Medication Safety for the Elderly

Wrinkles and age spots aren't the only changes that happen to our bodies as we age. Changes also happen within our bodies - affecting the way we handle medications.

Changes in our digestive systems can affect how fast medicines enter our bloodstreams. The circulation systems may slow, which affects how fast drugs reach the liver and kidneys. The liver and kidneys also may work slower, which affects how a drug breaks down and is removed from the body.

With an older person's body, the central nervous system also changes, meaning that the neurotransmitters (chemical messages in the brain) don't function as well as a younger person's. This may be why an elderly person is more likely, for example, to feel sleepy when taking an antidepressant.

Also with age comes an increase in body fat. Because many drugs are fat-soluble (meaning they can dissolve in fat), they remain in the body longer and increase the risk for overdosing.

Another problem is that as people age, they are more likely to be taking many medications for different conditions, for example an antidepressant, a blood thinner, a drug to lower cholesterol. The list goes on. This increases the risk of drug interactions.

If the person is seeing several doctors at once, there's a chance these doctors may not all be communicating with each other and the person may not be reporting all medications at each visit. This lack of communication between doctors leads to what is called a prescribing cascade. This means a doctor may prescribe medication to treat what the doctor believes is a medical condition, when in fact the medication will really be treating a side effect of another drug that the patient never mentioned being on. The more medications the patient is on, the more risks there are for side effects.

Everyone's body is different and unique. Having all of your doctors work together is the key to tailoring a plan that is just right. Here are some tips for working closely with the doctor to make sure you get the best care:

• Keep track of all side effects in a journal. Note the times of day of side effects, meal times, and when the medication is taken. Share this with the doctor.

• Before seeing the doctor, write out your questions about medications.

• Tell the doctor about your prescription and over-the-counter medications as well as supplements and herbs.

• Keep a written record of your medical history and medications. Be sure to bring it to all doctor appointments and to update this list when your medication, medication dosage or health status changes.

• Track and talk about your eating habits. These might help make a difference in how your body reacts to certain medications. Include coffee, tea and alcohol.

• Ask the doctor about ways to remember and recognize medications.

• Find out easier ways to take medications, especially if you have trouble swallowing them. Crushing them may help.

• Ask the doctor to write down directions for the medications so there are fewer chances for mistakes.

Related Articles The ABCs of Knowing Your Numbers Own Your Own Health Take Charge to Avoid Mistakes Rx Questions? Ask Your Pharmacist Making the Most of Your Doctor Visits Coumadin (warfarin) and Your Diet

External Sources The Council on Family Health U.S. Department of Health and Human Services Food and Drug Administration The Administration on Aging

This article was reviewed and updated June 2007.

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