Friday, October 7, 2016

How Older People Can Head Off Dangerous Drug Interactions

Potentially serious drug interactions are a daily threat to older people who take multiple medications and supplements, according to the U.S. Food and Drug Administration.

One drug can affect the effectiveness of other drugs and how your body uses them. For example, your kidney and liver may not work as well, which affects how drugs are broken down and leave your body, the FDA said.

“There is no question that physiology changes as we age. Many chronic medical conditions don’t even appear until our later years,” Dr. Sandra Kweder, an FDA medical officer, said in an agency news release. “It’s not that people are falling to pieces; some changes are just part of the normal aging process.”

The FDA says these safety tips will help prevent harmful drug interactions or side effects:
  • Follow your doctor’s directions
  • Keep a medication list
  • Learn about possible drug interactions and side effects
  • Routinely go over your medication list with your doctor

“As a society, we have become reliant on pharmaceuticals to help us attain a longer and higher-quality life. It’s a wonderful success of Western medicine,” Kweder said. “The goal should be for each of us to access that benefit but respect that medicines are serious business. To get the most out of them, you should take them with great care and according to directions.”

My Take:
I question the wonderful success of Western medicine. Sure we are living longer, but is the quality of life really better?

Polypharmacy (taking 5 or more prescription medications) is now the norm as we age. I routinely see new patients taking 10 or more medications daily. As I have noted in earlier blogs, no physician can properly manage polypharmacy – there are just too many drug interactions.

For example, Lisinopril, an ACE inhibitor prescribed for high blood pressure has 659 known adverse drug interactions. That includes 79 major drug interactions that represent 312 brand and generic products. One of those interactions is with Crestor, a statin drug that is the most prescribed drug in the world. Another is Lasix, a diuretic that is commonly prescribed with Lisinopril.

I recently had a new patient that at the age of 81 takes no prescription medication. Treatment of her sciatica was simplified by the lack of drugs pumped through body over the course of her life. In fact, the biggest obstacle I face in the treatment of elderly patients is polypharmacy.

It dramatically limits my nutritional options because of drug-herb interactions. Additionally, most if not all of their symptoms are caused or aggravated by the drugs they are taking.

The Bottom Line:
Here are my recommendations to head off drug interactions:
  • Eliminate as many drugs as possible. Most of the benefit from medication can be achieved through life style changes – diet, nutrition, exercise and weight loss.
  • Be you own health advocate. Research any medications before you agree to take them. Ask your physician for alternatives.
  • When you go over your medication list, ask your physician to help you reduce your medication. Physicians typically keep patients on a medication as long as the patient tolerates it, regardless of benefit. Blood pressure medication is a prime example.
  • Review the side effects for any drugs you take. If you feel you are suffering from any of the side effects consult with your physician about alternatives.

Source: September 24, 2016 National Institutes of Health

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