“One of the first duties of the physician is to educate the masses not to take medicine.”
– William Osler, MD
Most Commonly Used Prescription(Rx) and Over-the-Counter(OTC) Medications
- Lisinopril (Rx)
- Hydrochlorothiazide (HCTZ)(Rx)
- Levothyroxine (Rx)
- Omeprazole (PPI)(Rx and OTC)
Statins are the most commonly prescribed drug in elderly adults. Side effects include muscle pain and dysfunction in 10-15% individuals, cognitive decline, diabetes mellitus. Use should be closely monitored after age 75.
Proton Pump Inhibitors (PPIs) are recommended not to be taken longer than 8 weeks, except in high risk cases. PPIs can cause Clostridium difficile infections (CDI) (Simplify words-stomach pain!!, bone loss and fractures. Individuals taking PPIs are less able to absorb calcium, thyroid hormone, iron, magnesium, vitamin B 12, the strongest effect on calcium and magnesium. PPIs should be used at lowest dose for the shortest possible duration.
Antibiotics commonly prescribed are fluoroquinolones and trimethoprim-sulfamethoxazole (TMP/SMX). TMP/SMX can increase potassium especially those with renal insufficiency who are also taking blood pressure medication (ACE or ARBs).
Fluoroquinolones (Levaquin) can cause peripheral neuropathy, dizziness, insomnia, anxiety, restlessness and tendon rupture.
Nonsteroidal Anti-inflammatory Drugs such as ibuprofen, naproxen, aspirin increase the risk of gastrointestinal bleeding, peptic ulcer disease, heart failure exacerbation, and kidney injury.
Selective Serotonin Reuptake Inhibitors (antidepressants) increase the risk of falls and low sodium especially with those elderly taking a diuretic hydrochlorothiazide (HCTZ) or furosemide.
Zolpidem (Ambien) is used to treat insomnia. Women should take no more than 5 mg at bedtime. Use can cause delirium, fall, fractures and motor vehicle accidents.
Drugs have side effects. Polypharmacy (taking of multiple medications) should be done with vigilance and extreme caution.