Dangerous Drug Interactions: Medicines at War Within the Body

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If Mom or Dad is taking prescription and over-the-counter (OTC) drugs, there are probably negative side effects from each of the drugs. But there may also be more dangerous effects if they take five or more medications, because the drugs may conflict and, basically, go to war against each other, while also damaging otherwise functioning body organs and systems.

Your parents may have prescriptions from different physicians who are unaware of other medications prescribed by other doctors. Additionally, they may fill prescriptions at different pharmacies or online. Such is the possible foundation for the internal conflict and damage.

Polypharmacy Defined

The battle, known as polypharmacy, is estimated to cause the death of 100,000 older adults each year.

But, as caregiver, you have the unique ability to identify possible polypharmacy in your Mom or Dad and, by taking specific steps, can correct or eliminate the condition.

The average older adult takes five or more prescriptions drugs each day. In addition, many elderly people take various over-the-counter medications, such as antacids, laxatives or painkillers, which are often used without informing their physician. Each drug, while created to treat or correct a specific medical problem, will cause side effects and many times serious, negative and even life-threatening conditions.

Polypharmacy also includes:

  • Having even the correct and compatible prescriptions, but missing proper dosing of one or more.
  • Having even the correct and compatible prescriptions while also taking over-the-counter medications or, having a drink of alcohol or a beverage like coffee.

Symptoms of Polypharmacy

Be concerned if your parent is experiencing:

  • Tiredness, sleepiness or decreased alertness
  • Constipation, diarrhea or incontinence
  • Loss of appetite
  • Confusion, either continuous or episodic
  • Falls
  • Depression or general lack of interest
  • Weakness
  • Tremors
  • Hallucinations, such as seeing or hearing things
  • Anxiety or excitability
  • Dizziness
  • Decreased sexual behavior
  • Skin rashes

Reducing Polypharmacy

The first and most important step is to have every physician involved in treatment be aware of every medication and even multivitamin taken by Mom or Dad daily. Collect every bottle and make a detailed list including the drug name, size of dosage (in milligrams or international units), recommended dosage (daily or daily frequency, for example), and any cautions stated on the bottle or package.

Read every package insert or on-box description of the drug – including the small type – which details warnings about not taking the drug if certain other conditions exist, the possible side effects and the possible conflicts with other medications. You will quickly learn why to be concerned and, perhaps, understand how and why the medications can be at war with each other.

Identify on another sheet the possible side effects that you can observe. Refer to the list of symptoms above.

Bring all of the medication bottles/packages to one of the currently used pharmacies to request a database analysis of each drug and the combination, a procedure that will also identify side effects and drug conflicts.

Provide the two lists to every physician and medical center providing treatment to Mom or Dad, asking for a specific analysis of the need for the drug/medication.

Have the revised prescriptions re-written by only one physician who advises the other medical providers. And assign all of the prescriptions and even OTC medications to one pharmacy where the pharmacist can monitor the drugs regularly and serve as professional counsel to you regarding the drug regimen. This service is available without added cost.

Steps for Preventing Polypharmacy

Be concerned if Mom or Dad is erratic in taking even the right and most effective combination of drugs. Not taking one drug within the regimen may distort the balance and effectiveness of the combined prescription.

You may have to align the drug bottles and packages in a row for each of the daily dosing times. Or, consider buying a multi-hole plastic tray into which you can place each pill appropriately for the next dosing time. Do not put all of the pertinent pills in one bag because negative interaction of the doses may start while in the plastic bag.

If your Mom or Dad has problems opening the bottles or packages, request "easy opening" bottles from the pharmacist.

Concern for Polypharmacy by Medical Professionals

Government health programs are actively urging medical societies and their members to question patients regarding the drugs they are taking. Some hospitals around the nation require a total identification of all medications taken by a patient to be completed and analyzed before admission, and that all prescriptions be written by one physician and fulfilled at a single pharmacy.

Call to Action

Polypharmacy may be the biggest threat to the quality of health and life, and even life itself, for your Mom or Dad.

As caregiver, you can be the team leader in correcting and preventing polypharmacy. Your concern and action may be one of your greatest gifts ever to Mom or Dad.

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7 Comments

a very helpful tool is using the mednotes medication tool. Every time they add another drug to my dad I can add it to his profile on mednotes and it gives drug interactions with his current prescriptions and with his conditions.

It saved him a few times from taking things one doctor prescribed that would make his glaucoma worse. His IOP was so bad and then the ENT doctor prescribed something for allergies that would have been very dangerous to me dads already bad eyesight. My dad has 20 different prescriptions and other things given to him each day and I have found this service a life saver and so much information.
Ask the pharmacist for a quarterly review of medications, they are trained and qualified to advise and have all medications on file. Ask for recommendations on whether to continue certain medications and for any contraindications that could be risky. They can also suggest different dosages/medications in lieu of current meds that may treat certain illnesses more effective or at a reduced cost. Seniors typically continue to use the same pharmacy and most have at least a friendly, long known pharmacist that would be more than willing to help. Most pharmaceutical software checks for such recommendations on an on going basis, so take advantage of it and 99% of the time, there isn't a charge, its the law and their responsibility.

Sue Brophy
Very good advice, indeed, except that MIL doesn't listen. MIL KNOWS EVERYTHING so she self-medicates and plays doctor with her husband's meds as well. So, this is great advice IF and only IF elders are willing to listen and take advice from 'just the kids' (read, what the heck do we know?)