Mark Loehrke Times correspondent
To think there was probably a time when even a simple day-of-the-week medication organizer probably seemed a little over the top to many seniors. But aging has a way of piling up more aches, pains, and ailments (and the associated medications), meaning that keeping pills and dosages on track involves more than just knowing what to take when. It also means being aware of potentially harmful interactions between those drugs.
Pharmacy director Elizabeth Clements and her team at Community Hospital probably spend as much time comparing and answering questions about potential drug interactions as they do filling prescriptions. Here are some of her thoughts and recommendations for seniors as those drug organizers start to fill up:
What questions should seniors ask their doctor and/or pharmacist regarding potential drug interactions when starting a new drug?
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Elizabeth Clements: I would first ask if there are any interactions between the new medication and the current drugs. Second, I would ask if the drugs interact with any vitamins or supplements I’m taking. If there is an interaction, I would ask if it is safe for me to take the new medication or if there is an alternative medication that might be better for me. Finally, I would like to ask if there are any side effects I should look for that may need to be discussed with my provider.
How difficult is it as a pharmacist to avoid unwanted drug interactions for seniors who often already take multiple medications?
Clements: The more drugs a patient takes, the more likely there is a drug interaction. However, not all drug interactions require medication changes. Some drug interactions can be addressed by staggering medications or having the patient watch for specific symptoms. It is important that healthcare providers consider the potential effect of the drug interaction with the patient in mind. That is, if an interaction could cause symptoms that would worsen a patient’s medical condition, that drug combination may not be the best choice for the patient and we should look to other drugs to treat the patient. Sometimes it just isn’t possible to avoid drug interactions and we may have to make a decision about which interactions are safest.
What are some signs of possible adverse drug interactions or side effects?
Clements: Any drug interaction can have several signs to watch out for. With blood thinners, an interaction may increase the risk of bleeding. Interactions with blood pressure medications can cause your blood pressure to drop, which can make you feel dizzy. Interactions with pain or sedative medications can make you feel sleepy or weak and lead to falls. When starting a new medication, be aware of any changes in how you feel. Protecting your health is important and it never hurts to ask questions.
Have things gotten better or worse in recent years when it comes to drug interactions between seniors?
Clements: Drug interactions have declined in recent years. We’ve seen increased integration between electronic health records and pharmacies, giving healthcare providers a clearer picture of a patient’s medications. This allows providers to identify and address drug interactions that they were previously unaware of. However, the availability of new drugs – and learning to deal with new interactions – presents an ongoing challenge for healthcare providers and pharmacists.
What is good general advice for seniors regarding drug interactions?
Clements: Provide your provider with an updated medication list at every appointment. We often see patients with multiple medical conditions who use different healthcare providers for their care. These providers may use different medical records and may not have the most current list. Also try to use one pharmacy to get your medications. This allows your pharmacist to view your medication list for drug interactions. Foods can also interact with medications. Be sure to include that in your conversations with doctors and pharmacists.