Thursday, April 18, 2013

'110 drugs to avoid in the elderly' - do the doctors read this?

110 drugs to avoid in the elderly(PDF)
This is no surprise to me. Here is a resource: 110 drugs to avoid in the elderly(PDF).
Many of drugs are widely used,  with few side effects in younger patients, but their risks are researched and documented and can be horrible in the frail elderly.

 I was sitting with a client with anxiety disorder, who told me she took Ativan when she had to. She does not have dementia, or other chronic health issues. It works well for her.

They gave Ativan (AKA Lorazepan) to my late father, when his dementia was pretty bad, up until the time he refused any meds at all. (We don't know why!) This doctor who didn't know my father from Adam, and likely never read his files. There were 200 patients/residents in this wing. The Charge Nurse would accompany him on his rounds, outlining the health issues with the physician, and never once talked to me about him. Often, Michele complained, they would be eating lunch when this doctor did his rounds. I found this, myself. I was so shocked to see the doctor there as I was feeding dad his lunch that I froze and didn't have the temerity to ask him m
y questions. This doctor skipped my Dad's annual case conference, his excuse as he flew by my in the hall was that it was accreditation day in the LTC and he didn't have time.
Dad, in obvious pain.
They wouldn't ask the doctor for pain meds
until Dad could tell them he was in pain.
Dad had unmanaged pain. Doctors who work in long-term care must be generalists is everything. I don't think he was even a Geriatrician, and had patients with issues ranging from Dad's brain tumour, young men blind and immobile in wheelchairs, to a brain damaged 40-year-old, to my dear friend, Michele, who has spinal stenosis. In my later research, I found that these drugs are not tested on people over age 70. They are tested on people with only one chronic health issue, while we know most of our seniors have two or more. 

It took me three days to track down the doctor in the last week of Dad's life, when he needed morphine injections desperately.

My friend, Michele.
I wrote about her in my book.
On morphine 24/7 for pain
 Here is a Times article: Elderly Patients Routinely Prescribed Risky Drugs 
Doctors in the United States routinely prescribe potentially harmful drugs to older patients, and the problem is particularly acute in the South, a new study shows. As socioeconomic status grew lower, for example, the likelihood of being prescribed a high-risk drug increased. But even after accounting for these factors, the researchers found that the disparity persisted. Dr. Trivedi and his colleagues published their findings in the latest issue of The Journal of General Internal Medicine. 

Benzodiazepines Tied to Higher Risk of Dementia in Elderly

Sep 29, 2012 – Benzodiazepine Medications, Such as Xanax and Ativan, Linked to Increased Risk of Developing Dementia A new study has found that people

Ask an Expert: Is Ativan Okay for Alzheimer`s Patients? - NetWellness

Jun 5, 2008 – In my opinion, ativan should only be used rarely and sparingly for dementia patients. It can cause sleepiness and confusion and is addictive.

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