newjerseynewsroom.com

BY CAROL ABAYA

NEWJERSEYNEWSROOM.COM

SANDWICH GENERATION

With one of the highest number of seniors and elders in the country, New
Jerseyeans need to beware of the dangers of many commonly prescribed
medicines. Misuse of prescribed medicines coupled with OTC's and vitamins can not
only cause death, but in many cases certainly end an independent lifestyle
for elders.

Top on the dangerous ultimate repercussion list is falls, especially
resulting in hip fractures. A hip fracture can end the independence of an
older person.

According to a new report, "The Role of Medication Modification in
Falls Prevention and Reduction," by Kathleen A. Cameron, "Falls can
cause physical and psychosocial impairments, such as fractures of the hip,
spine, and forearm; fear of falling, with a subsequent restriction in
activities; possible nursing home admission; and death."

The report states than 30% of seniors living at home fall each year.
This number increases to 50% for those 80 and older. Overall, more than a
1,300,000 seniors fall each year, most often linked to medications. The
increased use of medications (prescribed, OTC and even vitamins) dramatically
increases the chances of falling.

While other factors may contribute to falls (e.g. unsafe conditions in
the home), the use of medications can be modified, thereby preventing falls
or reversing the potential for falls.

The report states that "the most common side effects or adverse effects
leading to falls included blurred or impaired vision, hypotension causing
dizziness and lightheadedness, sedation, decreased alertness, confusion and
impaired judgment, delirium, compromised neuromuscular function, lethargy,
gait and balance problems, and anxiety. Fortunately these are frequently
reversible with modification to the medication regimen."

Older people are more susceptible to adverse drug effects because the
way the body processes drugs changes -- absorption rates, distribution,
metabolic changes, and how medications are eliminated from the body. According
to the report, by age 65, the filtering ability of the kidneys has decreased
by 30%. And declining liver function can decrease the metabolism of
medicines, which then can become toxic to older people.

Those drugs that put older people most at risk include various
Benzodiazepines (Valium, Dalmane, Klonopin, Xanax, Restoril, and Activan).
Another class of medicines that cause major and very serious problems
is antidepressants. Specific drugs mentioned in the report include
tricyclics or TCAs, Elavil, Tofranil and Adapin.

The report states that these drugs "are associated with a 66% increase
in the odds of experiencing a fall." Also causing a higher risk for falls
and hip fractures are serotonin reuptake inhibitors such as Prozac, Paxil,
and Zoloft.

In general, the report says, various antipsychotics, postural
hypotension and antihypertensive medications, analgesics and even cardiac medications
can cause dizziness, blurred vision and confusion, thus leading to falls.
Other adverse effects include hallucinations and delirium, rapid heart beat,
and general weakness.

Other commonly used medications that can result in falls and adverse
symptoms noted above include those for: anti-nausea and anti-dizziness,
Parkinson; muscle relaxants; anti-diarrheal; urinary incontinence; and
gastrointestinal antispasmodics.

Sandwich Generationers should investigate a parent's medication routine
if any of these symptoms occur.

To prevent falls -- and the end of independence -- the study recommends
a falls risk assessment and intervention that includes at least an annual
medication review and modification regiment that can reduce the fall risk.

A complete copy of the report, which lists more specific problem
medications, can be obtained by e-mailing me at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .
A reliable web site for possible negative reactions and problems is
www.fda.gov/drugs. Go to "Drug Safety" section.

Further information on adverse medication effects and non-compliance of
a medication routine is available by going to www.sandwichgeneration.com.
Go into the Information Store section and then the Q&A section. Q&A 105
contains more helpful information.

The Sandwich Generation is reader interactive and questions are welcome.
Visit web site www.sandwichgeneration.com or e-mail directly
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