Thursday, December 29, 2016

How about a medication checkup next year?

I take three prescriptions for blood pressure and two vitamins (for diagnosed deficiency), and several other nostrums. I have to stagger them throughout the day or get nauseated.

Milta Little, DO, associate professor of geriatrics at Saint Louis University, recommends that people over 65 have their doctors go over their meds (many of which may come from other doctors).

Older people metabolize meds differently than younger ones (I have heard that older people should not take timed-release preparations--they don't break down as designed).

"Drugs may not play well with each other," Little says. This includes over-the-counter stuff.

Little says as a geriatrician, she thinks six prescriptions are too many--and stats show that those taking more than 10 have a higher mortality rate.

When Little goes over a patient's meds, she asks herself:

--How old is the patient? A "good" blood pressure for a younger person is 120/80. But for an older person, 160/90 may be OK. If drugs get the top number, the systolic, too low, say less than 130, the risk of falling is greater. Even her prescriptions for someone 90 are different than for someone 65. Over 100--she says she probably would prescribe nothing--if a person gets to 100, she says, it is probably not from anything doctors did.

How long has the person been taking the medicine? Prescriptions are not forever. For instance, there is no evidence that a 76-yr-old with high cholesterol, on a statin, should still be on it 15 years later if he or she has not had a heart attack or stroke within the year.

--Is the dosage correct? A small dose may be fine as you get older. Start low and go slow is her motto.

--What are the side effects? A drug may address one problem, but create another. Antidepressants, for example, can cause more frequent urination--which can lead to incontinence. An anti-diuretic for blood pressure can lead to or worsen gout.

Too many medicines can make you feel crappy instead of better.  Think about it. And get a doctor to go over everything.

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