Older people run twice the risk of being treated in emergency rooms for adverse reactions to drugs than those under the age of 65. One reason is that older bodies don’t eliminate drugs as easily as younger ones do, and seniors also take many more medications than younger people. Multiple medications multiply the risk of side effects, say experts.
“If you take three medications that have sedation as a possible side effect, then the compounding effect may not be 1+1+1=3, but 3x3x3=27,” Todd Semla, an expert on drug treatment for older adults, told “Consumer Reports on Health.”
Check out the medical conditions listed below and the drugs commonly prescribed to treat them. If you’re a senior citizen and your doctor prescribes any of them for you, ask if there’s a safer alternative.
Anxiety Drugs:
• Both chlordiazepoxide (Librium) and diazepam (Valium) can cause confusion, depression, incontinence, and dependence. A possible alternative could be alprazolam (Xanax), which is shorter-acting.
• Amitriptyline (Elavil) and doxepin (Sinequan) cause drowsiness, constipation, and urine retention. Shorter-acting citalopram (Celexa) paroxetine (Paxil) and sertraline (Zoloft) could be possible alternatives.
• Fluoxetine (Prozac) causes agitation and poor sleep. Consider citalopram (Celexa), paroxetine (Paxil), and sertraline (Zoloft) for alternatives.
Antihistamines:
• Chlorpheniramine (Chlor-Trimeton) and diphenhydramine (Benedryl) can cause drowsiness, confusion, and urine retention. Consider cetirizine (Zyrtec), fexofenadine (Allegra) and loratadine (Claritin) as alternatives.
High Blood Pressure and Benign Enlarged Prostate:
• Doxazosin (Cardura), prazosin (Vasoflex), and Terazosin (Hytrin) can cause incontinence as well as dangerously low blood pressure. Safer alternatives could include single-purpose drugs such as tamsulosin (Flomax) for benign enlarged prostate and diuretics to treat high blood pressure.
Pain Relievers:
• Naproxen (Aleve) can cause gastrointestinal bleeding and damage the kidneys. Substitutes may include acetaminophen (Tylenol) and ibuprofen (Advil).
Sleeping Aids:
• Barbituates (Nembutal) can cause drowsiness, confusion, and dependence. Shorter-acting drugs such as zaleplon (Sonata) can be an alternative as well as reviewing and perhaps changing sleeping habits.
Stomach Acid Drugs:
• Bisacodyl (Dulcolax) is a laxative used to relive constipation, but it can make bowel problems worse. As an alternative, try increasing the amounts of water and dietary fiber.
• Diphenoxylate (Lomotil) is used to treat diarrhea caused by gastroenteritis and inflammatory bowel disease, but can cause drowsiness and dependence. Alternatives include a change in diet and loperamide (Imodium).
A recent study at Britain's University of East Anglia found it was vital for doctors to review all drugs taken by older patients to ensure that the benefits outweighed the risk of side effects.
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