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MSNBC reports that "almost a quarter of older Americans are sent to hospitals or nursing homes because of problems with medications. " The cost of adverse drug reactions--in human casualties is estimated at 100,000 annually; the annual cost is $$ is a stunning $177 billion. [Source: California Pharmacists Association]
An outstanding, solidly researched book, by Jay s. Cohen, M.D., OVER DOSE:
The Case Against the Drug Companies, Tarcher /Putnam, 2001, addresses the issue. Dr. Cohen explains why adverse drug side effects have reached epidemic proportions, and why women and the elderly are particularly vulnerable to adverse drug side effects.
A 2000 study of nursing home patients, for example, found that of the 20,000 fatal or life-threatening medication reactions, 80% were preventable. A 2001 report by the General Accounting Office, "Drug Safety: Most Drugs Withheld in Recent Years Had Greater Health Risks for Women."
The problem, Dr. Cohen says, is not the drugs per se, the problem is often in the dosages recommended by drug manufacturers: they use a 'one size fits all' approach, and that can be lethal! In Britain, the agency regulating prescription drugs orders physicians to lower the dose of a drug, when it is found to cause harm. The U.S. Food and Drug Administration issues no such instructions to protect the American public.
Harmful side-effects are the result of inadequate research and poorly designed drug trials. The speeded up drug approval process may be good for the drug business, but it's lethal for public health. Doctors are losing confidence in the FDA: "The FDA used to serve a purpose. A doctor could feel sure that a drug he was prescribing was as safe as possible. Now you wonder what kind of evaluation has been done, and what's been swept under the rug." [Willman, LA Times, 12/2000]
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People over the age of 65 consume more than a third of all prescription medications in the United States. And as they and their medicines grow in number, there‚s growing concern about the elderly getting the wrong kind of drugs. In fact, almost a quarter of older Americans are sent to hospitals or nursing homes because of problems with medications.
MARILYN EIGENFELD of Los Angeles considers herself lucky to be alive. Seven years ago, she developed a sudden allergic reaction to ibuprofen, a common pain remedy.
"I had very bad reactions. I went into shock and had to be treated at the hospital, a very frightening experience," Eigenfeld said.
According to the California Pharmacists Association, more than 100,000 Americans die each year of adverse drug reactions. The annual bill for treating medication misuse is a stunning $177 billion.
The group most prone to adverse drug reactions? Senior citizens. Because seniors are taking a growing variety of medicines, they run a higher risk of dangerous drug reactions. Drug interactions with elderly people can be a problem. "It's not unusual for a patient getting six, seven, 10 medications at the same time and so these drug interactions can be significant," said Dr. Steve Gray of Kaiser Permanente.
Top 20 drugs used by older Americans, ranked by number of prescriptions issued.
Rank/Brand name/Marketer/Therapeutic category
1. Prilosec Astra Zeneca Gastrointestinal agent
2. Norvasc (5 mg) Pfizer Calcium channel blocker
3. K-Dur 20 Schering Potassium replacement
4. Lanoxin Glaxo Wellcome Cardiac glycoside
5. Lipitor (10 mg) Parke-Davis Lipid-lowering agent
6. Celebrex Searle Anti-inflammatory/ analgesic
7. furosemide Mylan Loop diuretic
8. Fosamax Merck Osteoporosis treatment
9. Glucophage Bristol-Meyers Squibb Oral anti-diabetic agent
10. Plavix Bristol-Meyers Squibb Anti-platelet agent
11. Prevacid TAP Pharm Gastrointestinal agent
12. Zocor Merck Lipid-lowering agent
13. Xalatan Pharmacia & Upjohn Glaucoma treatment
14. Pepcid Merck Gastrointestinal agent
15. Lanoxin Glaxo Wellcome Cardiac glycoside
16. Norvasc (10 mg) Pfizer Calcium channel blocker
17. Synthroid (0.1mg) Knoll Synthetic thyroid agent
18. Vioxx Merck Anti-inflammatory/ analgesic
19. Synthroid (0.05 mg) Knoll Synthetic thyroid agent
20. isosorbide mononitrate Warrick Anti-anginal agent
Source: "Enough to Make You Sick: Drug Prices for the Elderly," Families, USA Foundation, June 2001.
Some big HMOs like Kaiser Permanente now use computers to track patients with multiple prescriptions and flag any potentially harmful drug interactions. But health professionals say patients themselves need to be more alert to what they‚re taking.
"It would be very good if the patients would have a list of medications, who prescribed it, the dose, the directions," said pharmacist Harold Washington, Jr.
A volunteer group called SMART (Senior Medication Awareness and Training) Coalition endorses that idea and hands out cards on which seniors can track all their prescriptions.
"We're training those seniors to ask more questions, to take charge, to be responsible for their medicines,‰ said John Gallapaga of SMART.
"If I have to die, I don't want to die from a reaction to medication; there are other ways to do it naturally," Eigenfeld said. But she plans to do a whole lot more living by staying aware of the medicines she uses.
Avoiding medication mistakes
Become an expert on what ails you. Ask your doctor all about it and do your own research.
Know all about your medications. Thousands die each year from medication errors. Know what you're taking, what the name is, what the strength is and what it's for.
After taking new medications, watch for new symptoms that could be side effects.
Bring all of your medicines to the doctor with you -- even over-the-counter drugs and herbal remedies -- so your doctor can see
everything you are taking.
Be on guard, even in the hospital. Every time a drug is about to be administered, even intravenously, ask what it is.
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