Are You Taking Drugs You Don’t Need?

Are You Taking Drugs You Don't Need?
by Elizabeth Smoots, MD

In your medicine cabinet you may have a mix of prescription drugs and over-the-counter drugs to treat various conditions. Some of these medications are truly necessary, as people tend to have more health problems with age. But the more medicines you take, the greater your risk of suffering adverse reactions from the drugs.
When compared to younger people, seniors are more sensitive to drug interactions and side effects. Older people are especially susceptible to becoming confused, dizzy, or falling and breaking a hip. Previous studies have found unnecessary drugs common in nursing homes, hospitals, doctors' offices, and the home. Although medical providers have tried to address this issue, misuse of drugs remains a major problem for seniors.
List of Inappropriate Drugs
In the journal, Archives of Internal Medicine, researchers identified drugs that may be inappropriate for persons aged 65 years and older.
This is not a complete list, though. There may be other medications that can be harmful to you. Talk to your doctor.

Drug Name	Severity Rating
Indomethacin (Indocin, Indocin SR)	High
Pentazocine (Talwin)	High
Trimethobenzamide (Tigan)	High
Methocarbamol (Robaxin)	High
Carisoprodol (Soma)	High
Chlorzoxazone (Paraflex)	High
Metaxalone (Skelaxin)	High
Cyclobenzaprine (Flexeril)	High
Oxybutynin (Ditropan)	High
Rurazepam (Dalmane)	High
Amitriptyline (Elavil)	High
Chlordiazepoxide-amitriptyline (Limbitrol)	High
Perphenazine-amitriptyline (Triavil)	High
Doxepin (Sinequan)	High
Meprobarnate (Miltown, Equanil)	High
Lorazepam (>3 mg) (Ativan)	High
Oxazepam (>60 mg) (Serax)	High
Alprazolam (> 2 mg) (Xanax)	High
Ternazepam (>15 mg) (Restoril)	High
Triazolam (>0.25 mg) (Halcion)	High
Chlordiazepoxide (Librium)	High
Chlordiazepoxide-arnitriptyline (Limbitrol)	High
Clidinium-chlordiazepoxide (Librax)	High
Diazepam (Valium)	High
Quazepam (Doral)	High
Halazepam (Paxipam)	High
Chlorazepate (Tranxene)	High
Disopyramide (Norpace, Norpace CR)	High
Digoxin ( >0.125 mg/d, except if treating atrial arrythmias) (Lanoxin)	Low
Short-acting dipyridamole (Persantine)	Low
Methyldopa (Aldomet)	High
Methyldopa-hydrochlorothiazide (Aldoril)	High
Reserpine (>0.25 mg)	Low
Chlorpropamide (Diabinese)	High
Dicyclomine (Bentyl)	High
Hyoscyamine (Levsin, Levsinex)	High
Propantheline (Pro-Banthine)	High
Belladonna alkaloids (Donnatal and others)	High
Clidinium-chlordiazepoxide (Librax)	High
Chlorpheniramine (Chlor-Trimeton)	High
Diphenhydramine (Benadryl)	High
Hydroxyzine (Vistaril, Atarax)	High
Cyproheptadine (Periactin)	High
Promethazine (Phenergan)	High
Tripelennamine	High
Dexchlorpheniramine (Polaramine)	High
Diphenhydramine (Benadryl)	High
Ergot mesyloids (Hydergine)	Low
Cyclandelate (Cyclospasmol)	Low
Ferrous sulfate (>325 mg/d)	Low
All barbituates (except phenobarbital) except to control seizures	High
Meperidine (Demerol)	High
Ticlopidine (Ticlid)	High
Ketorolac (Toradol)	High
Amphetamines and anorexic agents	High
Naproxen (long-term use of full dosage) (Naprosyn, Avaprox, Aleve)	High
Oxaprozin (long-term use of full dosage) (Daypro)	High
Piroxicam (long-term use of full dosage) (Feldene)	High
Daily fluoxetine (Prozac)	High
Bisacodyl (long-term use) (Dulcolax)	High
Casacara sagrada (long-term use)	High
Neoloid except in presence of opiate analgesic use (long-term use)	High
Amiodarone (Cordarone)	High
Orphenadrine (Norflex)	High
Guanethidine (Ismelin)	High
Guanadrel (Hylorel)	High
Cyclandelate (Cyclospasmol)	Low
Isoxsurpine (Vasodilan)	Low
Nitrofurantoin (Macrodantin)	High
Doxazosin (Cardura)	Low
Methyltestosterone (Android, Virilon, Testrad)	High
Thioridazine (Mellaril)	High
Mesoridazine (Serentil)	High
Short-acting nifedipine (Procardia, Adalat)	High
Clonidine (Catapres)	Low
Mineral oil	High
Cimetidine (Tagamet)	Low
Ethacrynic acid (Edecrin)	Low
Desiccated thyroid	High
Amphetamines (excluding methylphenidate hydrochloride and anorexics)	High
Estrogens only (oral)	Low

