Community pharmacy chief has tips for avoiding drug interactions and side effects

Mark Loehrke Times correspondent

To think, there was probably a time when even a simple medication organizer for the day of the week probably seemed a bit overkill to many seniors. But getting older has a way of accumulating more aches, pains, and conditions (and the medications that come with them), which means keeping pills and dosages in order involves more than just knowing what to take and when. It also means being aware of potentially harmful interactions between these drugs.

Pharmacy manager Elizabeth Clements and her team at the community hospital probably spend as much time comparing and answering questions about potential drug interactions as filling prescriptions. Here are some of his thoughts and recommendations for seniors as those medicine organizers begin to fill up:

What questions should seniors ask their doctor and/or pharmacist regarding potential drug interactions when starting a new medication?

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Elizabeth Clements: I would first like to ask if there are any interactions between the new drug and the current drugs. Second, I would ask if the medications interact with any vitamins or supplements I take. If there is an interaction, I would ask if it is safe for me to take the new drug or if there is another drug that might be better for me. Finally, I would ask if there are any side effects that I should look out for that might need to be discussed with my provider.

As a pharmacist, how difficult is it to avoid adverse drug interactions for older people who are often already taking multiple medications?

Clements: The more drugs a patient takes, the more likely there is to be a drug interaction. However, not all drug interactions require drug changes. Some drug interactions can be handled by spacing out the medications or asking the patient to look for specific symptoms. It is important for providers to consider the potential effect of drug interaction with the patient in mind. That is, if an interaction could cause symptoms that could worsen a patient’s condition, that drug combination may not be the best choice for the patient, and we should consider other drugs to treat the patient. Sometimes it’s just not possible to avoid drug interactions, and we may have to decide which interactions are the safest.

What are the signs of potential adverse drug interactions or side effects?

Clements: Each drug interaction can have different signs to watch out for. For blood thinners, an interaction may increase your risk of bleeding. Interactions with blood pressure medications could cause your blood pressure to drop, making you feel dizzy. Interactions with pain or sedative medications may cause drowsiness or weakness and lead to falls. If you are starting a new medication, be aware of any changes in the way you feel. Protecting your health is important and it never hurts to ask questions.

Has the situation improved or worsened in recent years with regard to drug interactions in the elderly?

Clements: Drug interactions have decreased over the past few years. We saw increased integration between electronic health records and pharmacies, giving providers a clearer picture of a patient’s medications. This allows providers to identify and address drug interactions that they were not previously aware of. However, making new drugs available – and learning how to manage new interactions – presents an ongoing challenge for providers and pharmacists.

What is some good general advice for the elderly regarding drug interactions?

Clements: Provide your provider with an updated medication list at each appointment. We often see patients with multiple medical conditions using different providers for their care. These providers may use different medical records and may not have the most recent list. Also try to use only one pharmacy to get your medications. This will allow your pharmacist to review your medication list for drug interactions. Foods can also interact with medications. Be sure to include this in your discussions with doctors and pharmacists.

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