Lynn Harrelson
R.Ph., FASCP. Senior Pharmacy Solutions
Lynn Harrelson is a pharmacist who specializes in medication and prescription management for seniors. She provides health care services and information that help individuals remain independent in their homes, retirement and assisted living facilities.
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Question
In the past I've had allergic reactions to Metformin and my current Dr. had me placed on it again. Should I be...
Hello VMKmaggie, This situation can be very serious. No one should take a medication which they believe they are allergic. Each time body... Hello VMKmaggie,
This situation can be very serious. No one should take a medication which they believe they are allergic. Each time body is challenged by the “allergy causing compound”, the stronger the allergic reaction will be. Any questions about being allergic to any medication allergy should be addressed in any and all ways until resolved, meaning that you, the patient, is comfortable in taking the medication.
• Never ever take a medication that you feel many have caused you to have an allergic reaction until your questions are resolved.
• Prescriber offices (doctors and nurses) are changing over to the electronic record. Allergy information or other information may have been omitted or entered incorrectly.
• Ask the office to check your old (hard copy) records. If you know the date that the medication caused the “allergy”, please provide the dates with staff as this will help them in looking through your record.
• Another thing that may have happened, is that patients sometimes report how they respond to a medication and call it an allergy, the prescribers doesn’t classify the response as an allergy but as a reaction to the medication and your response may have not have flagged as an “allergy”.
• Always clearly describe your response to any medication.
• The allergy alert should have also been in the dispensing pharmacy’s computer system. Any allergies and/or reactions to medications should be shared with all the pharmacies/pharmacist s that provides services to you. Pharmacists can many times more rapidly follow up with the prescriber and are an advocate for patients.
• Always consult a second opinion if you continue to feel the situation unresolved.
• Always keep an updated list of medications, allergies and medication procedures with you at all times. When listing any medication allergy, also note your specific reaction and prescriber. Be sure to share any changes with all your health care providers.
• Include food allergies on your list because some medications are developed from foods or other plants.
• Except for emergency medications, I always encourage my patients to begin any new medications on Mondays, Tuesdays or Wednesdays. If you have response that you feel is not what you expect, your prescriber can be more easily reached. If you need to go to an emergency room, it is usually not as crowded see more
This situation can be very serious. No one should take a medication which they believe they are allergic. Each time body is challenged by the “allergy causing compound”, the stronger the allergic reaction will be. Any questions about being allergic to any medication allergy should be addressed in any and all ways until resolved, meaning that you, the patient, is comfortable in taking the medication.
• Never ever take a medication that you feel many have caused you to have an allergic reaction until your questions are resolved.
• Prescriber offices (doctors and nurses) are changing over to the electronic record. Allergy information or other information may have been omitted or entered incorrectly.
• Ask the office to check your old (hard copy) records. If you know the date that the medication caused the “allergy”, please provide the dates with staff as this will help them in looking through your record.
• Another thing that may have happened, is that patients sometimes report how they respond to a medication and call it an allergy, the prescribers doesn’t classify the response as an allergy but as a reaction to the medication and your response may have not have flagged as an “allergy”.
• Always clearly describe your response to any medication.
• The allergy alert should have also been in the dispensing pharmacy’s computer system. Any allergies and/or reactions to medications should be shared with all the pharmacies/pharmacist s that provides services to you. Pharmacists can many times more rapidly follow up with the prescriber and are an advocate for patients.
• Always consult a second opinion if you continue to feel the situation unresolved.
• Always keep an updated list of medications, allergies and medication procedures with you at all times. When listing any medication allergy, also note your specific reaction and prescriber. Be sure to share any changes with all your health care providers.
• Include food allergies on your list because some medications are developed from foods or other plants.
• Except for emergency medications, I always encourage my patients to begin any new medications on Mondays, Tuesdays or Wednesdays. If you have response that you feel is not what you expect, your prescriber can be more easily reached. If you need to go to an emergency room, it is usually not as crowded see more
Question
Mom's been on Aricept and Namenda for about a year and a half. She's lost 20 pounds in the last year. Could...
