Medicine146;s Grey Area

A new module for TB, improved HIV drugs and a cure for everything but the common cold. In the flurry of better-quicker-more effective medica...

A new module for TB, improved HIV drugs and a cure for everything but the common cold. In the flurry of better-quicker-more effective medication, geriatric treatments are still largely a grey area8212;quite contrary to the plethora of paediatric formulations.

Why do the elderly need special medicines anyway?
The slowing of kidney and liver functions is the primary reason why a person at 65 will react differently to a dosage he could take safely at 25. 8216;8216;Changes in the body composition make the elderly particularly vulnerable to ill effects of medicines,8217;8217; says Ranjit Roy Chaudhury, president of the Delhi Society for Promotion of Rational Use of Drugs and former chief of Delhi Medical Council.

PILL DRILL

Elderly and on medication? Cut and keep this on a bedside table
8226; Inform yourself on medicines you take. Quiz your doctor, raid a library
8226; Do not try out a new medicine simply because you read about it or it worked for a friend
8226; As a rule, don8217;t buy medicines without a prescription. And always seek a receipt. Frequent one trustworthy chemist or pharmacist
8226; Abide by the expiry date
8226; Always complete the course of treatment, particularly for antibiotics and anti-TB drugs
8226; Take your time opening the packaging. If possible, categorise the medicines by the day
8226; Involve a second person8212;a family member, social worker or friend
8226; Stick to a healthy diet. Exercise, do yoga or meditate
8226; Meet people, keep a pet

Doctors must be aware of this. Why don8217;t they take care of it?
Unfortunately, doctors themselves are the first guilty party. 8216;8216;They sometime prescribe unnecessary medicines. They prescribe medicines that react with each other to produce side effects. Sometimes they suggest the wrong dose or the wrong duration for the course,8217;8217; says Roy Chaudhury.

So what8217;s the way out?
In the UK, the British National Formulary recommended in 2002 that geriatric dosages be reduced by 50 per cent. But pharmaceutical majors do not produce such dosages. So it becomes imperative for the elderly themselves to beware of over-medication. Here8217;s a guide:

8226; Avoid self-medicating with antidepressants, tranquillisers and antipsychotic medicines
8226; Avoid self-medicating with penicillin of all types, including amoxycillin, if there is evidence of kidney disease
8226; Ditto with aminoglycoside antimicrobial medicines. The commonly used antibiotic Gentamycin belongs to this group
8226; Cut back doses of high blood pressure medicine first check with your doctor
8226; Try and avoid diuretics
8226; If a hypnotic is essential, let it be a short-acting one rather than a long-acting one
8226; Treat arthritis with Paracetamol and perhaps Ibuprofen. Avoid more toxic medicines
8226; Stick to non-steroidal anti-inflammatory agents