Medicine-Related Problems for Older Adults

What are signs of medicine-related problems?

Medicine-related problems may be mistaken for normal aging or worsening of a health problem. Some symptoms that may be caused by medicines include:

• confusion
• memory problems
• mood changes
• depression
• fatigue
• falling
• dizziness
• constipation or diarrhea
• blurred vision
• problems with urination.

If you think you may be having problems with any medicines you are taking, talk to your provider.

Why do medicines sometimes cause problems?

As people get older, they tend to have more health problems. Arthritis, high blood pressure, and heart disease are much more common in adults over the age of 70. If you have several health problems, you may need to take a lot of different medicines. This increases the risk of side effects and drug interactions.

Aging changes how the body absorbs and eliminates medicines. The liver and kidneys become less efficient at breaking down and removing drugs from the body. This means that older adults may have more problems with side effects from their medicines.

Many medicines are harmful if you take too much or if you take too little. If you take more than 1 medicine at a time, you may have problems you do not expect. All medicines can have side effects, or change the way other medicines work, even nonprescription drugs.

Medicines commonly taken by many older adults are:

• nonprescription drugs such as laxatives, antacids, antihistamines, decongestants, and NSAIDS (anti-inflammatory pain-relief medicines)
• narcotic pain medicines
• diuretics and other blood pressure medicines
• sleeping pills
• a heart medicine called digoxin.

Problems these medicines might cause are described below.

Nonprescription medicines

Nonprescription medicines can be dangerous. They may be harmful to people with high blood pressure, diabetes, and thyroid problems. They may affect how prescription medicines work.

Here are some examples of nonprescription medicines that can cause problems in older adults:

• Most laxatives should be used for no more than 1 week at a time. Constant use can drain the body of water, vitamins, and minerals. You may need more and more of the laxative to get results. Eventually the laxatives may not work. Laxatives can also change the effects of other medicines.
• Antacids can keep certain drugs for Parkinson's disease, high blood pressure, and heart disease from being properly absorbed by the body.
• Antihistamines are more likely to cause side effects in older adults. Side effects may include drowsiness, dizziness, confusion, dry mouth and eyes, constipation, and trouble urinating. They should be used only if recommended by a healthcare provider.
• Some decongestants can cause nervousness and trouble sleeping and raise your blood pressure. Do not take these medicines if you have heart problems, high blood pressure, diabetes, or glaucoma. Do not take these medicines if you have an enlarged prostate that affects your ability to urinate.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause kidney and stomach problems. These medicines can also make blood pressure medicines less effective. Aspirin, ibuprofen, and naproxen are NSAIDs that you may buy with or without a prescription. These drugs should not be taken with a blood-thinning medicine, because they thin the blood even more. Talk with your healthcare provider before taking NSAIDS. Adults 65 or older should not take NSAIDs for more than 7 days without their provider's approval.

Ask your pharmacist to help you choose the best medicines for your needs. Always read the directions on the medicine label.

Prescription medicines

Prescription medicines can also be dangerous. Here are some examples of nonprescription medicines that can cause problems:

• Narcotic painkillers are used to relieve severe pain. These medicines may cause confusion, sleepiness, and constipation.
• Antibiotics often cause diarrhea and may cause yeast infections. If you develop severe diarrhea or diarrhea that lasts more than 2 or 3 days while taking an antibiotic, contact your healthcare provider. If you are not having these significant side effects, be sure to finish taking all of the antibiotic prescribed.
• Diuretics, also called water pills, reduce the amount of water in the body. They are used to treat high blood pressure and heart failure. They may have the following side effects:
  • They can make you dizzy, especially when you are standing up, and increase your chances of falling.
  • Some may increase blood sugar levels. Talk with your healthcare provider about this if you have diabetes.
  • They can cause your body to lose potassium and other minerals. Signs that your body is low on potassium include weakness, muscle cramps, loss of appetite, irregular heartbeat, or constipation. If you have these symptoms, talk to your healthcare provider.
• Some other blood pressure medicines, such as beta blockers, may make you dizzy or faint when you get up quickly after sitting or lying down. Getting up slowly may help. Contact your healthcare provider if you keep having these symptoms continue or they get worse.

  Vasodilators are another type of blood pressure medicine. You may feel dizzy or have headaches while taking these medicines. Older adults may be more likely than younger people to have side effects. Your healthcare provider may prescribe another medicine if the side effects are severe.

• Digoxin can help the heart work better. It can also slow the heart rate. If the dosage is too high, digoxin can lead to dangerous side effects. Signs of too much digoxin include nausea and vomiting, extreme tiredness, loss of appetite, vision problems, irregular or slow heartbeat, confusion, and seeing or hearing things that are not there. If your heartbeat is slower than 50 beats per minute, or if you have any of these other symptoms, contact your healthcare provider right away.
• Sleeping pills can cause severe confusion or hallucinations (seeing or hearing things that are not there) if you take too much. They can also stay in the body for a longer time in older adults, which can leave you drowsy and increase your risk of falling.
• Tranquilizers can help you feel calm, but they can also make you sleepy, dizzy, or confused. They can increase your chances of falling. They may be habit-forming if you take them for a long time.

Other medicines, such as drugs used for Alzheimer's disease, can also cause dizziness. Sometimes taking medicines at bedtime, or taking them with meals, helps prevent side effects. Your pharmacist can tell you the best way to take your medicines.

How can I help prevent medicine-related problems?

To make sure that your medicines work best for you, make sure you know:

• the correct doses of all your medicines
• what side effects to watch for
• how safe your medicines are when you take them with other medicines.

Make sure that you tell your pharmacist and all of your healthcare providers all the medicines you are taking, including nonprescription drugs, natural remedies, and supplements. This is especially important if you have more than 1 healthcare provider.

Many nonprescription cold remedies contain antihistamines and decongestants, which can cause serious side effects. Check with your healthcare provider before using these medicines.

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