Each of these medications can cause changes in appetite. Actually changes in appetite can be seen in the use of almost all medications. ... Each of these medications can cause changes in appetite. Actually changes in appetite can be seen in the use of almost all medications. Higher doses and/or higher blood levels of medications with this side effect can result in increased loss of appetite.
Loss of appetite is often an under-appreciated side effect in today’s seniors because as there is an expectation that appetite always slows with age. Many seniors do eat less due to many reasons as they grow older. Taking multiple medications that affect appetite will cause the appetite to drop, so the natural drop in appetite can be worsened by medications.
Lynn Harrelson R.Ph., FASCP. Senior Pharmacy Solutions see more
Loss of appetite is often an under-appreciated side effect in today’s seniors because as there is an expectation that appetite always slows with age. Many seniors do eat less due to many reasons as they grow older. Taking multiple medications that affect appetite will cause the appetite to drop, so the natural drop in appetite can be worsened by medications.
Lynn Harrelson R.Ph., FASCP. Senior Pharmacy Solutions see more
Question
Is confusion a side affect of Sinemet?
Some of the more frequent side effects of Sinemet can be confusion, hallucinations, anxiety, agitation, depressed mood, thoughts of suicide... Some of the more frequent side effects of Sinemet can be confusion, hallucinations, anxiety, agitation, depressed mood, thoughts of suicide or even hurting oneself. Less frequent side effects are sleep problems (insomnia), strange dreams. These side effects can be from the medication itself; adding other meds that may interact with Sinemet can bring on these new side effects or worsen the side-effects specifically seen with Sinemet.
Dementia or deteriorating mental status can also be seen with Parkinson’s. Regretfully, part of the progression of Parkinson Disease (PD) is a progressive dementia. But, on the other hand, sometimes the confusion with which day it is may be due to lack of good sleep and enough sleep overnight. If this confusion developed quickly, it may be that your MIL is simply dehydrated. When a patient is dehydrated, the concentration of the medication in the blood system elevates as it would if the dose is too high.
Some facilities use reality boards…large print notices of time, day, place, etc. Check to see if these are available and mention to your MIL to look at the notices as a way to possibly help trigger recall of day and time. This process is sometimes called reality orientation.
I would encourage everyone to investigate participation in support groups for the particular condition(s) that your loved one has….. PD, Alzheimer, stroke, diabetes etc. The discussions back and forth with invited expert speakers or with caregivers/family who have cared for individuals with the condition can be very helpful in solving care issues and with understanding the medical condition and what can be done. Support groups are also a wonderful resource for community services that may be available to assist you in the various aspects of care for your loved one.
Lynn Harrelson, Pharm BS, FASCP see more
Dementia or deteriorating mental status can also be seen with Parkinson’s. Regretfully, part of the progression of Parkinson Disease (PD) is a progressive dementia. But, on the other hand, sometimes the confusion with which day it is may be due to lack of good sleep and enough sleep overnight. If this confusion developed quickly, it may be that your MIL is simply dehydrated. When a patient is dehydrated, the concentration of the medication in the blood system elevates as it would if the dose is too high.
Some facilities use reality boards…large print notices of time, day, place, etc. Check to see if these are available and mention to your MIL to look at the notices as a way to possibly help trigger recall of day and time. This process is sometimes called reality orientation.
I would encourage everyone to investigate participation in support groups for the particular condition(s) that your loved one has….. PD, Alzheimer, stroke, diabetes etc. The discussions back and forth with invited expert speakers or with caregivers/family who have cared for individuals with the condition can be very helpful in solving care issues and with understanding the medical condition and what can be done. Support groups are also a wonderful resource for community services that may be available to assist you in the various aspects of care for your loved one.
