I’m often asked by families about the effects of our residents (your loved ones) using multiple medications for the same condition. The term is called “polypharmacy,” and it typically applies to a senior being on five or more medications.
Taking a high number of medications at once can sometimes affect kidney function. Our kidneys remove waste products from the blood and produce urine. Before taking certain medications, it can be helpful to have some blood work to ensure the kidneys are functioning adequately.
Some medications need periodic monitoring.
Gabapentin, for example, is used chronic nerve pain. It is excreted through the kidneys. As we age and kidney function declines, the drug may increasingly accumulate in the body and side effects may emerge as a result of inadequate filtering. So what is the proper response? Clinicians should monitor and listen to their patients during examination. If symptoms start appearing that weren’t present before such as fatigue, headache, dizziness and anxiety, the provider should look into the “why” rather than prescribe medications to treat these new symptoms. This is precisely how polypharmacy becomes a common practice, and it shouldn’t be assumed that these symptoms are simply attributed to aging. If kidney functionality is reducing with age, a simple yet effective way of handling the treatment might be to slowly taper down the Gabapentin dosage.
Albumin, another example, is a blood protein that many medications bind to. In a malnourished or dehydrated individual, albumin levels may appear abnormal. For diabetics, it becomes a concern when we’re trying to heal a wound. But if that diabetic is taking insulin, hormones or steroids, it affects albumin levels and disrupts the wound healing. Sometimes simple remedies like hydration and proper nutrition are more appropriate than unnecessary medications — something a provider can and should examine more closely.
As we approach the cold and flu season, our seniors will be more vulnerable to coughing and sneezing. The antibiotics they are prescribed may be highly effective against bacterial strains, but not for viruses. Even worse, those same antibiotics can have negative side effects on our seniors, particularly with their gastrointestinal tract — leading to nausea, vomiting and diarrhea, and eventually dehydration.
Please be mindful of using antibiotics only when necessary, following specific instructions from your pharmacy (e.g. taking with food and finishing the regimen). It’s often safer to start with “first-line” antibiotics (e.g. amoxicillin) before using stronger medications.
Finally, one needs to consider the increased risk for falls with certain medications that are utilized for certain conditions. Many common medications can alter cognitive status, level of awareness and quick reflex response time. Providers will often consider these risk factors prior to prescribing such a medication, but it never hurts to raise these questions with them.
Making sure our seniors receive the most appropriate medication should be a top concern for all families, always taking into consideration potential side effects.
Stay Aware. Stay Hydrated. Stay Healthy.
Carmen Dalton, RN, BC, CALA
Director of Nursing
Van Dyk Park Place