Partnering with the Pharmacist to Avoid Dangerous Drug Combinations

May 27, 2015

Tips for Seniors and Caregivers from In Home Care for Seniors Services

According to the Taskforce on Aging Research, 77% of seniors between the ages of 65 and 79 suffer from one or more chronic diseases. For those over age 80, that number rises to 85%. The University of Florida College of Nursing reports that half of Americans aged 65 and older take five or more medications. Clearly, doctors, family members and caregivers have a great challenge in managing the often large number of pills their loved ones and clients take, particularly when there are multiple physicians working with the same patient. While these medications are meant to help seniors live full, engaging lives, they can sometimes interact, causing problematic health issues and even death.

The American Society of Consultant Pharmacists urges seniors, healthcare professionals and senior caregivers to regard the neighborhood pharmacist as a partner in keeping the senior healthy and as free of side-effects as possible. Pharmacists can be considered part of the healthcare team just as the in home care for seniors providers are. In fact, pharmacists understand their responsibilities include:

  • putting patients’ interests above those of the doctors, hospital, patients’ families and pharmacy;
  • ensuring that their patients’ medications are appropriate, safe and effective;
  • educating the patients and their caregivers in taking the medication;
  • identifying and resolving medication-related problems and potential drug interactions;
  • understanding the role of senior caregivers; and
  • understanding the unique medical and nutritional challenges seniors face and how these can effect medication effectiveness.

Because the pharmacist takes it upon himself or herself to provide extensive service, seniors and caregivers should never feel they are inconveniencing a pharmacist when they call with questions. Doctors consider pharmacists essential members of the health care team. Pharmacy colleges and associations train their students and members to assume these obligations. Perhaps the error the pharmacist dreads the most is the inadvertent drug interaction. Help him or her keep you safe by educating yourself on all your medications and potential dangerous drug combinations as well as the best questions to ask while at the pharmacy. When you or your in home care for seniors caregiver becomes aware of common medication interactions, you take the first step in preventing frightening reactions.

Smart Steps at the Pharmacy

When getting a new prescription, pick it up at a time when the pharmacy won’t be crowded so you feel comfortable asking lots of questions, particularly those about drug interactions. Avoid noon and 5:00 p.m. or later. Take your list of current medications (most Americans cannot remember everything they’re taking, so don’t feel bad). If you don’t have one, have your caregiver or family member help you put one together. Keep this list in an important spot so it won’t be lost and consider creating an extra copy for your purse or the car. Finally, keep all of your prescriptions at one pharmacy to avoid confusion and accidental dangerous drug combinations. If there’s a necessity to get a prescription from another source, make sure you provide that information to your regular pharmacist. Each pharmacist knows only what medications his or her company provides.

Particularly when the doctor has prescribed a new drug, write down or print out these questions to ask the pharmacist:

  1. What is the medication supposed to do? How will I know if it’s working?
  2. When and how do I take it?
  3. How long do I take it?
  4. Does this medication react badly with any other medications, any food or alcohol?
  5. What are expected side effects? When will they subside?
  6. Are there any side effects so severe I should stop taking the medication?
  7. What should I do if I forget to take a dose?
  8. How long does the medication last? Where should I store it?

These questions help start important conversations with the pharmacist so that he or she gets to know you or your loved one. During this interchange, the pharmacist may be able to gauge the patient’s eating and exercise habits, and propensity to take the medication consistently. All of this information goes into the patient’s file for reference for other pharmacy staff.

Top Most Common Dangerous Drug Combinations

While not a complete list, this selection represents very common dangerous drug interactions. Compare it with your current list of medications.

  1. SSRI (selective serotonin reuptake inhibitor anti-depressants) with prescription pain medications can cause delirium, euphoria, diarrhea and more.
  2. SSRIs with OTC antihistamines can cause drowsiness.
  3. HCTZ blood pressure medication taken with heart rhythm medication can lead to irregular heartbeat (arrhythmia)
  4. HCTZ blood pressure medication with OTC decongestants can raise blood pressure.
  5. Statins (cholesterol-lowering drugs) combined with yeast infection medication can cause kidney malfunction and even failure
  6. Statins combined with vitamin B complex can damage muscles and kidneys.
  7. Many medications and grapefruit juice. Don’t drink grapefruit juice if you’re taking statins, antihistamines, calcium channel blockers, many psychiatric drugs, some immunosuppressants and some anti-arrhythmics. Grapefruit juice blocks certain enzymes in the small intestine, preventing medication absorption into the body. 

These are just a few of the countless dangerous drug (and grapefruit juice) combinations that can impact your long-term health and even be life threatening. Again, the pharmacist and your doctor should work together to ensure you’re not mixing these to deleterious effect. You can also keep resources like WebMD’s easy-to-use Interaction Checker or RXList’s Drug Interaction Checker bookmarked for easy reference.

My Care Match Helps Keep You and Your Loved Ones Safe

Those looking for in home senior care services can fill out a profile on My Care Match, requesting a caregiver familiar with managing medications and health conditions. Caregivers help families handle healthcare team recommendations, prescription refills, meals, personal care and so much more. Click the link above to get started or contact us with any questions you may have!

About the Author

Doug Breuer is co-founder of and has worked in senior care for the last 9 years for the State of Oregon. From investigating cases of elder abuse to managing the delivery of long term care to residents of Central Oregon, Doug has been involved in all aspects of senior care.

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