Note: For your own health and safety, do not stop taking any medication unless you have consulted with your doctor and have her approval.
Risks for Inappropriate Drug Use    
When you are on a lot of medicine, how can you tell if you are taking more than you need? First of all, you need the help of your doctor to determine this. You and your doctor should be on a heightened state of alert for unnecessary medications if any of the following risk factors apply to you:

• Taking multiple drugs, especially if filling over 14 prescriptions a year
• Using over-the-counter drugs and supplements
• Visiting a number of different doctors
• Having trouble understanding instructions
• Saving medications for later use
• Borrowing or sharing medication
• Being age 65 years or older
• Being female
• Having poor health status
  Talk to Your Doctor    

The best way to fine-tune your medications is to work with your doctor. After all, most doctors are experts in the drug treatment of disease. But your doctor can only help if you tell him or her about all the medicines you are taking, including prescription and over-the-counter drugs and supplements.
Thoroughly review your medications with your doctor at least once a year. Write down a complete list, or better yet, bring all your medications into the office in a brown bag. And don't forget to include those in your medicine chest or kitchen cupboard that you only take once in awhile.
Another key is to ask questions. Keep inquiring until you understand the dose, frequency, and purpose of the medicines you are taking. Finally, don't be afraid to ask about nondrug options that can help you minimize your use of medications.

"Learn About Senior In Home Health Care in Tampa, Florida Senior Helpers Provides Many services in the Tampa, Florida area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check. If you need Home Care services in Tampa, Lutz, Land O Lakes, Seffner, Thonotosassa and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Tampa Home Health Care Company. "

Caregiver Meltdown

by Amy Goyer

There I was in the middle of Sky Harbor Airport in Phoenix, when I was told I was 8 minutes too late to check my bag for the flight. I was trying to get to Indianapolis for a memorial service for my uncle. Missing a flight would upset any traveler, but my reaction surprised even me.
Total and complete meltdown.
You know the kind — sobbing uncontrollably to the point where the airline attendant had no idea what to do.
I sat down on one of those hard plastic chairs, but people began to stare, so I went into the bathroom, locked myself in a stall and sobbed with great abandon.
As I cried (and it was an all out snort-cry as my friend, Mary, calls it) and talked to my sister on the phone, I knew people could hear me far and wide. I didn't care. I was way past the point of embarrassment.
How did I get to this point? Can you say "stress?" Oh yes. Let me tell you about the prior week…..
As you know, I am caregiving for my parents.  Shortly before my airport meltdown, I'd been on a business trip that kept me away for two nights. During that time, my Mom fell and my Dad developed an abscessed tooth. On top of all that, Mom developed a bad intestinal flu AND shingles!
I had stayed with them almost 24/7 all week, and we had two more emergency squad visits because my mom fell two more times,  both with transport to the hospital, one at midnight and the other at 3 am. Both trips resulted in all-night ER stays and no sleep. Thankfully, no broken bones or hematoma for Mom!
One of her falls happened literally 1 minute after I left her alone in the bathroom after having gone over and over the use of her walker, always holding on to something etc. But she had gone to get something out of her closet and didn't use the walker…and fell as she turned.

Mom – always a good sport even in the ER
I felt terrible! I think I was so tired that I didn't make the best choice at that moment…a typical caregiver's lament.
She said she'd done it so many times before and it was automatic — she just didn't think about her walker. And she was so tired and depleted it's no wonder she wasn't thinking well either.
Well the good news is, I finally stopped crying at the airport, got a flight the next day…and got some sleep.
Mom is getting better, and I arranged for help from my niece and sister and my wonderful concierge, Debbie. So I went off on another business trip…so far no more falls or ER visits! Mom is gaining strength and Dad is minus 3 teeth now. He's still got a great grin.
And I am a whole lot lighter after my big meltdown!
My experience brings home the point that as caregivers we need to take care of ourselves…if we don't, we will drive ourselves to the breaking point…and perhaps cause a bit of a stir in an airport!
Next time we go through a crisis week like that (and I'm sure there will be more of them), I will do things a bit differently…especially prioritizing getting more sleep – and more help!

