Medication and elderly people - Lloydspharmacy.com Health

Reviewed by Helen Marshall, pharmacist

As we get older, our use of medicines will often increase as we treat ailments that occur as a result of ageing.

Medicines are taken to ease, control or cure ailments. They are effective and safe if used correctly.

However, elderly people can be at increased risk from medicines for various reasons.

Medicine usage

Four out of five people aged over 75 years take at least one medicine.

36 per cent of this age group take four medicines or more.

The ageing body can be more susceptible to the side effects of medicines.
Elderly people with multiple diseases can often end up taking multiple medicines at the same time. With multiple medicines, there is an increased chance of side effects, interactions between different medicines and problems taking them correctly.
The physical effects of ageing, such as arthritis and failing eyesight and memory, can also cause issues in taking medicines the way your doctor intended.

Although your healthcare team will do their best to minimise such problems, there are a number of things you and your carers can do to ensure medicines provide the desired effect with minimal problems.

General advice

Discuss your medication with your doctor or pharmacist.

Learn the names of the medicines you are taking and find out why they have been prescribed.

You also need to know how often you should take them, and for how long. If it helps, write this information down.

Medicines often have more than one name:

a generic name eg atenolol. This is the medical name for the active ingredient of the medicine.
a brand name eg Tenormin. This is the trade name a manufacturer gives to a medicine.

This means the same medicine may have several different names or types of packaging.

If your pharmacist gives you a medicine that looks different to the one you are used to, make sure you ask for an explanation before leaving.

Taking medicines

Always try to take your medicines as intended by your doctor. Make sure you know what to do if you miss a dose or take too much.

To avoid mistakes, never take medicines in the dark. Always read the label before you take the medicine and check the expiry date.

Storage

Never mix different medicines in one container. Always store your medicines in the containers they were supplied in.

If you transfer medicines to other containers, you may not be able to identify them or know when they expire.

The stability of certain medicines can also be affected if they are transferred from their specially designed packaging.

Side effects

Talk to your doctor or pharmacist about possible side effects of your medicines so you know what might be expected.

Some side effects may disappear after a few days, while others may indicate that your dose needs reducing.

If any side effects are troubling you, talk to your doctor or pharmacist. Similarly, if you think your medicine is not effective, talk to your doctor or pharmacist.

Keep a permanent record of any allergies you have to medicines.

Herbal medicines

Always check with your pharmacist before taking non-prescription or herbal medicines alongside your prescribed medicines.

Some medicines should not be taken together because they affect each other once inside the body.

In the longer-term

Do not expect a prescription each time you visit your doctor. Advice may be enough.

If you are admitted to hospital, make sure you know whether any changes have been made to your usual treatment and why, before you are discharged. This might include discontinued medicines, dose changes or new medicines. Understanding any changes on discharge can help avoid confusion at a later date.

At least once a year, ask your doctor or pharmacist to review all your medicines to see if they are still needed, particularly if you are taking four or more medicines.

How can ageing cause problems using medicines?

Declining liver and kidney function

As we age, our livers become less efficient at breaking down medicines, our kidneys less efficient at excreting them.

This means that normal adult doses of certain medicines may be more likely to cause side effects.

To avoid this, your doctor may prescribe you a lower dose of a medicine.

Brain and nervous system

The brain and nervous system become more sensitive to certain medicines as we get older.

For example, elderly people are particularly susceptible to the side effects of opioid painkillers such as morphine and sleeping tablets such as diazepam.

Your doctor may prescribe lower doses of these types of medicines and for short periods only.

As we age we can also become more forgetful and may have trouble remembering what medicines are for, or whether we have taken them that day.

There are various strategies to help, including medicine reminder charts and pill boxes that can be filled with all the daily or weekly pills needed. A pharmacist or health visitor can help you arrange this.

Eyesight

Failing eyesight can cause problems with reading small print labels and information leaflets supplied with medicines. If this is a problem, ask your pharmacist for large print labels and leaflets.

Bones and joints

Arthritis is a common problem affecting elderly people, and it can cause particular problems with getting medicines out of childproof containers and administering medicines such as eye drops and inhalers.

