Prescription Drugs Can Be Bad Medicine Protective Measures You Can Take

Learn what drugs your parents take

Learn what prescription, over-the-counter medications and supplements your parents take-including their alcohol consumption.

When asked what drugs they take, people often do not mention drugstore remedies (over-the-counter drugs) or supplements like herbs, vitamins, amino acids, etc. While some people neglect to mention non-prescription drugs because they don't consider them as drugs, others keep the information to themselves because they fear their physicians' reaction. The same goes for alcohol consumption.

An older person might be taking an over-the-counter drug with a strong antihistamine, an evening martini and Ativan (a prescription anti-anxiety drug) – all three are strong sedatives, two of which aren't prescribed. A patient taking this combination of sedatives may come to the doctor reporting feeling listless and low energy. If the doctor learns of the combination of sedatives, he or she can recommend more appropriate medications to manage the patient's symptoms.

Many medications are metabolized by the liver or cleared by excretion through the kidneys. With advancing age both liver and kidney function tend to decline. Consequently the clearance of such drugs from the body takes longer. Inappropriate prescribing, along with reduced liver and kidney function, increases the risk of adverse medication events in older people. Unfortunately, physicians and nurses often overlook liver and renal function when prescribing medications or changing dosages.
Physicians prescribe the anticoagulant (blood thinner) Coumadin (also known as warfarin) to prevent clotting and strokes in older people who have heart conditions. Coumadin interacts with a wide variety of prescription and non-prescription medications. As many as half of all adverse drug events are linked to anticoagulants, which are also becoming one of the most widely prescribed drugs in older people.
To be on the "safe side", even when another doctor prescribes a drug, advise your parent to check it out with his or her primary care doctor and pharmacist.

Create an Rx Snapshot

Download a PDF of the free Rx Snapshot tool that anyone can use to help older people manage their medications safely and effectively. It is a simple way to record medications on a specially designed form.
It also provides tips for effective communication among patients, doctors, and pharmacists. It can help people: 1) keep updated records of their medications; 2) ask questions of doctors and pharmacists to better understand the risks and the benefits of their prescriptions to avoid drug interactions; and 3) consider generics as money-saving alternatives to brand name medications.

Check the Beers List

Check your parents' prescriptions against the Beers List, a national guideline and reference guide for pharmacists and physicians to improve the use of medication in the elderly. Led by Dr. Mark Beers, a group of 12 clinicians with expertise in geriatrics developed the list. First released in 1991, the most recent revision was released in 2006. Search the internet on "Beers list" to review the content of numerous links.

Primary care physician as medication point person

Aim to have your parent's primary care physician maintain a current record of all medications prescribed by all the doctors your parent sees.
While specialists treating a particular disease or condition may prescribe new medications, the primary care physician often manages ongoing monitoring of the disease or condition including prescription renewal. Each time your parent sees his or primary care physician; it is a good idea to bring a current list of all prescription, non-prescription over-the-counter drugs, and supplements that your parent takes.

Aim to have all prescriptions filled at one pharmacy

Meet with the pharmacist and request that the pharmacy monitor the drugs prescribed by various doctors and notify you and the primary care physician of potential problems.

Consider making an annual appointment to meet with the pharmacist. Bring a list, including dosages, of all the prescription drugs, over-the-counter medications, and supplements that your parent takes-including alcohol consumption. Ask the pharmacist to review the list and flag any potential problems. Do any of the medications interact with each other? Are any of the medications prescribed at a dosage too strong for older people? Are any of the medications contra-indicated in older people?

Consider consulting a Senior Care Pharmacist

If your parent is taking a large number of medications prescribed by several different doctors, consider engaging the services of a senior care pharmacist to review the complete list, including dosages, of all the prescription drugs, over-the-counter medications, supplements and alcohol that your parent takes. To find a senior care pharmacist, visit the Senior Care Pharmacist website, a service of the American Society of Consultant Pharmacists.