Saturday, November 12, 2011

Polypharmacy: Are you taking too many drugs? What can you do?

Recently I was an advocate for a patient that when asked about medications, named the one prescribed by his doctor, but didn’t mention the variety of vitamins and supplements that are part of his daily regiment. Since they were experiencing some serious side effects from their prescribed meds, I couldn’t help but wonder if some of the supplements, at least one of which I had never even heard of, could be interacting with medications.

People with chronic conditions are often prescribed a number of medications, plus many add vitamins, supplements and over the counter (OTC) drugs. It is not uncommon for people to be taking drugs to counter side effects from another medication. Further, some people want to take all their meds, including vitamins, at the same time. The fact is all this “mixing” can lead to nasty effects (tiredness, confusion, falls, dizziness etc.) and/or needed medications not working.

Food can also interact with medications, both prescribed and OTC. They can combine to make the drug more effective, keep nutrients from being absorbed, or render the medication useless. When you eat and take your medications can also make a difference. Alcohol and meds should never be mixed and drinking something hot should be avoided as it may destroy effectiveness.

You are at risk for polympharmacy if you:
• Take five or more prescribed drugs.
• Take supplements, OTCs, vitamins etc.
• Use more than one pharmacy
• Take meds more than once a day.
• Have a hard time remembering to take medications

To avoid the complications caused by Polypharmacy, consider the following:
• Make sure all your health providers (primary care, specialists etc.) knows all medications you are taking, how you take them and when. This includes prescriptions, vitamins, supplements and OTCs. Write down the name of the medication, supplement, OTC. For each one, write how much you take, when you take it (e.g. with breakfast), and how you take it (with a glass of water). Up date it regularly and provide a copy to all your medical providers. Be sure to include it in your personal health notebook and carry it with you.

• If you are being given a new prescription, ask about possible interactions with your current regiment. Both medical provider and pharmacist can check a drug interaction database. You can also check Drug Digest, which provides information on possible interactions for all medications including vitamins and herbs.

• Use only one pharmacy to fill prescriptions.

• Learn your medications by name and what they are for

• Read the directions and labels on all medications (including OTCs) to avoid interactions. Don’t hesitate to ask the pharmacist or your health care provider if you have questions.

• Avoid combination products such as cold formulas. Ask the pharmacist and/or medical provider for other options.

• Take medications as prescribed.

• Consider alternative solutions that do not involve medications. For example, exercise, mindfulness based stress reduction (MBSR) and/or therapy can be effective for treatment of depression and anxiety. The Center for Mindfulness at the University of Massachusetts Medical School has been conducting research for years on MBSR and finds that it can positively and often profoundly affect participants’ ability to reduce medical symptoms and psychological distress. The Stress Reduction Program has benefited people reporting a variety of conditions and concerns including chronic illness or pain, high blood pressure, fibromyalgia, heart disease, asthma, GI distress, skin disorder and many other conditions.

• For more information: University of Chicago Polypharmacy and the Elderly

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