The Risks in Using Multiple Medications

Prescription medications can improve the symptoms of a disorder and improve the quality of life. However, they also have the potential to cause dangerous side effects. A good guideline followed by physicians who prescribe medications to the elderly is to "start low and go slow," meaning the elderly should take new medications at a slower rate and start at about half the adult dose. As our bodies change with age, so does the need for a different dosage, interval and duration of treatment. The longer an individual is on a drug, the greater the likelihood of an adverse reaction. The effects of a harmful drug reaction can appear as an isolated symptom (drowsiness) or as a group of symptoms (depression and confusion). In the elderly, toxic reactions can occur even at low drug dosages. Therefore, the elderly should approach the use of prescription medication with caution and report any unusual or new symptoms to their health care provider. It is important to consult a health care provider before changing any prescription medication dosage.

Medications that Pose a Risk and Why:

(Medications listed below are to be avoided or need close monitoring)

Medications of Risk	Problems
Benzodiazepines (antianxiety), Long acting agents Diazepam (Valium) Flurazepam (Dalmane ) Chlordiazepoxide (Librium) Alprazolam (Xanax) Barbiturates	Confusion, sedation and falls.
Antidepressants (used to treat depression), Amitryptiline (Elavil) Doxepin (Sinequan) Imipramine (Tofranil)	Confusion, sedation, hypotension, falls, and urinary retention.
Antipsychotic Agents (used to treat mental disorders) Chlorpromazine (Thorazine) Thioridazine (Mellaril) Haloperidol (Haldol)	Confusion, sedation, hypotension, falls, urinary retention, Parkinsonism (involuntary shaking and twitching), tardive dyskinesia (TD).
Antihistamines (used to treat sinus problems and allergies) Diphenhydramine (Benadryl) Hydroxyzine (Vistaril)	Confusion, sedation, hypotension, falls, and urinary retention (inability to empty bladder), sleep disturbance.
Antiemetics (used to relieve nausea) Promethazine (Phenergan) Prochlorperazine (Compazine) Thiethylperazine (Torecan)	Confusion, sedation, hypotension, falls, urinary retention, Parkinsonism (involuntary tremors and rigidity), involuntary movement (tardive dyskinesia)
Analgesics (used to relieve pain) Propoxyphene (Darvon) Meperidine (Demerol)	Constipation, confusion, & sedation.
Antiparkinsonian (used to treat Parkinsons disease) Carbidopa-Levodopa (Sinemet)	Confusion, dizziness, hypotension, increase in cardiovascular toxicity.
Cardiovascular drugs (used to treat heart and blood vessels) Digoxin (Lanoxin) Warfarin (Coumadin)	Nausea, vomiting, anorexia, weight loss.Bleeding tendencies (requires close monitoring)
Antispasmodic drugs (used to prevent or relieve spasms) Dicyclomine (Bentyl) Hyoscyamine (Levsin, Levsinex) Pro-Banthine (Propantheline)	Dry mouth, constipation, urinary retention, delirium.
Urinary Incontinence drugs Oxybutynin (Ditropan) Tolterodine (Detrol)	Dry mouth, constipation, urinary retention, delirium, confusion