Judith Beizer
Judith Beizer, PharmD, is clinical professor at St. John’s University College of Pharmacy & Health Sciences, New York City.
https://www.StJohns.edu
Medications that are safe and effective for younger people sometimes can be dangerous for people nearing their 70s or older. Kidney function decreases as we age, so drugs remain in our system longer…and some receptors in the body become increasingly sensitive over the years, ramping up certain side effects.
Prescribing age-inappropriate medications can occur in different ways—doctors may not consider patients’ age when they prescribe drugs…they may neglect to review long-term prescriptions as their patients get older…and the patients themselves often are unaware that over-the-counter (OTC) drugs they’ve used for years might affect them differently as they age.
Among the drugs that are potentially inappropriate for older patients…
Diphenhydramine, the antihistamine in OTC drugs such as Benadryl and Tylenol PM, can cause confusion and/or excessive sedation in older patients. Other side effects include constipation, dry eyes and dry mouth.
Benzodiazepines, such as Valium and Xanax prescribed for anxiety, insomnia and muscle spasms…as well as certain nonbenzodiazepine sedative drugs, such as Ambien…can linger in older people’s bodies longer than expected, significantly increasing risk for falls.
Non-steroidal anti-inflammatory drugs (NSAIDs), including ibuprofen found in Advil and Motrin, can cause kidney damage when taken regularly and can exacerbate existing blood pressure or heart problems. Talk to your health-care provider about NSAID use.
Opioids, such as Vicodin, OxyContin and Percocet—commonly prescribed for pain relief—can cause confusion and drowsiness in older users.
Sulfonylureas, a class of diabetes drug that includes glimepiride and glyburide, can cause dangerously low blood sugar in older patients.
Muscle relaxants, including cyclobenzaprine and methocarbamol, can cause confusion, excessive sedation, constipation, dry eyes and/or dry mouth.
What to do: If you are nearing or older than 65, ask your pharmacist to review your prescription and OTC medications. If he/she raises concerns, mention this to your doctors—a medication change or dosage adjustment might be appropriate.
Better yet: People aged 65 or older should see a geriatrician. Geriatricians specialize in treating older patients and are more likely to know which drugs are inappropriate for this age group. To find a geriatrician in your area: Go to Medicare.gov or search for one in a local hospital or health network.
