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If you’re like the vast majority of us, reaching for an over-the-counter pain reliever for back pain or a headache just makes sense. We take the medication designed to treat whatever hurts and go about our day. We take prescription medications to keep chronic conditions under control, and most of the time, they work well enough that we rarely think about it much.
But occasionally, something seems to go wrong.
Maybe taking that NSAID leads to a strange burning in your stomach. Perhaps the Tylenol PM that used to put you into a good slumber each night now leaves you groggy for hours after waking. Even prescription medications might result in side effects that you never worried about before. And some of those side effects might be scary enough to warrant calling for help – if you have a medical alert necklace, severe side effects are a good reason to use it!
What in the world is happening?
Many would assume that if you’ve taken a certain drug before with no problems at all, you’ll have the same experience if you take it again years down the road. That might be true when you’re younger, but older adults might find that taking something familiar doesn’t have the same results or side effects as they age. In fact, as a person gets older, the way certain medications act in their body can become dangerous.
There are many reasons for this. One is the typical process of aging, when your liver and kidneys tend to become less efficient over time. Since these are the organs that do the most when breaking down drugs and other substances, taking medications can tax them even further.
There are also differences in metabolism. Seniors might have a slower metabolism, which can affect how long a drug stays in the body and how potent it seems to be. According to pharmaceutical giant Merck, the slower your metabolism, the more of the drug your body might absorb, which could mean a buildup of the medication in your bloodstream and organs. That can lead to a drug building up to even toxic levels in the body, and that invites a whole new host of potential problems.1
But not all medications lead to these issues. Some medications are safe to take for decades with no problems at all. So how do you know which drugs are going to be a problem for you? Though it’s impossible to truly predict which medications will metabolize as they should in the body, there are some medications with a higher incidence of problems than others.
That’s where the Beers Criteria comes in.
What is the Beers Criteria?
Named after American geriatrician Mark Beers, the Beers Criteria was developed in 1991 as a way to protect seniors from potentially dangerous medications. The list includes drugs that physicians should be wary of prescribing to elderly patients. There are about 100 medications on that list, and it’s updated every three years by the American Geriatrics Society.2
The medications are broken up into five sections. According to the Cleveland Clinic, those sections include medications to avoid that pertain to:
· Those with certain health conditions
· Those over the age of 65 who are not in palliative or hospice care
· Drugs known to cause negative interactions when combined with other medications
· Drugs with more harmful side effects than benefits
· Medications that should be used only in limited quantities, if at all, due to potential renal failure3
The drugs that fall under these criteria tend to be widely used. Here are a few examples.
· Benzodiazepines. Also known as Benzos, these might seem an obvious choice for the list because they can all cause significant drowsiness. Some include Valium, Ativan, Xanax, and Librium. In addition to fatigue, these drugs can cause confusion and lead to a much greater risk of falls and other injuries.
· Non-Benzodiazepines. These are drugs that relax you but don’t use the same mechanism as Benzos to do so. These include Ambien, Sonata, and Lunesta, which are often used as sleep aids. Using them for long periods of time can lead to delirium, a greater risk of falling, and a higher rate of fractures among the elderly.
· Antipsychotics. Sometimes stronger medications are prescribed for anxiety and depression. Though these often lead to a higher risk of stroke among those with dementia, there are other side effects that could be worse among the elderly, such as weakness or dizziness.
· Blood pressure meds. Alpha blockers like Terazosin, Prazonsin, and Doxazosin can be strong drivers of fatigue and lead to a greater risk of falls. They might also lead to blood pressure fluctuations that can then lead to dizziness, weakness, and falls or injuries.
· Anticholinergics. These medications help with muscle relaxation and sleep, including Benadryl, Dramamine, and Tylenol PM. The most common side effects include dry mouth, constipation, and confusion. But it’s also important to note that these medications can increase the side effects of others. For instance, Tylenol PM in addition to a drug that already makes you drowsy can lead to dangerous side effects, such as a slower heartbeat and severe fatigue.
· NSAIDs. Easily available over the counter, these medications include Motrin, Advil, Aspirin, and Aleve. These can lead to an increased risk of damage to your kidneys and stomach, as well as a higher risk of bleeding. These drugs can have a cumulative effect, so someone who takes them for many months for a painful back might notice the problems creep in after several weeks of use, even at the proper dosage.
If you are on any of these medications, it’s a good idea to wear a button alarm at all times. This helps ensure that if you feel any troublesome side effects, you don’t have to wait and wonder if they will get worse. And if you experience a fall or other problem, you don’t have to wonder when help will arrive. Medical alert wireless systems can alleviate the worry and serve as a round-the-clock safety net.
How to Stay Safe with Medications
It’s important to remember that the Beers Criteria list is a guide to medications that might be harmful; that doesn’t mean they will be harmful for everyone. Consider the list of criteria to be a guide that helps your doctor determine if a particular drug is worth the side effects before they prescribe it to you.
Here’s how you can help your doctor make good choices for you.
· Give your doctor an updated medication list that includes any supplements, vitamins, or home remedies you are taking. They need to know everything that you’re putting into your body. This gives them the information they need to make the best prescribing choices.
· Don’t hesitate to ask questions about your medications. From concerns about interactions to how and when to take the drug, every question matters. You might bring up something that will make your doctor take a second look at your drug list.
· Talk to your pharmacist. Be aware of all potential side effects and how your drugs interact with others. Make sure your pharmacist has an updated list of your medications as well.
· Report any side effects right away. Pay attention to new symptoms or problems that start when you begin taking the drug, such as diarrhea, indigestion, dizziness, discomfort, or changes in behavior.
· Research the medications you are on. If you spot any concerns with interactions, ask your doctor just to be safe. Repeat this research now and then, as drug formulations can change and new warnings can emerge over time.
· Carefully monitor any chronic conditions to see if there are changes in your health situation. For instance, some medications – especially those purchased over-the-counter – can drive up blood sugar levels. Some other medications might make asthma or respiratory concerns even worse. If this happens, tell your doctor right away.
· Never stop taking prescription medications without discussing it with your doctor. Even if you read something frightening about a particular drug, remember that your doctor is prescribing what is right for your unique situation. If you have concerns about a drug, talk to the doctor, but don’t stop the medication without specific instruction to do so.
Finally, pay attention to your body and your intuition. If something just doesn’t feel right since you started taking a certain drug, let your doctor know. Though there is a period of adjustment as your body gets accustomed to a new medication, any problems that are still showing up a few weeks after your first dose warrant a call to the doctor.
Now is a good time to look into senior alert systems. During that adjustment period as you begin a new drug, some mild side effects like dizziness or weakness can be common. And unfortunately, these are two symptoms that greatly increase your risk of falls. Having medical alert technology right at your fingertips can help you feel more comfortable about side effects or changes in medication and serve as your 24/7 safety net.
