Erickson Tribune

Health Secrets

UPDATED: Tuesday, February 13, 2007

'The pharmaceutical cocktail'

Posted on Friday, December 15, 2006
 

Avoiding multiple medication dangers

By Wendy J. Meyeroff
THE ERICKSON TRIBUNE

Consider the case of a lady we’ll call “Sarah.” Sarah is 70 years old and has mild arthritis, high blood pressure, heart disease, low bone density, and diabetes. For these conditions, she takes five different prescription medications.

Sarah’s scenario is not unusual. One report notes that 20% of Medicare beneficiaries have five or more chronic conditions and 50% are taking five or more medications.

The pharmaceutical cocktail
This mish-mash of medications in someone’s system has come to be known by physicians as a “pharmaceutical cocktail.”

“Too often, older adults find themselves arbitrarily handed different medicines, by different doctors, treating different conditions,” says Matt Narrett, M.D., chief medical officer for Erickson Communities. “Someone’s rheumatologist prescribes an anti-inflammatory for arthritis, the cardiologist prescribes a statin drug to fight cholesterol problems, and the list continues, with none of these doctors knowing what the other is putting into the person’s system.”

Narrett continues, “Unfortunately this disease- driven approach to treatment—the idea of prescribing what’s good for fighting each particular disease—isn’t always good for the overall treatment of the patient.” He points to the case of a woman whose family thought she was suffering from dementia. It turned out the multiple medications her different doctors had prescribed were making her foggy-headed and seemingly slow-witted, dulling her reflexes and causing other problems. “The family just figured, ‘That’s how Mom has to be,’” says Narrett.


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Seeking solutions
The good news is this scenario doesn’t have to happen if Sarah is part of a health care system that uses electronic medical records. “At Erickson we have a specialized electronic medical records system, called Centricity. It allows Erickson HealthSM doctors to access clinical information including medication checking instantaneously,” says Narrett. “Sarah’s doctor will see all the medicines she’s taking.” If something new has to be added to the mixture, the system will help the medical team evaluate which product can be added most safely.

If your doctor doesn’t have access to a system like Centricity, then it’s critical to make sure you know all the medications you (or a loved one) are taking and your primary care doctor knows them, too. Whenever new doctors prescribe yet another medicine, ask how it will interact with other drugs you are already taking. Give the physicians a list of those drugs (you should carry it with you), or have them call your primary care doctor.

Communication is critical
Even when a drug is highly recommended, stay alert to problems. If you are feeling nauseous, dizzy, or otherwise unwell after starting a new drug, make sure to provide your physician with feedback immediately.

Ask your doctor if a new drug is your best option. A strength-training exercise to build bone density might be a better alternative than a drug.

That is especially true if you are finding it hard to handle all your medicines. Experts say most people of any age take only about half their medications as prescribed and their adherence to proper drug regimens worsens as the number of drugs they have to keep track of increases. Be honest with your doctor if you are having problems maintaining your drug regimen.

Caution, not fear
We want to be clear that we are not trying to discourage you from taking medication when you need it. If you read about a drug that sounds interesting in The Erickson Tribune’s articles on osteoporosis, or saw an ad on TV, you should be able to discuss drug options with your doctor—but discussion is the key. Narrett doesn’t think physicians should write a prescription because the patient asks for a medicine. Instead he feels doctors should follow this course of action:

“First, look at the patient’s overall medical history, including the other drugs he’s taking. Next, evaluate what risks a new drug would add and how those risks would compare to any problems that might arise if he didn’t take this additional medicine. Finally, are there any nondrug options that would be feasible for this person?”

Develop a good flow of communication with your doctor and you have a better chance of reaping the benefits of today’s wondrous medications, while minimizing drug dangers.



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