Since medicines are of no use if you can’t get into them, your pharmacist can supply your medicines in non-click lock containers on request. He or she can also provide devices to make using medicines such as eye drops and inhalers easier.

But you will need to remember to keep medicines that are in non-click lock containers well out of the reach of children.

Mobility

If you have difficulty getting to the doctor’s to collect prescriptions or to the pharmacy to get them dispensed, tell your doctor or pharmacist. Home visits and delivery arrangements can be made.

Swallowing

Many elderly people have trouble swallowing tablets and capsules. You should always take tablets and capsules with plenty of water.

Tell your doctor or pharmacist if you have difficulty swallowing them, because many medicines also come in liquid or soluble forms that are easier to swallow.

Advice for specific groups of medicines

Diuretics (sometimes called water tablets)

Diuretics are used most commonly to treat high blood pressure. They are also used to treat conditions such as heart failure and cirrhosis of the liver, in which they remove excess fluid that has been retained in the body.

Diuretics are designed to draw water out of the body, which means you may need to go to the toilet more frequently. For this reason, try to make sure you can easily get to a toilet quickly.

It is usually best to take diuretics in the morning to avoid disturbing your sleep with trips to the toilet at night.

Another possible side effect of diuretic medication is it can cause a drop in your blood pressure when you get up from lying down or sitting. This may make you feel dizzy or light-headed.

If you find this is a problem, get up slowly. If you do start to feel light-headed, sit or lie down until the symptoms pass.

Because the aim of diuretic medication is to remove fluid from the body, you should try not to counter its effect by drinking too much. Just drink enough to satisfy your thirst.

Some forms of diuretic medicine also remove salts (potassium and sodium) from the body. For this reason, your doctor may want to monitor your levels of these salts using a blood test.

Sleeping tablets

Good advice

The following may help if you can't sleep.

Keep to regular bedtimes - don't sleep or doze during the day.

Don't drink tea or coffee in the evening.

Have a set time for getting up in the morning.

Make sure your bed and bedroom are comfortable; not too cold or too warm.

Sleeping problems are common. Try not to get frustrated if you can't sleep.

Sleeping tablets should only be used as a short-term treatment. This is because the tablets lose their effect after a while because the body gets used to the medicine.

Common side effects of sleeping tablets include unsteadiness and feeling drowsy the next day. Such side effects are more common in the elderly and increase the risk of falls.

Don't drive if affected by sleeping medication.

Sleeping tablets should not be stopped suddenly. Your doctor will advise on how to stop them gradually.

Painkillers

Pain and stiffness in the back and joints is common in old age. Weight reduction, warmth and exercise may all help.

If the pain does not settle, see your doctor.

Simple painkillers such as paracetamol (eg Panadol) can be effective for arthritic pains.

Many stronger painkillers such as co-codamol (eg Solpadol), co-dydramol and morphine (eg MST continus) cause constipation as a side effect, so a laxative may also be needed.

Aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (eg Brufen, Nurofen), naproxen (eg Naprosyn, Synflex) and others can cause bleeding from the stomach or bowel.

Elderly people are at particular risk from this side effect, particularly those with heart and kidney problems.

More than one NSAID should not be taken at the same time. If you've been prescribed an NSAID by your doctor, you should not buy aspirin, ibuprofen, naproxen or diclofenac over the counter to take as a painkiller as well. Ask your pharmacist for advice when buying painkillers.

Talk to your doctor or pharmacist if painkillers do not provide effective relief.

Based on a text by Professor Marion McMurdo, honorary consultant in medicine for the elderly, Dr Patrick Davey, Dr Jens-ulrik Rosholm, Dr Erik Skjelbo, Dr Lotte Fonnesbaek, pharmacist and Jens Peter Kampman, consultant

Last updated 02.12.2010

The materials in this web site are in no way intended to replace the professional medical care, advice, diagnosis or treatment of a doctor. The web site does not have answers to all problems. Answers to specific problems may not apply to everyone. If you notice medical symptoms or feel ill, you should consult your doctor - for further information see our Terms and conditions.