Medicine is the most common treatment for many of the problems associated with aging. Medicine treats and cures diseases, prevents life threatening illnesses, relieves pain, and helps terminally ill patients. Often, people have a better quality of life and live longer because of the medicine they take.

However, medicine can sometimes be a double-edged sword for the aging person. If prescription medications, over-the-counter medications, and herbals and supplements are not taken properly, there can be devastating results.

Taking medication improperly can lead to unnecessary visits to the emergency room, hospitalization, or admission to a nursing home.

Changes in your body
Aging causes a change in the body's processes. These changes create a need for a different dose strength of some medications that are taken by the elderly. In some instances, a medicine can be most effective in a child's dose. It is important that your doctor, nurse, and pharmacist know your age so the right dosage and dose strength is prescribed. Overdoses can occur in aging adults because of the body's inability to handle the medication. During routine visits to your doctor, be sure to discuss any new symptoms that you may have experienced since your last visit (Table 1).

Age-related problems associated with taking medicine can be easily overcome if you discuss them with your doctor (Table 2).

Problems remembering to take medication, being able to read the labels, and being able to open the bottles are just a few of the everyday problems that should be discussed with your physician. There are solutions available to help you overcome these types of problems. For example, inexpensive electronic devices that beep to remind you when to take your medicine are available. You can ask that instructions and labels be printed in large print to make it easier to read. Getting a printout of instructions also helps if you have difficulty hearing your physician or remembering what he said.

When your doctor prescribes medication, don't be afraid to ask questions about it. You should always know what you are taking and why. Ask your doctor if the medication is necessary and if it is the best medicine for your condition. Also, be sure to ask if the new medication will affect other medicines that you are taking. Ask if you are taking the right dose, although, often, the dose has to be adjusted a time or two to get it just right for you. Ask what side effects you may have while taking the medication. After you begin taking a medication be sure to let your doctor know if you experience any problems such as feeling drowsy, confused, or depressed. Let him or her know if you can't sleep, feel shaky, or are not steady when you walk. All of these symptoms are important considerations in prescribing the right medication and the right dosage.

Just because the label of an over-the-counter herbal supplement says "natural" does not always mean it's safe. You should keep in mind that herbals can interact with your prescribed medicine. The Food and Drug Administration (FDA) does not regulate herbals so companies don't have to demonstrate if their herbal is effective, safe to use, or if it has an adverse effect on other medicines. For example, ginkgo biloba and other herbal supplements used in memory loss can interact with blood thinners, high blood pressure medications, ibuprofen, and naproxen. Remember, it's important to let your doctor and pharmacist know what kind of herbals or supplements you are taking.

Keeping a record
The benefits of your medication are at the highest when you take the proper dose at the prescribed intervals. If you take a medication daily, it is best to take it at the same time each day. Keeping a written record of your medication schedule is an excellent way to keep up with how much you have taken and when the medication was taken. A spiral notebook is an inexpensive and convenient way to keep a written record of your medication schedule. You can show the record to your doctor at each visit. You can also note any new symptoms or side effects you experience. The record can help pinpoint the cause of any problem. You can also list the results of any testing your doctor has prescribed for you to do at home, such as the results of testing your blood pressure or blood-sugar level.

Taking medications doesn't have to be a double-edged sword. For better health and management of your medications, talk to your health care professional if you have questions about your medicine. Make sure your doctor knows everything you take, which includes herbal tea, vitamin supplements, or over-the-counter medicine. Your medicine should improve your health and well-being rather than contribute to illness, so always speak up if you have questions, and tell the doctor if you have side effects.

Nancy Chaffee, RPh, MSHA
Columbus, Georgia

References:

• Williams RD. Medication and older adults. FDA Consumer. 1997. National Alliance for Caregiving, AARP. Family caregiving in the US: findings from a national survey. 1997.
• Hanlon, JT, et al. Development of the family caregiver medication administration hassles scale. The Gerontologist. 2003;43:360-368.

• American Geriatrics Society: www.americangeriatrics.com
• Food and Drug Administration: www.fda.gov/cder/consumerinfo/DPAdefault.htm
• National Council on Patient Information and Education: www.talkaboutrx.org
• Peter Lamy Center for Drug Therapy and Aging, School of Pharmacy, University of Maryland:  www.pharmacy.umaryland.edu/lamy