If you're over 65, odds are you're taking at least five or six
medications every day. Do you know what they're doing to your body? You
probably don't, and your doctor might not either.
"The average person over 65 now uses seven different
medications per day, four prescribed and three over-the-counter," says
Andrew Duxbury, MD, associate professor of geriatrics at the University of
Alabama at Birmingham and director of the senior care clinic at UAB's Kirklin
Clinic. "There's never been a controlled study on a human being involving
more than three drugs circulating in the body at the same time. So no one
knows, scientifically, exactly what's going on in your body when you take
seven, 10, or a dozen at a time."
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Medication errors in seniors are among the most common
preventable errors in the healthcare system today. About one in every three
people over 65 will have some sort of adverse medication event that requires a
hospital visit, according to Duxbury, and some 10% to 15% of all emergency room
visits are related to medication reactions or drug interaction problems in
One Patient, Many Doctors
Part of the problem is that many people over 65 see multiple
physicians. A typical 70-year-old man might see a family doctor for regular
checkups, a kidney specialist to control his diabetes, and a cardiologist for
his irregular heartbeat. "In some cases, one doctor will be treating a
condition and add a medication, but fail to tell a patient that they should
discontinue a different medication prescribed by another doctor, so they end up
taking both," says Wayne K. Anderson, PhD, dean of the University at
Buffalo School of Pharmacy and Pharmaceutical Sciences, which has a specialized
program in geriatric pharmacotherapy. "One doctor may not be aware of what
other doctors are prescribing."
Good medications in bad combinations can be dangerous and even
deadly. Statistically, a person taking eight medications can expect at least
one drug interaction problem that will negatively affect his or her health,
Anderson says. For example, if you're taking a medication that has
blood-thinning properties and then begin to take aspirin on a regular basis,
and your doctor doesn't know about both, it can put you in danger of
uncontrolled bleeding. Some herbal medications -- which many doctors don't know
their patients are taking -- can also influence the blood's ability to clot,
causing further problems. That's just one possible set of interactions.
The wrong medications, or the right medications in the wrong
combinations, can lead to a "cascade effect." Anderson recalls the
story of a man whose doctor prescribed pain medication for his osteoarthritis.
The medication caused nausea, for which he was prescribed anti-nausea
medication. That drug caused tremors that looked like Parkinson's
disease -- and things spun out of control. "The man was being treated by
two or three different physicians. One of them prescribed medication for
Parkinson's, which caused more nausea and more tremors, and an inability to
sleep. So he was prescribed sedatives, which led to absent-mindedness, more
shakiness, and dementia-like behavior," Anderson says. "He went from a
gentleman who enjoyed his walks and getting the Sunday paper at the corner
store to a man who was bedridden with a diagnosis of end-stage parkinsonism and
senile dementia." Ultimately, a pharmacist discovered the out-of-control
drug combination and notified the man's doctors. Fortunately, he regained
normal function and was released from the hospital taking nothing more than