Lynn Harrelson, Pharm BS, FASCP see more
Question
Mom took Ativan 0.5mg last night for 1st time and is very sluggish today. She is taking it for Dementia and an...
Hello ppalmer316, Although this medication is not usually recommended for use in patients over 65 years, Ativan is at times prescribed for... Hello ppalmer316,
Although this medication is not usually recommended for use in patients over 65 years, Ativan is at times prescribed for anxiety in that age group. When it is used extra caution needs to be exercised for the very reason your mother has experienced…..drowsiness or what is often called a morning drug hangover.
Ativan (lorazepam) acts centrally in the brain and when the concentration is too high, patients experience bothersome side effects…… drowsiness, sedation, etc. All patients do not respond the same way to the same dose. Patients who are older, female, have lower body weight, poor liver or kidney function, or take more than 5 other medications should always be started on the smaller doses and doses should be increased slowly, if they need to be increased. This is recommended because their body may not be able to eliminate or clear a routine daily of dose of any medication over time, but this is even more of a problem when their health begins to decline.
There is no one recommended dose for patients over 65 years, but starting at the lowest dose would be best, 0.25mg and adjust upward if and when needed. Medications for anxiety are often prescribed to be dosed regularly every day. I recommend that after an initial dosing period (2-5days) that patients be given a drug holiday, (skip one or more doses) to see how they respond not using the medication. Many times anxiety behaviors will improve after patients are able to get a restful sleep and may need only smaller doses every other day, every 3rd day, etc.
Please note that if given regularly for a longer period of time, that patients may not continue to respond to the same dose and may need an increase in the dose. When doses are higher and/or given over an extended period, extra caution should be exercised when this medication is stopped.
If or when this medication is to be stopped, the dose taken should be slowly tapered downward due to the potential of withdrawal side-effects.
Lynn Harrelson, Pharm BS, FASCP see more
Although this medication is not usually recommended for use in patients over 65 years, Ativan is at times prescribed for anxiety in that age group. When it is used extra caution needs to be exercised for the very reason your mother has experienced…..drowsiness or what is often called a morning drug hangover.
Ativan (lorazepam) acts centrally in the brain and when the concentration is too high, patients experience bothersome side effects…… drowsiness, sedation, etc. All patients do not respond the same way to the same dose. Patients who are older, female, have lower body weight, poor liver or kidney function, or take more than 5 other medications should always be started on the smaller doses and doses should be increased slowly, if they need to be increased. This is recommended because their body may not be able to eliminate or clear a routine daily of dose of any medication over time, but this is even more of a problem when their health begins to decline.
There is no one recommended dose for patients over 65 years, but starting at the lowest dose would be best, 0.25mg and adjust upward if and when needed. Medications for anxiety are often prescribed to be dosed regularly every day. I recommend that after an initial dosing period (2-5days) that patients be given a drug holiday, (skip one or more doses) to see how they respond not using the medication. Many times anxiety behaviors will improve after patients are able to get a restful sleep and may need only smaller doses every other day, every 3rd day, etc.
Please note that if given regularly for a longer period of time, that patients may not continue to respond to the same dose and may need an increase in the dose. When doses are higher and/or given over an extended period, extra caution should be exercised when this medication is stopped.
If or when this medication is to be stopped, the dose taken should be slowly tapered downward due to the potential of withdrawal side-effects.
Lynn Harrelson, Pharm BS, FASCP see more
Question
Are there meds for my mom who has developed severe claustrophobia?
Often such behaviors can be due to changes in personality that is often seen with aging and may come from one or more causes. Such... Often such behaviors can be due to changes in personality that is often seen with aging and may come from one or more causes. Such behavior may be the result of trauma from her youth, it may be from dementia or changes in her brain that causes such acting out. It could be caused by a urinary tract infection. It also may be the result of the one or more medications that are being used. And all of these conditions can be worsened if she is dehydrated.
