Medication and the Elderly

Reviewed by Helen Marshall, pharmacist

As we age, our use of medicines will often increase as we treat ailments that occur as a result of ageing. However, elderly people can be at increased risk from medicines due to various factors:

Medicine usage

• The ageing body can be more susceptible to the side effects of
  medications
• Elderly people with multiple conditions will often end up taking
  multiple medicines at the same time. In these cases, 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
  he way your doctor intended.

So what can you do to minimize these problems?

• Discuss your medications with your doctor or pharmacist. Learn the names of the medicines you are taking and find out why they have been prescribed.
• Make sure you understand the schedule for taking them. Store them in medication planners that allow for different times of day (i.e. breakfast, lunch, dinner, bedtime etc.)

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 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. 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

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.

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