Certain medications are known to be harmful to elderly patients
Three Strikes
Strike One: As we age our bodies absorb nutrients less efficiently.
Strike Two: Drug use just compounds the problem.
In the September 1999 HSI Members Alert, we told you how drugs can interfere with the absorption of nutrients. For instance, some drugs that inhibit digestive acids to prevent heartburn have been shown to significantly decrease absorption of vitamin B-12 – one of the primary vitamins needed to prevent anemia.
Other medications that are known to play a role in nutrient depletion are among the most frequently prescribed drugs on the market. Antibiotics, blood pressure medications, tranquilizers, anti-depressants, anti-inflammatories, cholesterol-lowering drugs, and estrogen can all strip valuable vitamins and minerals from the body. When two or more of these drugs are combined – especially in an older patient – the risk of developing anemia rises.
And that’s when things get truly complicated, because anemia dramatically increases mortality risk for patients with chronic health problems such as heart disease and cancer.
Strike Three: A study from Duke University reveals disturbing evidence that more than one in five seniors who are prescribed drugs are receiving medications known to be harmful to older patients.
Slipping through the cracks
In the early 90s, Mark Beers, M.D., and several other specialists in geriatric drug therapy, developed a list of medications that were inappropriate for nursing home residents.
The list – now known as the Beers List – was amended in 1997, and updated in 2003, and has become a well known tool for guiding doctors away from prescribing medications that may be harmful when taken by older patients.
In an interview with HealthDayNews, Dr. Kevin Schulman, a professor of internal medicine at Duke University and one of the authors of the study, said that even though someone over the age of 65 may be in good health, their kidneys don’t function as well as they did when they were younger. This is one of the primary reasons that some medications can be harmful. Antidepressants and muscle relaxants can put particular stress on the kidneys.
The Duke team examined the outpatient prescription claims for more than 765,000 people aged 65 or older who had more than one prescription filled during 1999. Using the Beers List, the researchers produced this data:
- More than 20 percent of patients over the age of 65 may be taking inappropriate prescription drugs
- More than 15 percent of these patients received prescriptions for two or more of the drugs on the Beers List
- Four percent of the patients were prescribed three or more drugs on the list
- Psychotropic drugs (such as antidepressants) on the Beers List were prescribed the most, totaling more than 40 percent of the prescriptions
- Muscle relaxants on the Beers List were the second most commonly prescribed
Obviously, there are quite a few doctors out there who are asleep at the switch. And as a result, their patients may be suffering.
If you’re elderly and you regularly use prescription or over-the-counter medications, talk to your doctor about the Beers List, which you can find on the website for the Duke Clinical Research Institute(http://www.dcri.duke.edu/ccge/curtis/beers.html).
Sources:
“Inappropriate Prescribing for Elderly Americans in a Large Outpatient Population” Archives of Internal Medicine, Vol. 164, No. 15, August 2004, arcinte.ama-assn.org
“Many Older Patients on Risky Drugs” Steven Reinberg, HealthDayNews, 8/9/04, story.news.yahoo.com
“Updating the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults: Results of a US Consensus Panel of Experts” Archives of Internal Medicine, Vol. 163, No. 22, December 2003, ncbi.nlm.nih.gov
