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Albuquerque Journal
 KNOW YOUR MEDS
 
Drugs interact differently as we age, so do your homework
 
BY MATT ANDAZOLA/JOURNAL STAFF WRITER
 

    Our bodies work differently as we age, that’s no secret. But what you may not know is there’s a huge difference between the way a medication works in middle years and the golden years.

    About 30 percent of hospital admissions for older adults are medication-related, and people over 65 are more than seven times as likely as others to be hospitalized because of medication problems, according to the New Mexico Prescription Improvement Coalition.

    To avoid that fate, it’s important to do a lot of your own legwork, local pharmacists say. Keep your doctors informed about what medication you take; also be sure you know when and how to administer it, and whether it is age-appropriate.

    Because many patients 65 and over have multiple prescriptions, they risk more problems related to drugs interacting poorly with one another, or drugs affecting conditions other than those they are meant to treat, says Melanie Dodd, associate professor in the College of Pharmacy at the University of New Mexico School of Medicine.

    “That’s why it’s so important for any patient to keep a full and accurate list of their medications, and bring that list to every medical interaction” with pharmacists, doctors or other providers, she says.

    Having a list helps doctors avoid drugs that interact poorly with what you already take, says Thomas Murvin, pharmacy director for Lovelace Health Plan. The list also should keep doctors from overprescribing for the same issue (if your primary care doctor prescribes a cholesterollowering statin like Lipitor, your cardiologist may not know, and he or she may prescribe a second statin like Zocor).

    On your list, include any over-the-counter medication or supplements, says Nathan Varley, manager of Medicare Pharmacy Services for Lovelace Health Plan. It’s especially important to include aspirin — because it’s a blood thinner — and herbal supplements, he says.

    “Some of those herbal supplements can have very serious reactions with prescription drugs,” he says.

    Varley says a pharmacist can use computers to check every possible adverse reaction involving medication and advise you whether to continue using certain supplements while on prescription medication.

Always ask questions

    Don’t leave the pharmacy counter unless you’re absolutely sure how to take your medication, says James Mathews, a registered pharmacist with Presbyterian Healthcare Services.

    “Until you understand, until you’re completely comfortable, keep asking questions,” he says. “Don’t worry about the person in line behind you.”

    Knowing how to take your medication also means knowing when in the day to take it and how much time should pass between doses, Dodd says. Do you take it with a meal or on an empty stomach?

    Also, Dodd says to know what to do if you slip up and miss a dose.

    If you’re one of the millions of people struggling under the weight of prescription drug costs, fight the temptation to stretch your medication by lowering your dose or taking it less frequently.

    “If you’re not taking your medication every day, as directed, it’s not helping you,” Mathews says.

What to watch for

    If you can’t cover the bills, talk to your pharmacist, Murvin says. Pharmacists and doctors may be able to switch from a brand name to a generic. Most therapeutic drugs common among seniors have generic alternatives that are much more affordable, he says.

    Don’t worry about going generic, but try to stay consistent once you switch (or, for some drugs with multiple generic brands, stick with only one), Murvin says. It’s not a good idea to hop around many medications.

    Be wary of certain medications, Dodd says. Some, such as diphenhydramine (commonly sold as Benadryl), work fine in many age groups, but aging livers and kidneys may have trouble metabolizing and filtering them from your system.

    That means, Varley says, that drugs accumulate in your system more easily than they did in the past. In Varley’s experience, the issue of ageinappropriate medication pops up most commonly with muscle relaxers like cyclobenzaprine.

    A list of medications to use with caution has been compiled in a pamphlet by the New Mexico Commission for Prescription Improvement Coalition, part of the New Mexico Medical Review Association.

    If you see one of your medications on that list, don’t panic, Mathews says.

    “If you’re on the list, talk to your provider before you make any changes to your medication regimen,” he says.

What to ask

    Don’t be afraid to ask your pharmacist for guidance — this is one time when you can ignore the line behind you. Before leaving the pharmacy counter, make sure you’re absolutely clear about:

how to take your medication (especially if it’s injectable or comes in an inhaler).

how often to take your medication.

when in the day to take your medication.

how much time should pass between doses.

whether to take your medication on a full or empty stomach.

what to do if you forget to take a dose.

Source: Melanie Dodd, associate professor in College of Pharmacy at the University of New Mexico School of Medicine.

Drug warnings

    As bodies age, they respond differently to medications. Some work well in your 50s, but may not be appropriate after your 65th birthday. A handful can be harmful. Some, including allergy medication diphenhydramine (Benadryl), are available over the counter.

    A list of medications to use cautiously has been compiled by the New Mexico Prescription Improvement Coalition, part of the New Mexico Medical Review Association. The list is printed in a pamphlet on the association’s website (http://www.nmmra. org/resources/Patient_ Safety/178_1840.pdf) or by mail by calling 998-9753.

Source: New Mexico Medical Review Association pamphlet Keep a list

It’s almost impossible for doctors and pharmacists to perfectly coordinate medication without your help, especially if you see many different doctors or go to multiple pharmacies. That’s why you need to keep track of what medications you use, and take a list with you to every medical appointment or pharmacy visit.

On the list, include:

prescriptions. over-the-counter medication, especially aspirin. multivitamins and herbal supplements.

Source: Nathan Varley, manager of Medicare Pharmacy Services for Lovelace Health Plan 
 

Source: Albuquerque Journal 

 

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