The Prevalence of Polypharmacy
Polypharmacy, defined as the regular use of multiple medications, is a growing concern for older adults. As people age, they often develop multiple chronic conditions, leading to an increase in prescribed drugs. While often necessary, this complex regimen can increase the risk of adverse drug events, falls, cognitive issues, and hospitalizations. Regular, proactive medication reviews with a healthcare provider are essential to ensure the benefits of each drug outweigh its risks.
Common Prescription Medications
Older adults take a wide array of prescription medications to manage age-related health issues. These can be grouped into several key categories:
Cardiovascular Drugs
Heart disease and high blood pressure are extremely common in older populations, leading to high usage of these medications.
- Statins: These are lipid-lowering drugs used to manage high cholesterol and reduce the risk of heart attacks and strokes. Examples include atorvastatin (Lipitor) and simvastatin (Zocor).
- ACE Inhibitors and Beta-Blockers: These are prescribed for high blood pressure and heart-related conditions. Lisinopril (Prinivil) is a common ACE inhibitor, while metoprolol is a frequently used beta-blocker.
Antidiabetic Agents
With diabetes prevalence increasing with age, these medications are very common. Metformin (Glucophage) is a primary drug used to manage blood sugar levels.
Gastrointestinal Medications
Heartburn and stomach ulcers are common ailments that lead to the use of proton pump inhibitors (PPIs).
- Omeprazole: Often used to treat acid reflux and other stomach issues, omeprazole (Prilosec) is available both by prescription and over-the-counter.
Analgesics and Pain Management
Pain management is a significant part of senior care. While some older adults may be prescribed potent pain relievers like hydrocodone, nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen are widely used. NSAIDs should be used with caution due to potential side effects like stomach irritation and kidney issues.
Mental Health Medications
Depression, anxiety, and insomnia are common concerns. Many older adults take antidepressants or sleep aids. These medications require careful management, as some can increase the risk of confusion or falls.
Thyroid Hormone Replacement
Levothyroxine (Synthroid) is a common prescription for individuals with an underactive thyroid gland, a condition that can become more prevalent with age.
The Role of Over-the-Counter (OTC) Drugs
OTC medications are used frequently by older adults but carry their own set of risks, especially when mixed with prescription drugs.
- Pain relievers: Acetaminophen is often recommended for mild to moderate pain due to its favorable safety profile compared to NSAIDs. However, excessive use can cause liver damage.
- Antihistamines: Certain older antihistamines, like diphenhydramine (Benadryl), can cause drowsiness, confusion, and other side effects in seniors. Newer, non-drowsy options like loratadine or cetirizine are generally safer.
- Laxatives and Antacids: These are frequently used but can interact with other medications or cause side effects if not used correctly.
Potential Drug Interactions and Safety Concerns
As the number of medications increases, so does the risk of drug-drug or drug-disease interactions.
- Drug-Drug Interactions: One medication can alter the effectiveness or increase the side effects of another. For instance, combining multiple sedating drugs (like certain sleep aids and antihistamines) can significantly raise the risk of falls.
- Age-Related Changes: The aging body processes medications differently. Changes in kidney and liver function can affect how drugs are metabolized and eliminated, potentially leading to higher drug levels in the body and increased toxicity.
The Beers Criteria
Developed by the American Geriatrics Society, the Beers Criteria is a list of potentially inappropriate medications for older adults. It helps healthcare providers identify drugs that should be avoided or used with caution in this population due to higher risk of side effects or less effectiveness.
Medication Management Best Practices
Effective management is critical to minimizing risks associated with polypharmacy.
- Keep a Master List: Maintain a single, updated list of all medications, including prescriptions, OTCs, vitamins, and supplements. Share this list with all healthcare providers and keep a copy in your wallet.
- Use One Pharmacy: Using a single pharmacy allows the pharmacist to monitor for potential drug interactions.
- Regular Medication Reviews: Schedule a comprehensive medication review with a primary care physician at least once a year, or after any hospitalization. This practice, sometimes called "deprescribing," aims to eliminate unnecessary medications.
- Use Organizers and Reminders: Employ pillboxes, phone alarms, or automated dispensers to help remember doses and schedules.
- Store Medications Safely: Keep all medicines in a cool, dry place, out of the reach of children and pets. Properly dispose of expired or unused medications.
Comparison of Common Pain Relievers for Seniors
| Feature | Acetaminophen (Tylenol) | NSAIDs (Ibuprofen, Naproxen) |
|---|---|---|
| Best For | Mild-to-moderate pain, fever. First-line for chronic pain. | Mild-to-moderate pain, fever, inflammation. |
| Cautions in Seniors | Risk of liver damage with excessive dose. | Higher risk of stomach ulcers, kidney problems, high blood pressure, and heart issues, especially with long-term use. |
| Drug Interactions | Minimal, but toxic with excessive alcohol. | Can interact with blood thinners, blood pressure medication, and diuretics. |
| Best Practice | Use as directed, not exceeding maximum daily dose. | Use with caution and for short periods only. Consult a doctor for long-term use. |
Conclusion
Understanding what are common medications old people take is the first step toward safer medication management. With a proactive approach to medication reviews, careful attention to potential interactions, and consistent communication with healthcare providers, older adults can effectively manage their health conditions while minimizing associated risks. Empower yourself with knowledge and tools to navigate the complexities of medication use in later life.
For more detailed information on medication safety and deprescribing strategies for older adults, consult the National Institute on Aging website.
