Ask a Pharmacist

Some prescription and over-the-counter medications can make you drowsy. There are a lot of medications that are sedating, and that can lead to issues with balance. Dosing schedules are important when trying to avoid daytime drowsiness caused by certain medications. This is a particular problem with seniors because drowsiness can increase unstable walking and cause falls. Also, people need to be cautioned about driving while taking a medication that might make them drowsy. It is always best to check with your doctor or pharmacist before using any medication, especially if you are adding an OTC medication, which may not be part of your medical record.

There are medications that help memory, especially individuals with Alzheimer’s, but there are medications that can cloud memory and interfere with and exacerbate memory issues, and that’s something to watch for in the elderly. Some medications like certain sleep aids can leave people a little hazy, and they have a harder time waking up and standing up. If this happens, they may need talk to their doctor about reducing the medication’s dose.

Seniors tend to be on diuretics, the medications that help increase urine production. People are typically on diuretics if their blood pressure is high or they have congestive heart failure. A diuretic medication removes fluid from the body, which helps reduce blood pressure. But with a diuretic medication, you end up needing to deal with the side effect of frequent urination. So when you take a diuretic, you have to consider being home or being close to a bathroom. Often people will take a diuretic in the morning and stay at home. Diarrhea is another common side effect of many medications. Antacids with magnesium, antibiotics, nonsteroidal anti-inflammatory drugs (NSAIDS) and chemotherapy medications are some of the most common medicines that induce loose, watery stools.

Yes, a dosing schedule is important, because every medication that you take has a specific dosing schedule — once a day, three times a day, etc. You should try to take your medication at the same time every day for the most beneficial effect of that medication. And if the medication is discontinued by the doctor, that needs to be noted and followed.

When a person is living at home and needs help taking medications, it is important that there is a family member or friend who sets up the medications. A caregiver from a home care agency cannot legally open medication containers and put medications in cassette dispensers and pillboxes. Family members need to do this. A professional in-home caregiver can remind a care client to take their medications or put a medication in the client’s hand or into a cup. The caregiver can observe the care client take the medication and report back to the family about the loved one taking their medication.

There is some controversy when it comes to expiration dates, but I do think people need to be cognizant of expiration dates. Certain medications like insulin, nitroglycerin and liquid antibiotics are most sensitive to expiration dates. If you have questions about the potency and effectiveness of medications you take, always check with your doctor or pharmacist. You especially don’t want the elderly taking medication that expired years ago.

Keep medications in a safe place and out of the reach of children and pets. Some medications need to be refrigerated, but the majority do not, and you can keep them in a dry place that’s not exposed to temperature extremes. Also, be sure not to mix up your medications. Keep each medication in its own distinct bottle unless someone is managing the dispensing of medicines via cassettes or pillboxes. Being able to distinguish one medication from another gets harder with age.

Eating grapefruit and foods with vitamin K, such as kale, spinach and other green leafy vegetables, cause the most common food-drug interactions. Grapefruit can slow the metabolism of some drugs, so it increases the drug levels in your body. Vitamin K helps the body with blood clotting but can interfere with blood-thinning medications. A lot of people on blood thinners just don’t drink grapefruit juice anymore or they eat only small amounts of vitamin K-rich foods. To be safe with your medications, you can always ask your pharmacist, “Are there any medications where I can’t eat grapefruit or drink grapefruit juice or eat foods with vitamin K?”

People over age 65 are at higher risk for flu and should check with their doctor about the right flu vaccination. There are some restrictions for people with certain medical issues, but overall it’s recommended that most elderly people receive the flu shot. Also, anyone over 50 should consider the shingles vaccine, because singles has had a resurgence lately, especially among older people. If you don’t catch shingles in time, it has some long-term side effects including possible nerve pain and loss of vision. Also, for seniors 65 and older, the benefits of the pneumococcal vaccine is an important topic to discuss with their doctor.