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Medicines & The Elderly

Elderly people sometimes take a variety of medicines for various problems. Is this correct?
Just because elderly people suffer from multiple health problems does not mean that they should take multiple drugs. Infact, these drugs may not only produce side effects but they may interact and have an undesired effect. Moreoever, because of problems with eyesight and hearing and failing memory, elders may not comply strictly with the doctor's instructions. So, as far as possible drugs should be kept to a minimum and attention should be paid to problems that can be treated without drugs. 
Can you give some examples of treatment without drugs?
  • Nutritional problems can be corrected with proper diet.
  • Physiotherapy will give relief  in the case of  joint problems like arthritis.
  • Mental depression can be treated with counselling where family members are included.
  • Mild diabetes and increase in blood pressure can be treated by suitable diet and exercise.
  • Constipation can be managed by taking more fluids and a high fibre diet.
For a simple problem, is it okay to resort to self-medication?
When elders suffer from pain, they may not feel it as youngsters do. This maybe due to diabetes, decreased sensitivity of the nerves and so on. So, a silent heart attack could be mistaken for a simple case of 'Gastritis' or acidity.
Elders tend to take drugs on a long term basis while the drugs were actually meant to be taken for a short time. For eg; pain-relievers for an arthiritic condition are taken over a long period resulting in ulcers and even failure of the kidneys. So it is best to avoid self-medication and consult a physician whenever possible. 
What are the guidelines for elders for drug-therapy?
  • Medicines should not be taken over a long period without a physician's advice.
  • The doctor's instruction should be followed strictly.
  • Dosage should not be altered on their own.
  • Drugs prescribed for one patient should not be used for another without the doctor's advice.
  • Some medicines should not be stopped all of a sudden.
  • Self-medication should be avoided.
What are the diffferent types of drugs that are commonly prescribed for elders? What are their possible side effects? What is the advice that could be given while taking these medicines.
  1. "Water tablets": Given to increase the amount of urine produced.
    Side Effects: Alteration of body salt balance, loss of bladder control, falls due to drop in B.P.
    Advice: Unless otherwise directed , should be taken only in the morning.
  2. "Sleeping Tablets": Helps people to sleep.
    Side Effects: Confusion, falls due to unsteadiness, loss of bladder and bowel control, and dependence on the drug.
    Advice: Avoid if possible, by using other means to sleep eg. relaxation techniques, massage etc.
  3. "Anti-depressants": Lifts the mood in depression.
    Side Effects: Confusion, drop in B.P. (Leading to falls), decresed bowel movements, dry mouth.
    Advice: Try to use other means such as counselling.
  4. "Tablets for B.P.": Decrease the Blood Pressure.
    Side Effects: Increased fall in B.P. (leading to guiddiness and falls), depression and impotence.
    Advice: Non-drug therapy where possible.
  5. "Anti-Parkinson's Medicine":  Reduces tremor and rigidity.
    Side Effects: Nausea, poor appetite, confusion. See: Parkinson's
  6. "Pain Killers": Relieve Pain.
    Side Effects: Some of them cause acidity, gastro-intestinal bleed and ringing in the ears. Some of them cause constipation and dependence.
    Advice: When the drugs cause problems, other pain relieving measures have to be tried.
  7. "Anti-biotics": To combat infections.
    Side Effects: Diarrhoea, Skin rash
    Advice: Antibiotics should be taken as a full course as prescribed by the doctor.
  8. "Steroids": Reduce reactions and in turn inflammations.
    Side Effects: Confusion, gastro-intestinal bleeding.
    Advice: Though they are very useful, they should be taken only as per the advice of a doctor.







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