My recommendation would be to assure that she is well-hydrated, that she has a clear urinalysis, no underlying infection. If you could target in on the time her “behaviors” started, ask if any new medications started just prior to that period. You can also ask her consultant pharmacist at the facility to evaluate if any of the medications may be contributing to the problem. The problems you reported could be her reacting to one or more medications that she is taken. Gradual dose reductions in any of the medications over time may alleviate the behaviors. You mother may benefit from a geriatric psychiatric evaluation; but very often new medications are added with such reviews. In seniors, I always suspect such behavior may be the result of the medications being used and always try to evaluate if what she is currently taking may need to be reduced or stopped.
I would summarize that you look at the big picture, if changes are made, that changes be made in one medication at a time and that reductions be made slowly, abruptly stopping medications may also cause changes in behaviors.
Lynn Harrelson, Pharm BS, FASCP see more
My recommendation would be to assure that she is well-hydrated, that she has a clear urinalysis, no underlying infection. If you could target in on the time her “behaviors” started, ask if any new medications started just prior to that period. You can also ask her consultant pharmacist at the facility to evaluate if any of the medications may be contributing to the problem. The problems you reported could be her reacting to one or more medications that she is taken. Gradual dose reductions in any of the medications over time may alleviate the behaviors. You mother may benefit from a geriatric psychiatric evaluation; but very often new medications are added with such reviews. In seniors, I always suspect such behavior may be the result of the medications being used and always try to evaluate if what she is currently taking may need to be reduced or stopped.
I would summarize that you look at the big picture, if changes are made, that changes be made in one medication at a time and that reductions be made slowly, abruptly stopping medications may also cause changes in behaviors.
Lynn Harrelson, Pharm BS, FASCP see more
Question
What is the likelihood of a medication causing a person to hear and see things that aren't there?
Medications can cause individuals to hear or see things that are not there. Medication, before and after they are available to be... Medications can cause individuals to hear or see things that are not there. Medication, before and after they are available to be prescribed, are monitored for these side effects and many more. If a medication can cause this side effect, it is noted in the consumer information sheets provided with prescriptions. Side effects are grouped into broad classes such as ‘frequently seen’ or ‘rarely seen’. However an individual’s general and mental health condition greatly affects the individual’s response to any medication. Also, other medications being used as well hydration may alter the side effects and how severe that side effect might be. Any serious side effect should be discussed with the prescriber, hearing and seeing things that aren't there should be promptly discussed with the prescriber. see more
Question
My mother was given the wrong medications when she went into the hospital. How can I get this situation addres...
In each hospital there is an individual/department to address such problems since errors of this type may be due one or more issues from... In each hospital there is an individual/department to address such problems since errors of this type may be due one or more issues from one or more departments or how they department communicate. The Joint Commission of Healthcare Accreditation Organization or other credentialing organizations evaluate how such problems are received and addressed.
I would encourage you to discuss the error with the Patient Services Coordinator, Quality Assurance Coordinator, etc ( these are some of the usual titles).Take your notes and always ask for feedback and what processes are in place to prevent things like this from happening again. Facilities usually reinforce procedures, retrain, establish new processes. see more
I would encourage you to discuss the error with the Patient Services Coordinator, Quality Assurance Coordinator, etc ( these are some of the usual titles).Take your notes and always ask for feedback and what processes are in place to prevent things like this from happening again. Facilities usually reinforce procedures, retrain, establish new processes. see more
Question
Does statin medication for cholesterol deteriorate muscles in the elderly?
Statin medications may alter the development of certain proteins involved in muscle metabolism and function. This may result in muscle pain... Statin medications may alter the development of certain proteins involved in muscle metabolism and function. This may result in muscle pain and tenderness and can result in a condition known as statin myopathy.
When patients notice moderate muscle aching, they are advised to stop taking the statin drug and contact their doctor. Muscle aches and pains usually disappear within a couple of weeks after stopping the statin drug.
