Disadvantages of treating the elderly with drugs

 As we get older, we have more complaints and symptoms that seem like they’re seeking medication. Drugs like diphenhydramine, as well as the combination of diphenhydramine and acetaminophen (TYLENOL PM) have been designed (or at least marketed) to help us fall asleep faster and for longer.

These over-the-counter medications in particular may be attractive to older adults, many of whom find it difficult to get the sleep that is otherwise unattainable.

Disadvantages of treating the elderly with drugs
Risk of complications resulting from drug interactions
Unfortunately, although sedative antihistamines are effective, they do not provide the natural, healing sleep that the body and mind need, and they are full of potential side effects, which can be dangerous, especially for the elderly, such as: worsening bladder obstruction, increased risk of falls, an increased likelihood of delirium, and a greater chance of being diagnosed with dementia (Dementia is a temporary state of confusion, usually caused by fever, intoxication, drug use, pain, or shock.

Dementia is an advanced state of loss of memory and other mental abilities, often associated with Alzheimer’s or a decrease in the amount of blood flowing to the brain), all of which motivate the use of more drugs, while each has potential negative effects on the bodies and minds of aging.

Terazosin is one of the most common medications used to treat urinary retention, and although it helps relieve symptoms of the condition to some extent, it also affects the blood vessels. This leads to orthostatic hypotension.

Immediately after a patient is hospitalized, doctors tend to take the patient’s drug list at home, and add new ones to it.

While opioids can be essential in controlling acute pain, they have associated side effects that should be watched for, such as severe constipation, and can increase the risk of falls and worsen bladder obstruction. Studies conducted on elderly patients with buttock fractures revealed that from 16% to 62% of them suffer from delirium; The intensity of the pain appears to lead to a risk factor associated with delirium in the tested group, and the patient may not get enough morphine to relieve his pain (including the great discomfort caused by a distended bladder and obstructed enlarged colon); However, it is noted that diphenhydramine alone can cause delirium in older patients.

Read also: Choosing a Doctor: Health Care in Old Age C14
Although lorazepam can quickly calm irritation and make aggressive patients malleable, it is rarely the ideal solution. Because it does not treat the underlying causes of the behavioral change, moreover, benzodiazepines also increase the risk of falls and can precipitate delirium by making individuals groggy and disoriented. The American Geriatrics Association has felt that benzodiazepines should be avoided in the elderly; It included this class of drugs in the list of “five things that doctors and patients should beware of”; It is a dedicated menu for the Department of Geriatrics for the Education Campaign to Choose Wisely to Improve Doctor-Patient Relationships.

As often happens with patients who are hospitalized, they become infected and are given a strong antibiotic. Antibiotic treatment kills not only harmful bacteria but also beneficial bacteria in the intestines. Diarrhea is perhaps a frequent result of this radical change in the normal intestinal microflora. Also, patients who are hospitalized and treated with antibiotics are at risk of developing a serious intestinal infection with C. difficile bacteria.

The popularity of Amitriptyline and other older tricyclic antidepressants in psychiatry has waned. But they are still used to relieve chronic pain, although their efficacy for this purpose is questionable. Unfortunately, tricyclic antidepressants, like related antihistamines, can cause bladder obstruction and constipation, as well as increase the risk falls and delirium.

High rate of polypharmacy
There are a lot of elderly people who take a lot of drugs; This puts them at risk for serious adverse reactions and drug interactions. When I look at the drugs that patients and old friends are taking, I notice a lot of drugs prescribed by different doctors, and I notice many samples of drugs available without a prescription, and I wonder if there is anyone who supervises the use of all these drugs, and research indicates that in Many such cases miss medical supervision.

Among those over the age of 65, polypharmacy, i.e. the patient’s regularity to take five or more drugs at the same time, increased from 30.6% to 35.8% between 2005 and 2011; This puts about 15% of older adults at risk of complications from drug interactions. Perhaps what makes matters even more complicated is that about two-thirds of older adults also take nutritional supplements, and the last third regularly take over-the-counter drugs.

The elderly grew up in a time when physicians were more paternalistic and responsible; That is why they are accustomed to obeying the doctor’s orders, and not asking about the extent of their need for these drugs, and they may be more reluctant to ask the doctor about the preparation available without a prescription, or the nutritional supplement.

If you have an elderly relative or friend who takes many drugs, urge him to consult a doctor