Guest guest Posted August 18, 2004 Report Share Posted August 18, 2004 > " HSI - Jenny Thompson " > <HSIResearch > Cold Beers > Wed, 18 Aug 2004 10:00:37 -0400 > > Cold Beers > > Health Sciences Institute e-Alert > > August 18, 2004 > > ************************************************************ > > Dear Reader, > > There's no other way to put it: Far too many doctors > are letting > seniors down. > > A new study from Duke University reveals disturbing > evidence that more > than 20 percent of all seniors who are prescribed > drugs are receiving > medications that are known to be harmful to older > patients. > > This lapse in " care-giving " is nothing less than > shameful. But it > serves as a stark warning: No one should meekly > accept what a doctor > prescribes. Ask questions. Research. Take control of > your health care. > > --------------------------- > > Slipping through the cracks > --------------------------- > > > In the early 90s, Mark Beers, M.D., and several > other specialists in > geriatric drug therapy, developed a list of > medications that were > inappropriate for nursing home residents. The list – > now known as the > Beers List – was amended in 1997, and updated in > 2003, and has become > a well known tool for guiding doctors away from > prescribing > medications that may be harmful when taken by older > patients. > > In an interview with HealthDayNews, Dr. Kevin > Schulman, a professor of > internal medicine at Duke University and one of the > authors of the > study, said that even though someone over the age of > 65 may be in good > health, their kidneys don't function as well as they > did when they > were younger. This is one of the primary reasons > that some medications > can be harmful. Antidepressants and muscle relaxants > can put > particular stress on the kidneys. > > The Duke team examined the outpatient prescription > claims for more > than 765,000 people aged 65 or older who had more > than one > prescription filled during 1999. Using the Beers > List, the researchers > produced this data: > > > * More than 20 percent of patients over the age of > 65 may be taking > inappropriate prescription drugs > * More than 15 percent of these patients received > prescriptions for > two or more of the drugs on the Beers List > * Four percent of the patients were prescribed three > or more drugs on > the list > * Psychotropic drugs (such as antidepressants) on > the Beers List were > prescribed the most, totaling more than 40 percent > of the > prescriptions > * Muscle relaxants on the Beers List were the second > most commonly > prescribed > > Obviously, there are quite a few doctors out there > who are asleep at > the switch. And as a result, their patients may be > suffering. > > --------------------------- > > Adding up the danger > --------------------------- > > > Kidney stress caused by drugs on the Beers List is > by no means the > only health problem older people face when filling > prescriptions. > > In the September 1999 HSI Members Alert, we told you > how drugs can > interfere with the absorption of nutrients. For > instance, acid > blockers (such as Prilosec and Nexium) have been > shown to > significantly decrease absorption of vitamin B-12; > one of the primary > vitamins needed to prevent anemia. > > Other medications that are known to play a role in > nutrient depletion > are among the most frequently prescribed drugs on > the market. > Antibiotics, anti-depressants, anti-inflammatories, > blood pressure > medications, cholesterol-lowering drugs, estrogen, > and tranquilizers > can all strip valuable vitamins and minerals from > the body. When two > or more of these drugs are combined - especially in > an older patient - > the risk of developing anemia rises. > > And that's when things can get really complicated, > because anemia > dramatically increases mortality risk for patients > with chronic health > problems such as heart disease and cancer. > > --------------------------- > > How much can you take? > --------------------------- > > > The harm that a single drug may do – by stressing > the kidneys and > depleting nutrients – is small compared to the harm > that can occur > when several drugs are taken at the same time. > > In the e-Alert " Iron in the Fire " (6/3/03), I told > you about a study > conducted by Medco Health Solutions, Inc. (a company > that manages drug > benefit plans). Researchers concluded with this > shocking statistic: > the average senior receives 25 prescriptions > annually - a 100 percent > jump from just five years ago! > > As the over-medication of seniors grows at an > alarming rate, we see > two serious problems becoming even greater health > threats: 1) the > wider variety of drug intake creates conflicting > side effects (and as > we've seen before, many doctors treat drug side > effects with > additional drugs), and 2) these potent drug mixes > rob patients of the > very nutrients they need most when fighting an > illness. > > --------------------------- > > New coin > --------------------------- > > > A few days ago I came across a word that was new to > me: Polypharmacy. > This is the practice of prescribing too many > medications. > > Along with polypharmacy I would coin this word: > Negligentpharmacy; the > practice of prescribing drugs that are known to be > harmful to certain > patients. > > Unfortunately, many older people are victims of both > polypharmacy and > negligentpharmacy because too many doctors are not > well trained or > conscientious enough to know the harm that some > drugs may cause. > That's why young and old patients alike have to be > diligent whenever > their doctor writes a prescription. > > Ask questions. Research. Take control of your health > care. > > ************************************************************ > > ...and another thing > > For some of us, antidepressant drugs are only as far > away as our > kitchen faucet. > > You may have heard about the recent report from the > UK that traces of > Prozac have been found in the drinking water there. > Needless to say, > British environmentalists are nearly apoplectic, as > well they should > be. > > Apparently Prozac finds its way into the water > system by way of > treated sewage water. Or you might call it > not-treated-enough sewage > water. But whatever you call it, there's no getting > around the fact > that Prozac in tap water has already been ingested > and digested by > someone else. > > Not exactly what you would call " jolly good! " > > According to the BBC, a Drinking Water Inspectorate > spokesman said > that the Prozac was " most likely highly diluted. " > Wow... " Most > likely. " THAT'S reassuring! > > One of the disturbing aspects of this very > disturbing situation, is > the fact that Prozac is one of the drugs that > appears on the Beers > List. So whether they want to or not, elderly people > in Britain may be > picking up a little Prozac in their afternoon tea. > > Meanwhile, back here in the U.S., we've had Prozac > in our waterways > for months already. > > In the e-Alert " Air Freshener " (11/5/03), I told you > about Bryan > Brooks, a Baylor University toxicologist, who > discovered traces of > Prozac's active ingredient (fluoxetine) in the > tissue of blue gill > fish in a lake in Dallas, Texas. Brooks speculated > that the fluoxetine > made its way from the urine of Prozac users, through > a water treatment > plant, and into the lake. > > So there's your proof – from England to east Texas – > what goes around > comes around. > > Over the past few years, worldwide sales of Prozac > have totaled well > over $2 billion per year. I think I'll have the > distilled water, > please. > > To Your Good Health, > > Jenny Thompson > Health Sciences Institute > > ************************************************************ > > Sources: > > " Inappropriate Prescribing for Elderly Americans in > a Large Outpatient > Population " Archives of Internal Medicine, Vol. 164, > No. 15, August > 2004, arcinte.ama-assn.org > " Many Older Patients on Risky Drugs " Steven > Reinberg, HealthDayNews, > 8/9/04, story.news. > " Updating the Beers Criteria for Potentially > Inappropriate Medication > Use in Older Adults: Results of a US Consensus Panel > of Experts " > Archives of Internal Medicine, Vol. 163, No. 22, > December 2003, > ncbi.nlm.nih.gov > " New Data Uncovers Medication Matrix: Multiple > Physicians, Pharmacies > and Drugs Over-Medicate Seniors; Drive Higher Costs " > Press Release, > Medco Health Solutions, Inc., 5/21/03, > businesswire.com > " Prozac 'Found in Drinking Water' " BBC News, 8/8/04, > news.bbc.co.uk > " Fish on Prozac? How Depressing! " MSNBC, 10/23/03, > msnbc.com > > Copyright ©1997-2004 by www.hsibaltimore.com, > L.L.C. The e-Alert may > not be posted on commercial sites without written > permission. > > ************************************************************ Quote Link to comment Share on other sites More sharing options...
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