Statins may cause muscle cells to break down in the more severe cases and this condition is called rhabdomyolysis. The most common signs and symptoms of rhabdomyolysis are severe muscle aching throughout the entire body, muscle weakness, dark or cola-colored urine. This condition is more often seen with the higher doses of the statins and when statins are taken with other meds that worsen this effect.
You should be sure that your father is off the medications that are contribute to this condition and ask the physician to monitor the appropriate labs see more
When patients notice moderate muscle aching, they are advised to stop taking the statin drug and contact their doctor. Muscle aches and pains usually disappear within a couple of weeks after stopping the statin drug.
Statins may cause muscle cells to break down in the more severe cases and this condition is called rhabdomyolysis. The most common signs and symptoms of rhabdomyolysis are severe muscle aching throughout the entire body, muscle weakness, dark or cola-colored urine. This condition is more often seen with the higher doses of the statins and when statins are taken with other meds that worsen this effect.
You should be sure that your father is off the medications that are contribute to this condition and ask the physician to monitor the appropriate labs see more
Question
How do I know if my mother has dementia or is just taking too many prescription drugs?
The pharmacists specializing in Senior Care are excellent resources of getting advice on how to approach medication use and the overuse of... The pharmacists specializing in Senior Care are excellent resources of getting advice on how to approach medication use and the overuse of medication. I would develop a relationship with such a pharmacist and ask them to be an advocate for your mother and their use of multiple medications, cumulative side effects and her body's declining ability to handle the multiple medications.
The pharmacist could also coach you to do the same. Some physicians are hesitant to stop medication unless there is full support of the family or medical power of attorney. If the physician won't consider stopping orders, ask if they would consider a drug holiday-not taking a medication for a period of time, sometimes it is called a hold order. It is a temporary stop and can be structured to meet the needs of your mother.
If your mother is in a nursing or assisted living facility, then enlist the assistance of their consultant pharmacist, attend care planning meetings, speak with the ombudsman or medical director to make you needs known. see more
The pharmacist could also coach you to do the same. Some physicians are hesitant to stop medication unless there is full support of the family or medical power of attorney. If the physician won't consider stopping orders, ask if they would consider a drug holiday-not taking a medication for a period of time, sometimes it is called a hold order. It is a temporary stop and can be structured to meet the needs of your mother.
If your mother is in a nursing or assisted living facility, then enlist the assistance of their consultant pharmacist, attend care planning meetings, speak with the ombudsman or medical director to make you needs known. see more
Question
Does someone with dementia know they have a problem?
In helping evaluate patients in nursing homes, many times the intermittent "dementia' proved to be TIA's (transient ischemic... In helping evaluate patients in nursing homes, many times the intermittent "dementia' proved to be TIA's (transient ischemic attacks) or mini strokes. I would strongly urge a comprehensive evaluation. Bring in a log of the times and length of episodes of the "dementia". Also, changes in blood sugars for some patients can cause problems, that’s why the time log is beneficial. see more
Question
Is there something I can do to see if my mom is loosing her sense of taste or smell?
Loss of taste and smell can occur at any age and there can be many reasons. If the loss is a rapid onset, you may want to think about any... Loss of taste and smell can occur at any age and there can be many reasons. If the loss is a rapid onset, you may want to think about any mediations that may have been recently started. Certain medications, such as some antibiotics, high blood pressure medications and chemotherapy can cause a loss of taste. Antibiotics often change the natural flora of the mouth and GI tract. A good replacement source of lactobacillus (natural non-sweetened yogurt) may help. Also, some patients with certain medical conditions (Parkinson's disease and Alzheimer's disease), may develop loss of taste. I would suggest that you speak with your pharmacist and ask that they review your mother’s medications as a possible source for her loss of taste. I would also discuss the possibility of sjogrens syndrome with a good ear, throat and nose specialist. see more
Huge decision among COVID conditions. Any advice?