Seniors and Medication Safety

Prescription Drugs

Older adults take more medication now than ever before. One reason is that older adults need more medication for chronic conditions. Statistics show that adults over 65 years old consume more than 30 percent of all medications prescribed and purchase 40 percent of all over the counter medications. Recent studies show the average person over 65 takes between two and seven prescription medications daily.

With aging, many body processes are altered and often slow down, affecting the way medications are absorbed, distributed, metabolized and excreted. These elements combine to create a greater risk of drug interactions, drug/food interactions, and side effects. Some medications will not work or have dangerous side effects when taken with other medications. Unfortunately, almost 40 percent of all adverse drug reactions reported each year involve people over 60 years old.

Tips to reduce adverse drug reactions

• Make sure your medications are clearly labeled and carefully follow the label instructions.
  Examine the medication itself before taking it. Check for capsules or tablets that differ from the others that are enclosed. Read the label and examine the medication at every dose.
  
•  Review all your medications with your doctor or pharmacist at least once a year or when you start taking a new medication. Make sure that your health care provider knows about all of the medications you take. This includes all prescription, non-prescription medication, herbal medicines, dietary supplements and any other type of medication.
  
• Get prescriptions refilled far enough in advance to avoid running out of medication.
  
• Before you travel, ask your doctor or pharmacist how you should adjust your medication schedule to account for changes in time, routine and diet. Bring your doctor's and pharmacist's phone numbers with you. When flying, carry your medications with you. Do not pack them in your checked luggage.
  
• Before you drink alcohol or take non-prescription drugs with your prescription drugs, check with your doctor or pharmacist
  
• Keep a record of the medications you are taking and organize your medication schedule.  If you are taking several different medications or if you are particularly ill, keeping a record of medication as you take it can help you use medications properly and safely. Check with your pharmacist or healthcare provider for tips on organizing and keeping track of your medications and their schedules.
  
• Never take medication in the dark.
  Turn on the light to ensure you have the right medication and take the correct dose. If you need glasses to read, be sure to wear them when taking medication.
  
• Take medications at the proper time.
  In some cases, medications should be taken either before, after or during meals. Check with your doctor or pharmacist.
  
• Take your medications for the entire duration they are prescribed.
  Symptoms sometimes disappear before the condition has totally cleared up. If you stop taking the medication too soon, your recovery may take longer.
  
• Never take more medication than prescribed
  Taking twice as much never means that you will get better twice as fast. Too high a dose may make the medication ineffective. It might even be dangerous.
  
• Never take any medication that has been prescribed for a friend or relative.
  The same medication may work differently for different people. Take only those prescription drugs that are prescribed for you.
  
• Always replace child resistant caps carefully.
  
• Know what your medications look like.
  If you take more than one type, be able to tell them apart by size, shape, color, number or name imprint, form (tablet or capsule) or container. If a refill of a prescription looks different than before, consult your pharmacist to make sure it is the correct medication.
  
• Keep all medications in their original containers and store them in a cool, dry place, away from bright light. Unless specifically instructed, do not store medications in the refrigerator.
  
• Never mix medications in the same container. 
  
• Keep the Poison Center phone number 1-800-222-1222 available. Call them with any questions you may have about medication interactions, effects, or about overdoses and accidental poisonings.

Over-The-Counter Medications

The range of health problems that can be treated with nonprescription medications is large, and continues to grow.  There are more than 100,000 over-the-counter (OTC) drugs that you can buy without a prescription.  Like prescription medications, they are serious medications that need to be taken with care.  Common over-the-counter medications include pain relievers, laxatives, cold preparations and antacids.  All of these can cause an adverse drug interaction when taken with prescription drugs.

Tips for Taking Over-The-Counter (OTC) Medications

• Start by always reading the label.
  Reading the label will tell you:  What the medication is for (Indications), how to take the medication (Directions), active ingredients and inactive ingredients (Contents), what are unusual reactions (Warnings), and precautions for use (Precautions).
  
• Know what types of over-the-counter medications to avoid taking with your prescription medications.
  When in doubt, ask your pharmacist or doctor before you buy or use an OTC medication.  Taking an OTC medication safely is too important for guesswork.
  
• Select over-the-counter products that will treat only the symptoms you have.
  Multi-ingredient products, such as combination cold remedies, may contain medication for problems you don't have.
  
• Take the medication EXACTLY as stated on the label.
  When it comes to over-the-counter medications, more is not better! Taking too much of a nonprescription medication can be harmful. Never guess the amount of medication that should be taken.
  
