By MICHAEL D. JUDD
Patients are increasing their risk for adverse drug reactions by taking a growing number of prescription medicines, over-the-counter drugs and nutritional supplements.
While adverse drug reactions pose a threat to anyone taking a medication, the problem is a particular concern for seniors. Nearly half of adults 65 and older take five or more medications each week. That puts seniors at the greatest risk of polypharmacy from taking multiple prescription drugs to manage health issues such as diabetes and hypertension.
Add non-prescription drugs to the daily doses of medications and the chance of an adverse drug reactions rises significantly. Acetaminophen, ibuprofen, and aspirin are among the most commonly used over-the-counter drugs. Generally, the more drugs a person takes, the greater the risk of adverse reactions and drug interactions.
Reducing the risk of adverse reactions requires patients to be actively involved in their health care, particularly if several physicians are managing treatments for different illnesses. If your physician prescribes a medication, be sure you know the name of the drug, why it has been prescribed, what side effects it may have and how the medication may interact with other drugs and supplements you are taking.
What drug categories pose the greatest risks?
The drug categories most commonly involved in adverse reactions are cardiovascular agents, antibiotics, diuretics, anticoagulants, hypoglycemics, steroids, opioids, anticholinergics, benzodiazepines, and nonsteroidal anti-inflammatory drugs. These categories include some of the most frequently prescribed drugs in the U.S.
Why do seniors face the highest risks of drug interactions?
Older people react differently to medications than younger people. Aging alters body fat and water composition. These changes can alter therapeutic drug levels, causing greater concentrations of water-soluble drugs and longer half-lives of fat-soluble drugs. Compared to the general population, older people are more likely to have several chronic disorders, each requiring at least one medication and increasing the possibility of an adverse reaction.
How can I reduce the risk of an adverse drug reaction?
Whenever possible, use one pharmacy for all your prescriptions. Pharmacies keep track of what prescription drugs you are taking and are able to spot the potential for an adverse reaction and then work with your physicians for alternative. Always read the labels on drugs and supplements. They may tip you off to possible drug interactions. Never take a new drug without asking your pharmacist about its side effects and interactions with other drugs.
Do you have a current medications list?
Make a list of all medications, including generic and brand names, dosages, dosing frequency, and reason for taking the drug and the names of your current medical care providers. Take a copy of the list every time you visit a health care provider so it can be included with your medical records. Many pharmacies offer wallet cards for keeping a current list of medications with you. Ask your primary caregiver or pharmacist to run your medication list through a drug interactions database to identify possible problems, especially if you’re on five or more drugs.
Can nutritional supplements pose risks?
Some supplements can have serious interactions. Many people take ginkgo biloba in hopes of improving memory or omega-3 fish oil supplements probably believing fish oil helps their hearts. Both supplements can cause bleeding in patients taking prescription blood thinners like warfarin, or the familiar brand name, Coumadin. Notify all your health care providers of the supplements you take.
What about vitamins?
Patients may face some risk of adverse drug interactions from vitamins, although the dangers are much less than posed by prescription medications. These risks are greater for patients using some vitamins while also undergoing chemotherapy. Vitamins cay also pose a risk for patients with some conditions such as inadequate liver or kidney function. Include any vitamins you take on the medication list you give to every health care provider.
Michael D. Judd is System Director of Pharmacy of the Cayuga Health Systems, which includes Cayuga Medical Center and Schuyler Hospital. He is a registered pharmacist with a master’s in business administration.