugs behind the pharmacist's counter are derived from plants used as natural remedies since ancient times. Grapefruit juice is used to prevent gout attacks, for example. Go figure. So, supplements are drugs, too, and they deserve the same caution as prescription meds when mixed with others.
Not surprisingly, alcohol is a common offender. The NIH warns that "mixing alcohol with certain medications can cause nausea and vomiting, headaches, drowsiness, fainting, or loss of coordination. It also can put you at risk for internal bleeding, heart problems, and difficulties in breathing." In other words, alcohol, whether it has sedative or stimulant effects on any person, should be considered a drug when taking other medication.
If you're experiencing something you suspect is a medical condition, such as memory loss or difficulty, dizziness, or sleepiness, particularly for seniors, the medication may mimic the symptoms. Before you skip or stop taking the meds, consult your doctor. Ask your healthcare provider if any new health problems you are experiencing could be due to your medications at your regular physical.
4. Keep a Medication List
There are many good reasons to keep a list of your current medications besides remembering which ones you're taking. Making a list is an excellent excuse to go through your cabinet or drawer and collect all your medicines. You can check duplicates and expired prescriptions (Don't mix expired medications with new ones!), find out if you need to take one you've forgotten about, and add any non-prescription medicine or supplements (including vitamins) you need to update your doctor on.
Keep the list with you. And keep it current. Give a copy to a friend or relative – for sure your emergency medical contact person – in case of emergency and when you're traveling. Note any medicines you're allergic to or have had bad reactions to. Wear a medical alert bracelet for severe medicine needs (like insulin) or allergies. Store your medication list on your cell phone in a notepad app. If you're fortunate enough to have a healthcare provider who has your prescription record online, this can save you a lot of headaches when filling out medical forms – even at the dentist. These forms almost always ask for the dosage, too, so those should be included.
A medication list should include the following:
- Your prescription medicine's brand name or generic name.
- Over-the-counter medication, herbal preparations, and supplements that you take regularly or on occasion.
- Condition you're treating with the medication.
- The dosage (for instance, 300 mg).
- How often do you take it?
- Anything you're allergic or reactive to.
- The phone number of your pharmacy.
Most people see more than one provider. Even if they don't ask, share your list with each provider and ensure it's updated at each visit. It's okay to suggest it to your provider, and it's essential, and it would be worth scheduling an annual review of medications with your primary care physician.
Some meds are expensive, and sometimes there are generic alternatives. It also matters which insurance you use and where the pharmacy might get the medicine. These days, a good pharmacy can check the price of drugs from one provider or another. Using prescription discount cards (they're free) also can get you a surprising discount sometimes. Ask your healthcare provider if there is a less expensive, effective alternative.
Also, tell your doctor if the medication doesn't work. If you're taking pain medication, it should lessen the pain. It could be a simple fix. New drugs are being developed all the time. Your primary physician is the one to ask. They may say it's safe to try it. Before you try a new brand-name pharmaceutical, you know the price. A drug that costs two dollars in its generic form may be $600 in its brand version.