• Use extra caution when taking more than one over-the-counter drug product at a time.
  Always compare active ingredients before taking more than one over-the-counter medications at the same time. Many over-the-counter medication contain the same active ingredient, which means you may be getting more than the recommended dose without even knowing it.
  
• Don’t use over-the-counter medications after their expiration date.
  Dispose of all medications promptly after their expiration date and be careful not to throw them away where children or pets may find them.
  
• Most non-prescription medications are intended for temporary use; this is usually stated on the medication label. Talk to your doctor if taking an over-the-counter medication becomes more than a temporary practice.

Are you a hazard to your grandchildren?

A study conducted by the United States Consumer Product Safety Commission states that 36 percent of childhood ingestion accidents related to prescriptions involve a grandparent’s medication. Prescriptions for older adults are some of the most toxic medications, posing the greatest threat of a tragic outcome if ingested by a child. Even the most loving grandparents can put their grandchildren in danger when they unknowingly overlook simple precautions. It is more important than ever that grandparents be familiar with poison prevention procedures.

• When visiting a home with young children, make sure medications in purses, bathroom kits, and suitcases are not available to children.
  
• Be careful of weekly pill minders.  They help to organize medication but most are not child resistant.
  
• If young children visit your home, remember to keep medication and household chemicals locked or out of children’s reach.
  
• Avoid taking medication in front of young children, they like to imitate.
  
• Only give infants and children over-the-counter medications that are especially formulated for their age and weight.

Medication Disposal

Environmental concerns and exposure to unintended individuals is a potential problem for disposal of unwanted or expired medications.  Recently in the media, reports of medications being detected in the water supply and affecting aquatic life have prompted concerns, as water treatment does not remove the majority of medications.  Possible effects include:

     1.  Effects of fish developing behaviors of the opposite sex affecting spawning.
     2.  Antibiotics in the environment may hasten the development of bacterial resistance.

In many situations medication is not considered hazardous waste and many agencies recommend disposal in the regular trash.  Consistent with the Minnesota Pollution Control Agency and guidelines from the Office of National Drug Control Policy, HRPC recommendations for medication disposal are as follows:

     1.  Keep medications in original, legible, labeled container blacking out only the patient name. 
     2.  Alter the medication (add water to pills; add salt/flour to liquids).
     3.  Seal the medication container top and place in another container to conceal it.
     4.  Discard in the regular trash.

Per Federal guidelines, the following tables list medications that should be flushed down the toilet:

Medicine                                                            Active Ingredient

Actiq, oral transmucosal lozenge                          Fentanyl Citrate
Avinza, capsules (extended release)                     Morphine Sulfate
Daytrana, transdermal patch system                    Methylphenidate
Demerol, tablets*                                                Meperidine Hydrochloride
Demerol, oral solution*                                        Meperidine Hydrochloride
Diastat/Diastat AcuDial, rectal gel                       Diazepam
Dilaudid, tablets*                                                Hydromorphone Hydrochloride
Dilaudid, oral liquid*                                            Hydromorphone Hydrochloride
Dolophine Hydrochloride, tablets*                      Methadone Hydrochloride
Duragesic, patch (extended release)                     Fentanyl
Embeda, capsules (extended release)                   Morphine Sulfate; Naltrexone Hydrochloride
Fentora, tablets (buccal)                                      Fentanyl Citrate
Kadian, capsules (extended release)                     Morphine Sulfate
Methadone Hydrochloride, oral solution*             Methadone Hydrochloride
Methadose, tablets*                                             Methadone Hydrochloride
Morphine Sulfate, tablets (immediate release)*     Morphine Sulfate                          
Morphine Sulfate, oral solution*                           Morphine Sulfate    
MS Contin, tablets (extended release)*                  Morphine Sulfate
Onsolis, soluble film (buccal)                                 Fentanyl Citrate
Opana, tablets (immediate release)                       Oxymorphone Hydrochloride
Opana ER, tablets (extended release)                    Oxymorphone Hydrochloride
Oramorph SR, tablets (sustained release)             Morphine Sulfate
Oxycontin, tablets (extended release)*                  Oxycodone Hydrochloride
Percocet, tablets*                                                Acetaminophen; Oxycodone Hydrochloride
Percodan, tablets*                                               Aspirin; Oxycodone Hydrochloride
Xyrem, oral solution                                             Sodium Oxybate

*These medicines have generic versions available or are only available in generic formulations.

updated: 3/10