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Medications and Older Adults

Mary Parker of Oak Ridge, Tenn., is quick to joke about her health problems. Her vibrant smile and upbeat attitude belie her 78 years. But last year she had a health problem she didn't find amusing. The medication she took for her swollen sinuses left her so weak and dizzy she couldn't get out of bed.

"I felt like I wanted to die," she remembers. "It was awful."

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She learned an important lesson from the episode. She thinks twice before taking any medication, questions her doctors and pharmacists, and reviews all her medications regularly with her primary physician.

Parker's attitude is a good one for older adults to have, experts say. As people age, they often develop a number of problems taking medications. Being aware that problems may occur is the first way to minimize them.

"You are a partner in your health care," urges Madeline Feinberg, Pharm.D., a pharmacist and former director of the Elder Health program of the University of Maryland School of Pharmacy. "This is a partnership between you, your doctor, and your pharmacist. You need to be assertive and knowledgeable about the medications you take."

The Food and Drug Administration is working to make drugs safer for older adults, who consume a large share of the nation's medications. Adults over age 65 buy 30 percent of all prescription drugs and 40 percent of all over-the-counter drugs.

"Almost every drug that comes through FDA [for approval] has been examined for effects in the elderly," meaning people over 65, says Robert Temple, M.D., director of one of FDA's offices of drug evaluation. "If the manufacturer hasn't done a study that includes the elderly, we would usually ask for it."

More than 15 years ago, the agency established guidelines encouraging drug manufacturers to include more elderly patients in their studies of new drugs. FDA suggested that upper age limits for drugs be eliminated, and that even patients who had other health problems be allowed to participate if they are able. Also, drugs known to pass primarily through the liver and kidneys should be studied in patients with malfunctions of those organs. This has a direct benefit for older adults, who are more likely to have abnormalities of liver or kidney function and other illnesses.

In several surveys, FDA discovered that drug manufacturers had been using older adults in their drug studies; however, they weren't examining that age group for different reactions to the drugs. Now, they do. Today, new prescription drugs are generally required to have a section in the labeling about their use in the elderly.

Says Temple, "The FDA has done quite a bit and worked fully with academia and industry to change drug testing so that it does analyze the data from elderly patients. We're quite serious about wanting these analyses." In 1999, these analyses became a regulatory requirement.

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