http://blog.aarp.org/2011/07/20/caregiver-meltdown/

"Learn About Senior In Home Health Care in Tampa, Florida Senior Helpers Provides Many services in the Tampa, Florida area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check. If you need Home Care services in Tampa, Lutz, Land O Lakes, Seffner, Thonotosassa and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Tampa Home Health Care Company. "

National Research Council Wants Better Training for Home Caregivers

National Research Council Wants Better Training for Home Caregivers
By Kathleen Doheny

Home health care is a growing trend, allowing many people in need of medical services to avoid hospitalization and nursing homes. But improvements are needed to be sure that care at home is safe and effective, according to a new report from the National Research Council.

"There is a great opportunity to provide quality health care in the home for any of a variety of people in our population, from the very young to the very old," says David H. Wegman, MD, emeritus professor of work environment at the University of Massachusetts, Lowell. He chaired the National Research Council committee which issued the report.
"But to do this safely and effectively, we need better management and information about technologies as they are used in the home, and better training for both formal health care providers and the large informal pool for how to use these technologies in the home safely and effectively," Wegman tells WebMD.
Wegman says he is talking about medical devices from as seemingly simple as a home blood pressure monitor to more complicated oxygen delivery systems and other devices.
The report, "Health Care Comes Home: The Human Factors," was released today.
One in four U.S. adults, or more than 61 million Americans, cared for an adult family member, partner, or friend with a medical condition or disability in 2009, according to another report, also issued today, by AARP. It put the value of all this care at $450 billion in 2009. That is up 21% from the total in 2007. The AARP report is titled "Valuing the Invaluable: The Growing Contributions and Costs of Family Care giving, 2011 Update."

Recommendations for Home Health Care

The National Research Council report was requested by the Agency for Healthcare Research and Quality. The National Research Council is the principal operating agency of the National Academy of Sciences and National Academy of Engineering.
The National Research Council committee sought out experts. It also conducted a workshop on human factors in home health care before issuing the report.
Among the recommendations:

• The FDA should promote the development of new standards for labels on medical devices for home use. They should set new standards for the instructions that accompany the devices. The instructions should be easily understood.
• The FDA and the Office of the National Coordinator for Health Information Technology should work together to regulate, certify, and monitor devices and health information technologies. For instance, they should work together on a device such as a blood pressure monitor and the technology that relays the results to doctors and patients.
• The FDA should improve its existing reporting system for medical device problems. The system is known as MAUDE (manufacturer and user facility device experience). Wegman cites problems, including being poorly used.
• Training of home caregivers, both formal and informal, should be improved. Advocacy groups and professional practice organizations should take on this task, the committee says.
• Research is needed in many areas, including how to better coordinate caregivers and support services.
• Federal agencies such as the Department of Health and Human Services should help people who need home health care to modify their homes for caregiving when needed.

Wegman says the hope is that the FDA and others involved will read the recommendations and begin to implement them.
The recommendations are applauded by AARP, says Susan Reinhard, PhD, RN, AARP's senior vice president of public policy. She wrote the AARP report.
"We call it the new normal, this caregiving," she tells WebMD. And it is not simple.
In its report, AARP finds that home caregivers are asked to do more complicated services. This includes bandaging and wound care, tube feedings, managing catheters, and giving injections and operating medical devices.
"Some of the things that family caregivers do would make a first-year nursing student shudder," Reinhard says in a news release.
In an interview with WebMD, she says that the National Research Council report "supports our overall goal of helping people to live at home independently if that is their choice."

"Learn About Senior In Home Health Care in Tampa, Florida Senior Helpers Provides Many services in the Tampa, Florida area. We provide a full array of Home Care services for seniors and the elderly living in this beautiful area. Our Home Care Services are provided by bonded and insured employees and all employees pass a National Background check. If you need Home Care services in Tampa, Lutz, Land O Lakes, Seffner, Thonotosassa and the surrounding areas we are an excellent choice with impeccable references. Home Health Care for your elderly loved ones is never an easy choice but we can promise we will do our best to make it as painless as possible. From our family to yours we sincerely thank you for considering Senior Helpers of Tampa Home Health Care Company. "