Keeping track of multiple prescription meds

Q. My elderly mother seems to take a lot of prescription medicines. Should I be concerned?

A. Your mother has plenty of company. The National Center for Health Statistics reports that 75 percent of Americans age 75 and over take at least five prescription medicines daily. That figure doesn't count all of the over-the-counter, herbals - and perhaps a surprise, illegal substances - that many seniors take.

Although taking multiple meds may be appropriate, it also can lead to problems such as interactions between drugs, difficulty following directions, problems communicating with health-care providers, and problems getting all the information patients need.

On the other hand, many seniors have problems because they aren't taking medicines that would help them. For instance, most seniors have high blood pressure, which untreated causes damage to the heart, arteries and kidneys, as well as stroke, vision loss, erectile dysfunction, memory loss, and fluid in the lungs. Yet 1 in 5 adults with high blood pressure doesn't know it and 3 in 10 adults who have been diagnosed with the condition are not taking medicines to treat it.

Certain drugs are more likely to be linked to problems. A recent federal report found that 67 percent of all drug-related hospital admissions among seniors were connected to four categories of medicines: blood thinners (anticoagulants such as Coumadin), insulin, oral antidiabetics, and antiplatelets (thrombosis inhibitors, such as aspirin).

Misuse of prescription painkillers (such as hydrocodone, oxycodone and fentanyl) and illicit opioids such as heroin has reached epidemic proportions in the U.S., and seniors are no exception. A recent report found that emergency departments recorded a 78 percent increase in admissions among seniors for this issue between 2006 and 2012.

For most seniors with chronic pain, opioids are a risky choice. Within a week, patients can be physiologically dependent on them. In time, as doses are increased, quitting becomes more difficult. Also, falls are more likely for seniors on opioids. Some doctors are now saying opioids should not be used for fibromyalgia, chronic headache, or low back pain, as they are more likely to hurt than help patients.

Another danger: When seniors leave unused opioids in the medicine cabinet, other family members or guests may take them.

Much of what we know about the special issues seniors face with drugs comes from a physician-scholar, Mark Beers, who in 1991 published a list of medicines that were considered inappropriate for older adults. This problem stems from the reality that most clinical trials of new drugs exclude people over age 65 (as well as children and pregnant women). So, it is only after a medicine has been on the market for a while that it may become apparent which may harm the elderly.

The Beers List was most recently revised in 2015. You can find it at no cost on the web. Go to www.AmericanGeriatrics.org, and type "Beers Criteria" in the search bar for the full list.

If you find a medicine you are taking on the list, do not stop taking it without consulting your physician. The Beers List is only a guideline; a drug on it could be absolutely fine for you, especially if you have been taking it for a long time.

Generally, drug side effects are more likely as we age, and our body's systems may slow down so that some drugs are metabolized (processed) more slowly. For example, if you use diazepam (Valium), and its effects linger after you awaken, you may be more prone to falling and injuring yourself. There are other drugs in this category that are all metabolized by morning and would be a better choice.

To protect yourself and your senior loved ones from improper use of medicines:

Always tell your physician or pharmacist what other medicines, including over-the-counters and herbals, you are taking.

Always use the same pharmacy, making sure that it has a computer system that will detect a potential drug interaction or other problem.

Read the package insert that comes with your prescription medicine and the labels of any over-the-counter medicines you take.

Get more information online by doing a Google search on your medicines, or consulting the Beer's List.

Albert I. Wertheimer, Ph.D., professor of pharmacy administration at Temple University School of Pharmacy, and Patricia J. Bush, Ph.D., professor emeritus at Georgetown University School of Medicine, are co-authors of "Your Drugs & Sex: How Prescription and Non-Prescription Drugs Can Affect Your Sex Life."