Using medicine

People age 65 and over buy more than 25 percent of all prescription medicines and 30 percent of all nonprescription (over-the-counter) medicines sold in this country. Older people are also more likely than younger people to have long-term illnesses such as arthritis, diabetes, high blood pressure, and heart disease that require taking medicines on a regular basis. Because older people often have several different health problems, it is common for them to take several different medicines.

When compared to younger people, older individuals tend to be more sensitive to the effects of many drugs. For example, a drug such as Valium(TM)(diazepam) may stay in an 80-year-old body four times as long as it does in a 40-year-old body. The liver and the kidneys break down and remove most drugs from the body. As people age, these organs may not work as rapidly as they once did and some drugs may leave the body more slowly, sometimes causing side effects. Therefore, when drugs are prescribed by a doctor or other health care provider, it is a good idea to ask if it is the proper dose for an older person.

Many patients see several different doctors who each may prescribe one or more medicines. In such cases, it is very important that at least one doctor keeps track of all the medicines a person is taking to minimize drug-drug interaction and other risks associated with taking many medicines. If the (primary care) doctor is unaware of the medicine already prescribed by other doctors and health care providers, this can cause problems.

Tell the doctor and pharmacist about medicines that the person you are caring for is taking, including nonprescription medicines. These include the following:

• All prescription drugs from any doctor, including eye drops, creams, and ointments.
• Nonprescription medicines, including vitamins, minerals, antihistamines, sleeping pills, laxatives, cold medicines, and antacids.
• Folk remedies, nontraditional products, or "alternative medicines," such as plant compounds, herbs, special teas, or nutritional supplements.
• "Social" drugs such as alcohol, tobacco, or caffeine.

It will be helpful to the doctor, in making diagnoses, to know all the medicines that the patient is taking. The doctor needs this information because nonprescription medicines can interact with each other as well as with prescribed medicines in ways that could be harmful to the patient. Nonprescription medicines can also cause side effects that the doctor may have to treat.

Pharmacists are able to give you information about side effects of medicines and even how they can interact with each other. Ask the pharmacist for this information and ask any other questions you have about the medicines when you have prescriptions filled or refilled. Doing so may prevent a serious problem. Your goals are to:

• Follow the doctor and pharmacist's instructions. If you don't understand their instructions, ask for clarification
• Know all medicines that are being taken and their side effects
• Know if the medicines being taken by the patient are safe to use together
• Ask for generic brands in order to keep costs lower
• Watch for side effects from the medicines and report them in a timely manner

It is especially important that if a person has difficulty breathing or if there is swelling in the throat, call 911 or take the person to an emergency room immediately.