By: Mark S. Lachs
Have you ever wondered why you are taking SO many medications? Have you asked your doctor if there are any medications you can do without? Have you considered if each individual medication is helping or hurting you? You are not alone if you are being overprescribed medications by your doctors.
Over the past several decades there have been amazing advances in medical care due to the development of new and effective medications, and many of these medications have significantly improved the quality of life as we age. Along with these major improvements, however, has come another problem — the piling on of prescription drugs has led to patients being overmedicated. This phenomenon, which is called polypharmacy can collide with an aging body and as we get older, too many drugs can cause a world of trouble. This is further complicated by the availability of over-the-counter vitamins and supplements, all of which can interact with prescribed medications.
6 QUESTIONS TO ASK …
1. Polypharmacy and Drug-Drug Interactions:
“Do all of my prescribing doctors know exactly what other medications I’m taking?” As we get older, we tend to see more doctors, and each doctor prescribes more drugs (in addition to over-the-counter solutions we take). It’s a good idea to keep a list of your medications with you at all times. Remember to update it when you start a new drug or change your dosage. You can use sites like www.drugs.com to see if your medication interacts with anything new you are prescribed.
2. Drug-Disease Interactions:
“What medications should I be avoiding?” Ask your doctor to educate you about what kinds of medications to avoid and make sure every prescriber knows your chronic conditions.
3. Slower Elimination of Drugs:
“Do I have a copy of my most recent blood work?” It’s a good idea to bring this report to every doctor visit. As we age, many of the organs that are supposed to remove drugs from our bodies, do it more slowly. This blood report typically includes kidney and liver function test results which will allow anyone prescribing a drug to see if the dose is okay or if it needs to be lowered.
4. Changes in Body Composition:
“Is the dosage prescribed appropriate for my age?” As we age, muscle mass is being replaced by fat and this can affect the level of the medication in the blood.
5. Changes in the ‘Target’ Organ:
“Is a lower dose practical or possible?” As we age, our bodies become more sensitive to certain medications. The solution is to “start low and go slow”- to start with a minimal dosage. You can always have a dosage increased later.
6. Cognitive or Sensory Changes that Preclude You from Taking a Drug Correctly:
“Am I keeping my medications organized?” There are options for keeping an organized system for your medications such a daily pill box and calendar reminders, and always be sure that you have the ability to open those childproof bottles
Taking medications properly and communicating with all your doctors is key to a successful outcome. Talk to your doctor, advocate for yourself, ask questions, keep records, and never start, stop, taper, or permanently discontinue a medication without his/her say-so.
It’s also important to remember that you don’t need a prescription to get into trouble! Be sure to tell your doctor EVERYTHING that you are taking – including vitamins and supplements. Sometimes a supplement or natural compound can cause a negative interaction with your medication. Supplements are not as widely studied as those for prescribed medications and the effects are not all known.
Mark is the Co-founder, Executive Vice President and Chief Gerontological Officer at CompassCare. He is MD, MPH and Co-Chief of Geriatrics at NY Presbyterian Hospital and a Distinguished Professor of Medicine at Weill Cornell Medical College. Mark is a bestselling author and is internationally recognized as an expert in aging.