Tuesday, January 09, 2007

Kicking drugs may be necessary

…Medicine on the Midway, the Univ of Chicago magazine, ran a story in its Winter issue on withdrawing seniors from some of the many meds they may be taking.

…It’s nothing for some older people to be piling in 15 scripts. More, sometimes.

…Some Univ of Chi-town profs wrote an article in the Mar 27, 2006, issue of the Archives of Internal Med proposing a general framework for taking older people off some meds.

…Often, they point out, the reasons the person started on the drug is long gone (hey, maybe the drug worked!).

…They call it a “prescribing cascade,” this off-handed continuation of stuff.

…In one case, the researchers said a pharmacy supplying a nursing home suggested a statin for a 100-year-old guy. Statins are long-term preventives and carry a lot of side efx.

…Often these long-term drugs are expensive, too, and hard to metabolize.

…Docs should look at how long it will take for the patient to benefit. Pain relief can be immediate, some of these other things, too long-term.

…Docs also should work with family to set goals.

…Yes, physicians should prescribe based on evidence of effectiveness and safety, but judgment has to have a place, too.

…Speaking of tossing drugs, the AARP Bulletin (Jan 2007) had a neat story on how you should never flush unused or unwanted drugs.

…Trace levels of drugs are being found in 80% of US waterways tested.

…Hormones and antidepressants may be harming fish and wildlife.

…They suggest taking drugs to hazardous waste disposal sites.

…How about the trash?

…Some pharmacies will take back meds, too. Ask!

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