According to the
American Society of Health-System Pharmacists, more than 34
percent of seniors take medications prescribed by more than
one physician and 72 percent take medications that were
prescribed more than six months ago. This is one reason why
caregivers need to be aware of the potential for drug
interactions. There may be times when multiple medications
are needed to manage symptoms or provide relief in some
form. Interactions occur when medications donít work in
tandem with one another and instead one of the drugs or both
of them together adversely affect your loved oneís health.
Prescription and over the
counter (OTC) medications should both be considered when looking at
drug interactions. Herbal remedies and food interactions can be a
source of concern as well. Finally, drug reactions are just as
critical as interactions since they can cause problems for the
patient as well.
Drug interactions are often a
concern for people since as they age, they tend to take even more
medications. What most people donít realize, however, is that common
OTC medications can cause serious drug interactions as well. For
this reason alone, it is critical to take a complete list of
medications to both your doctor and your pharmacist.
Some patients may think it is
ďoverkillĒ to provide the list to both the doctor and the
pharmacist. After all, the doctor prescribes medication; he should
know the interactions to look for, right? Well, not always.
Pharmacists train in medication
and specialize in learning about interactions. It is best to check
with both of them just to be sure that nothing can adversely affect
your loved oneís health. Experts use this explanation as a basis for
suggesting that individuals use the same pharmacy each time they
have a prescription filled. The pharmacy keeps records and flags the
account for possible drug interactions. Bring a record of any OTC
medications that your loved one takes as well so that your
pharmacist can have a complete record of medications given at home.
Almost all pharmacies provide
printed leaflets with each prescription. Read these leaflets
carefully and pay close attention to the side effects and possible
drug interactions. If you need to ask a question about the
medication, it helps to take the leaflet to the doctor with you. You
can also call the pharmacist with your question to be sure that the
medicine your loved one was prescribed is one that can be safely
taken without causing problems with other medications.
The Ohio Department on Aging
provides an information sheet with helpful information about drug
interactions and reactions. Some of the interactions they list
1. One medication can
increase or decrease the effectiveness of another.
2. Taking two medications
can produce one interaction that can be dangerous for the patient.
3. Taking two medications
that are similar can produce one reaction that is greater than one
would normally expect.
Depending on the condition being
treated, your physician may suggest not taking particular OTC
medications. For example, epileptics need to be careful when taking
diphenhydramine (e.g. Benadryl) or cold medicines containing
phenylpropanolamine (PPA) since these drugs are known to increase
seizure frequency. Make sure that the physician treating you is
aware of all health conditions which may affect the medications you
need to take.
While there are some individuals
who have found tremendous health benefits from taking herbal
remedies, caregivers should still be concerned when considering
their use. Just because an herbal remedy touts that it is
all-natural does not mean that it is safe. Some of these herbal
products can cause dangerous interactions with medications that you
may be taking. Also, donít take an herbal remedy for the same
condition for which medication has already been prescribed unless
approved by the doctor. Write down any herbal remedies along with
other medications that you are taking to be certain that the doctor
has an accurate picture of everything that is taken at home.
Some preparations can contain
high amounts of metals such as lead and mercury due to processing.
In addition, contaminants such as pesticides may also be found in
some of these remedies. Some herbal remedies have been found to
contain illicit prescription medicines and were not labeled as such.
Herbal remedies often make
claims on the packaging that have not been safely evaluated by the
Food and Drug Administration (FDA). Without standardized testing,
some of these remedies can be a source of trouble for the patient
since there is little data to back up these claims. Since many
companies market these remedies as food supplements, they arenít as
stringently monitored by the FDA. In addition, manufacturers arenít
held to the same accountability standards as pharmaceutical
If you feel it necessary to take
an herbal remedy, consult your loved oneís physician first. Exercise
caution when reading labels. Some remedies have been found to
contain so little of an herb that it is nothing more than a placebo.
For example, one research study found that more than 60 percent of
ginseng products contained so little ginseng that they were
Certain foods can also affect
medications, usually in ways that the medicine is absorbed
throughout the body. Some of these foods or additives to foods
include caffeine and vitamin K (found in broccoli). There are also
medications that interact negatively with grapefruit juice which
reduces or eliminates the effect of the medicine. There are many
other foods to consider and the pharmacy may have this information
for specific medications.
Food can slow the absorption
of some medicines throughout the body.
Meals high in carbohydrates
can adversely affect the absorption rate of some medications.
Some medications need
food to help it absorb for the bodyís use.
Although not technically a food, alcohol is often grouped with foods
when considering interactions with medications. The National
Institute of Alcohol Abuse and Alcoholism estimates that 25 percent
of emergency room admissions may have alcohol-drug interactions as a
component of the underlying problem. The elderly are especially at
risk for this type of interaction since they consume more than 30
percent of all prescription medications consumed in the U.S. today
and the risk for alcohol abuse is also significant in the elderly
Alcohol intensifies the effect
of some medications, such as sedatives or pain medicines. What's
more, some medications increase the effects of alcohol causing
dizziness, drowsiness, inability to control balance or walk
properly, as well as many others. Alcohol can exhaust enzymes needed
to metabolize the medication, thereby prolonging the absorption of
the medication and risking more side effects in the body. It can
also have the opposite effect by prolonging the metabolizing of
medication the bloodstream, rendering the drug less effective.
Whether it is alcohol or other
foods, be certain to check with your doctor or pharmacist to
determine whether or not there is any concern with foods that are
used in the home. Keep track of any adverse reactions and check with
your doctor immediately if there is cause for alarm.
While there are concerns about
foods or medicines interfering with one another, there is also the
question of how a person will react to a medication. Side effects
are possible with any medication on the market since there are many
different types of people and diseases. It is important to minimize
side effects while treating the underlying condition.
Keep a diary at home of any
reaction that seems unusual. Some of the items to include in the
When was the
medication was given?
How long did it take
to notice the reaction?
What is the nature of
Does it seem to get
better or worse as time goes by?
Is this a known side
effect of the medication?
How much discomfort
does it cause in the patient?
Your physician may suggest other
areas to observe.
By keeping a comprehensive diary
of reactions, you can determine whether or not this is a true drug
reaction or a symptom of the underlying disease, or even a new one
that may be developing. Your doctor will want to see the diary, at
least in part, when trying to figure out how best to treat the
As caregivers, giving medication
can be one of the scariest responsibilities. Being diligent and
staying informed is perhaps one of the best remedies. Be certain
that you maintain open lines of communication with both the doctor
and the pharmacy in order to better provide care for your loved
Online Drug Interaction Database:
There are several online
drug databases that can give you information as to the types
of interactions which may be of concern for you. One such
example is from Eckerd Pharmacy. This database can track
interactions between medications, alcohol, grapefruit juice,
and other food interactions. It allows you to add
medications, providing a comprehensive report of possible
interaction concerns. You can find the interaction database
Another online database
that can check for drug interactions is located at
www.drugs.com/drug_interactions.html. This database also
accepts multiple medications and provides a printed report.
Instead of using these
reports as the final authority, take them to your physician
or pharmacist to be certain that the results are applicable
to your loved oneís condition.