Polypharmacy in the elderly

Featuring Dr. Duncan Miller, BSc, MD
Polypharmacy in the Elderly
Duration: 2 minutes, 42 seconds

Polypharmacy is of particular concern in the elderly.

Not only do you acquire more chronic healthcare conditions as you age, but your body loses the capacity to deal with medications like a younger and more healthy person might. For example, as you get older, you tend to lose muscle mass and gain more fat, and that affects how medications are distributed throughout your body, so you may need a lower dose of medication than a person who is younger and healthier than you are.

With age, your liver and kidneys, which tend to break down a lot of medications, don't work as well, and often, those medications will build up over time. A good adage is when you're taking medications to remember that all pills are basically poisons with useful side effects. Similarly, when taking a new medication, you wanna start on a low dose and slowly increase it.

Also, if you can take one medication that can do the job of two things like, for example, help your pain and help your sleep, rather than take two different medications, you're far ahead of the game. It's important to review any new medication with not only your healthcare provider, but with a pharmacist who knows a great deal about these products as well.

Over-the-counter medication often has the mystique of being safer because it's available without a prescription; however, this is often not the case and you should always confer with a pharmacist or your healthcare provider before starting them. For example, anti-inflammatory medications – although they're a wonderful pain reliever – can often reduce blood flow to the kidneys and make other medications pile up in your body, or they can lead to such complications as bleeding from your stomach.

Similarly, antihistamines, which are often used to help people sleep – they take them for non-prescribed reasons, so to speak – can cause problems in elderly men by making their prostate retain urine. Similarly, they can lead to falls in the elderly.

So, whenever taking a new medication, it's always a good idea to consult with either the pharmacist or with your primary healthcare provider. Just remember that treatment for your condition will vary with the individual and the condition they may have, so always consult your primary healthcare provider for more information.

Presenter: Dr. Duncan Miller, Family Doctor, Vancouver, BC

Local Practitioners: Family Doctor