Now falling ill can be a drug side effect.
A 78-year old New York lady was found unconscious on the floor of her apartment by a neighbour. She had blacked out and fallen and Doctors were a little puzzled as to why. Until they looked at her medical history.
Our lady had had a number of heart ailments in the past, but recently had been suffering from a cold and cough. Doctors found that she was currently taking:-
-
Lopressor – to control high blood pressure
-
Digitalis – to help heart rhythm
-
Coumadin – to prevent strokes from blood clots
-
Furosemide – to lower blood pressure
-
Lipitor – to lower serum cholesterol
-
Baby aspirin – to reduce cardiac risk from blood clots
-
Celebrex - for arthritis pain
-
Paxil – for depression
-
Vallium – to help her sleep
-
Levofloxacin – antibiotic for her cough
-
Ibuprofen – for the cold
-
Cough medicine
This lady is not alone – in New York the average ‘older adult’ takes 4.5 prescription drugs and 2.1 over-the-counter items at any one time. Indeed being poisoned by your cocktail of drugs is so common that Doctors even have a name for it: Polypharmacy.
The new illness – drug cocktails
Dr Michael Stern, writing in the June 2007 issue of Emergency Medicine says that Polypharmacy is now responsible for 28 per cent of all hospital admissions, and if it were classified as an official disease it would be the fifth leading cause of death in America.
As it is Prescription drug related death has increased by 68 per cent in the last 5 years and is the second largest cause of avoidable death in America.
Stern as a specialist in Geriatric Emergency Medicine in the New York Presbyterian Hospital knows the problem only too well. Stern points to the fact that many of these drugs can use the same biochemical pathways, causing system overload..
Older people just don’t handle the drugs as well as younger adults do
But that’s not the real problem. One major factor is that the elderly take about 40 per cent of all the prescribed drugs; almost twice the volume the young take. Yet all too often the clinical trials used young healthy adults for their research. Age related changes in physiology as people age can significantly alter the way the body handles these drugs, even if just two or three drugs are taken. Just as a child is not the same as a small adult , neither is an old age pensioner an older, young healthy adult. It is quite clear that major organs, hormone systems and the circulation system function less well. Drugs are less easily absorbed through the gut, the liver detoxes the body less well, the kidneys excrete less well too. Senior citizens have less lean body mass, and more fat and fat is an excellent solvent and will ‘hold’ the drugs longer. All in all, the elderly just find it harder to deal with drugs, than those healthy young guinea pigs in the tests.
Of course it all may be different when taking cancer drugs – with 80 or more per cent of cancers developing in the over 65 generation you would expect the clinical trials to be 80 per cent or more biased towards this group of people.
But as the Hospitals in New York report Polypharmacy is a serious and deadly problem.
Maybe Doctors in the UK should be paying closer attention to drug interactions that haven’t been tested in clinical trials. To date we only seem to hear their incessant worries about supplements or herbs and how they might interact with the cancer drugs. Certainly it is not unusual for a cancer patient to be taking seven or eight drugs simultaneously by the time the steroids, pain-killers and antibiotics are added into the total. If they have other ailments it can be more. Certainly in the 100 or more Personal Prescriptions I’ve seen this year half the people have at least one other illness and are taking two or three drugs for that with the cancer drugs on top..
Our lady on the floor? The drug cocktail gave her a stomach ulcer - she passed out because of the bleeding (she remembers having a stomach ache). She needed a blood transfusion and was told to stop taking the Celebrex, Ibuprofen and aspirin!