Alternative Mental Health News - Article: 48 Drugs Found Especially Hazardous to Elderly Patients

[Guest guest]

Article: 48 Drugs Found Especially Hazardous to Elderly Patientsindex

Some medicines pose unacceptable hazards to an aging body, or at best are

ineffective. A list of 48 such drugs, authored by a panel of dozen doctors,

geriatric psychiatrists, pharmacologists, and other specialists, was published

Dec. 8 in the AMA's Archives of Internal Medicine.

The list assigns a high severity rating to Prozac, Dalmane, Elavil, Miltown,

Xanax in doses greater than 0.2 mg, Halcion in doses greater than 0.25 mg, and

all barbiturates except when used to control seizures, among others.

Drugs that were well-tolerated for years become unpredictable and sometimes

lethal as the body slows down.

An update of criteria established in 1997 by Dr. Mark Beers, who developed it

for the Merck Manual, the report was intended as a guideline to potential risks,

not a mandate. " We realize that aging is an individualized process, and there

are some 65-year-olds who are healthy and do fine on these medications, " said

Donna M. Fick, a geriatric nurse with the Medical College of Georgia and

principal author of the panel's report.

" The single most common problem that I see in my practice comes from the

benzodiazepine group of tranquilizers like Valium and Xanax, " said Dr. Tom W.

Jackson, a geriatrician who served on the panel.

" These drugs tend to calm people down, but they also disinhibit them. The

effects are much like alcohol, " he added. " Folks who are on these medications

.... are actually four times more likely to fall and break their hip than people

who are not on these medications. "

Daily fluoxetine (Prozac) was cited for " long half-life of drug and risk of

producing excessive CNS [Central Nervous System] stimulation, sleep

disturbances, and increasing agitation. Safer alternatives exist. "

About amitriptyline (Elavil), the report warns: " Because of its strong

anticholinergic [inhibiting the action of the neurotransmitter acetylcholine]

properties, amitriptyline is rarely the antidepressant of choice for elderly

patients. "

Additional findings summarized in the report:

" Thirty percent of hospital admissions in elderly patients may be linked to

drug-related problems or drug toxic effects. Adverse drug events (ADEs) have

been linked to preventable problems in elderly patients such as depression,

constipation, falls, immobility, confusion, and hip fractures. A 1997 study of

ADEs found that 35% of ambulatory older adults experienced an ADE and 29%

required health care services (physician, emergency department, or

hospitalization) for the ADE. Some two-thirds of nursing facility residents have

ADEs over a 4-year period. Of these ADEs, 1 in 7 results in hospitalization.

" In 2000, it is estimated that medication-related problems caused 106,000 deaths

annually at a cost of $85 billion. Others have calculated the cost of

medication-related problems to be $76.6 billion to ambulatory care, $20 billion

to hospitals, and $4 billion to nursing home facilities. If medication-related

problems were ranked as a disease by cause of death, it would be the fifth

leading cause of death in the United States. The prevention and recognition of

drug-related problems in elderly patients and other vulnerable populations is

one of the principal health care quality and safety issues for this decade. "

 

 

 

 

 

 

 

Find out what made the Top Searches of 2003