Some Questions of Medications for the Elderly

Medical problems are different for the older patient for various reasons. One of the major differences is the way that the body reacts to medication. Here we are will briefly describe a few of the most important considerations.

As we get older, above the age of thirty, we begin to lose part of what is called our "organ reserve." When we are younger, our hearts can pump ten times the amount of blood required to sustain life, our kidneys can excrete six times the waste products that we produce in our bodies each day, and all of our other organs have very similar reserve powers which fortunately are very seldom required. After the age thirty, we begin to lose this organ reserve at a rate of between one or two percent each year. We don't even notice this lose, unless we are in a certain situation in which we really need it. Loss of reserve power means that it is more difficult to restore the equilibrium of the body after a severe insult to a body function.

As we get older, our bodies detoxify drugs at a slower rate. In medical terms, the drug is metabolized more slowly. A little goes a long way in older patients. In essence, with older patients we can get the same effect from a lower dosage; the regular dose of a drug can become an overdose. The first rule that any good physician observes with an older patient is to keep the dose low.

Side effects of medications can stimulate disease, and unwary physicians and patients often mistake a drug reaction for an underlying medical problem. A small dose of codeine may cause severe fatigue and sleepiness, a little digitalis may cause profound nausea and vomiting, a diuretic to remove fluid from the ankles may cause dizziness and kidney problems. The second rule that a good physician observes is to suspect that the whole problem might be a minor drug reaction, cured simply by removing the offending drug.

Another reality is that entirely new side effects can appear in the elderly. A sleeping pill may keep the patient it is subscribed to awake. A tranquilizer may excite an elderly patient or cause severe depression. These paradoxical reactions are not fully understood by medical professionals, but they are very common. Again, the good physician and the thoughtful patient or relative will suspect the drug first.

No one is a better health advocate for you than yourself. Make sure to research medications and to consult a physician before taking any.