Event negative effect of taking a medicine, which might vary from mild discomfort to departure. Some doctors may be too fearful of adverse drug events: some specialists consider that some elderly individuals are undertreated because of physicians’ concerns that drugs could cause an adverse event, for example a stroke or a heart attack. In this instance, patients may fail to obtain advantage from drugs due to excessive anxiety among physicians.
Because so many elderly folks will likely be taking more than one and occasionally many drugs, their risk for an adverse drug event is heightened. Furthermore, many patients have multiple physicians and regularly receive prescriptions and take drugs purchased by one or more doctors with no other physicians’ knowledge. (This isn’t advocated. Patients should guide every physician about all drugs, prescribed, over-the-counter, or herbs or NUTRITIONAL SUPPLEMENTS they take at every single office visit.)
It’s additionally been scientifically confirmed that old folks’ bodies generally respond differently from younger people’ bodies to the exact same dose of drug. Additionally, typically, drugs haven’t been analyzed on people older than age 65 prior to the pharmaceutical company receiving acceptance for the drug to be sold. Speeds of metabolism, levels of body fat (which acts as a storage reservoir for many drugs), and liver or kidney decreased function are just a couple of reasons for inconsistent results to some medicines in the senior people.
As an example, a dose of digoxin for the heart that’s considered a standard dose for the typical man younger than age 65 can occasionally cause a cardiac arrhythmia in an elderly man. The elderly man may also have symptoms including nausea, vomiting, confusion, and other side effects not seen in younger individuals. One essential reason for this unique difference is that elderly individuals have less healthy hearts.
Based on Dr. Rosanne M. Leipzig in her 2001 article for Geriatrics, occasionally undesirable events caused by drugs are mistaken by physicians for aging related issues, such as INCONTINENCE or even DEMENTIA or CONFUSION. Leipzig says that risk factors for an adverse drug reaction in an elderly individual who’s taking many drugs (polypharmacy) should be considered, as should the dosage of the drug.
Some Drugs Are Less Advisable For Elderly Individuals
Leipzig counsels against the prescribing of particular drugs to individuals age 65 and older; for example, she recommends against prescribing the antidepressant Elavil (amitriptyline), the sedative Valium (diazepam), the muscle relaxant Flexeril (cyclobenzaprine), and the nonsteroidal anti-inflammatory (NSAID) Indocin (indomethacin), among other drugs that she believes are unsuitable or dangerous for many elderly individuals. Instead, she advocates selecting another drug in precisely the same category; for example, rather than Elavil, prescribing Pamelor (nortriptyline) because it’s more easily taken by elderly individuals and has fewer side effects.
Leipzig reasons, “Acquaintance with the drug groups and specific agents that are usually contraindicated in elderly individuals also will help reduce the possible dangers and side effects.”
Many physicians don’t recognize they must take the age of their elderly patients into account when ascertaining both which drug to use and what dosage to prescribe. In a review of studies on drugs prescribed for elderly individuals, reported in a 2000 issue of The Annals of Pharmacotherapy, the researchers found that about 14 to 24 percent of patients were prescribed drugs that weren’t recommended for elderly individuals.
Usually prescribed inappropriate drugs contained Elavil (amitriptyline), an antidepressant, the painkiller Darvon (propoxyphene), and Valium
(diazepam), a long acting stress drugs. Girls older than age 80 and patients on MEDICAID were the most likely to be prescribed unsuitable drugs. Nursing home patients were also more likely than others to get improper drugs for old individuals.
Long-Term Pain And Adverse Drug Events
Many elderly folks take drugs for the long-term pain of ARTHRITIS or other debilitating medical issues. When some painkillers are taken on a regular basis, patients may experience side effects, including serious stomach upset or even ULCERS. Based on Dr. Steven D. Feinberg, in his 2000 article for Geriatrics, attention should be taken in prescribing painkillers. He considers that muscle relaxants and drugs in the benzodiazepine (sedative) type are occasionally overprescribed to elderly patients.
Dr. Feinberg additionally points out that although acetaminophen is well taken, it can cause liver damage over the long term and says that physicians should examine the liver function of patients who often take high doses of acetaminophen. Aspirin is another drug that individuals may take for granted, but it can cause gastrointestinal bleeding, rashes, and even shock, all which are adverse drug events.
Nonsteroidal anti-inflammatory drugs are often prescribed for long-term pain, but they may cause ulcer disease. If the patient also have alcohol, the danger of gastrointestinal bleeding is raised further.
Drugs in the opium type drugs alleviate pain, but old individuals are more likely to be too sensitive to drugs like morphine. They can also be immune to taking such drugs, worrying they’ll become addicted to these medicines. They may become habituated or addicted to these drugs, and attentive doctor oversight is significant.
Corticosteroid drugs including Prednisone, prescribed for inflammation, also can cause adverse drug events; for example, they are able to cause high blood sugar (hyperglycemia) in elderly individuals, loss of calcium from bones, and even CATARACTS.
External drugs (applied to the skin) may be effective for treating pain, and they usually have limited adverse effects and are safer than oral medicines. Zostrix (capsaicin) is one such medication (used for pain control after an episode of shingles), and there are other prescribed and over-the-counter external agents.