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House Call: As you age, medications bring more risks

Tue., Feb. 25, 2014, midnight

Remember the first time you found a gray hair? Or noticed fine lines around your eyes? You may be less aware of internal changes happening as you age because you cannot see them in the mirror.

One of those changes is how your body responds to and metabolizes medications. No matter how well you have cared for yourself, your liver, kidneys, central nervous system and heart are probably not functioning quite as efficiently as when you were 30. As a result, medications, even nonprescription, can affect you differently. You may have more side effects or your body could take longer to clear out the medication. As you age, start taking supplements, or develop new medical conditions requiring more than one medication, medications you have been taking for years need to be reviewed and sometimes changed.

Preventing complications that can occur from taking multiple medications means reviewing all of your medications with your health care provider and your pharmacist. Take a complete list of all of your medications, vitamins, herbal remedies and supplements with all the dosages to all your health care appointments. Review the list with your provider to make sure medical records are accurate. Update your medication list after every appointment, hospital visit and trip to a pharmacy and make sure at least one family member or close friend knows where to find it.

Sometimes, despite best efforts, your medications interact with each other in a way that causes adverse effects. When you begin a new medication, pay attention to any new symptoms (especially dizziness and weakness, which can lead to falls or other accidents) and report them or any other concerns to your health care provider and/or pharmacist. It may be that the new medication or others you are already taking need a dosage adjustment, to be changed or to be stopped all together. Do not stop taking any medication without consulting your health care provider.

Take medications as prescribed to get the full effects and benefits from them. If you feel your medication routine is too complicated for you to stick to it or that you cannot afford it, your provider may be able to find ways to simplify it or reduce the cost. There are also solutions to other barriers that may keep you from taking your medication. You can get non-childproof caps if needed, enlarged print labels, and pillboxes with separate compartments for different times of day and the days of the week. A daily checklist may help you keep track.

Hospital stays and ER visits are times when medications often change. For example, acute pain from an injury may raise your blood pressure and your blood pressure medication dose may be adjusted to get your blood pressure back into a safe range. As you heal and your pain is better controlled, it may be appropriate to return to your pre-injury dosage of blood pressure medication. Before you leave the hospital, whether to go home or to a different health care facility, find out if you should continue with new medications or new dosages of existing medications prescribed during your stay.

Be sure to ask questions of your doctor, physician’s assistant, nurse practitioner, nurse and/or pharmacist anytime there is a change to your medications. Are there any alternative treatments you could try before turning to medication? Is a prescribed medication considered to be high-risk in older people? Is there a lower risk or lower cost medication you could try first?

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section.

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