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    Tuesday, August 10, 2004

    Careless Doctors: Doctors are also apparently giving the wrong drugs to the elderly:

    Medications that are considered unsafe for older people are frequently being prescribed to patients over 65, researchers reported yesterday.

    The study, which examined prescription rates, found that 1 in 5 older patients received at least one unsafe drug.

    Here's the study:

    A total of 162,370 subjects (21%) filled a pre-scription for 1 or more drugs of concern.... More than 15% of subjects filled prescriptions for 2 drugs of concern, and 4% filled prescriptions for 3 or more of the drugs within the same year.

    The drugs of concern fall for the most part into three categories - muscle relaxants, tranquilizers, and old generation anti-depressants. The list also includes an old anti-inflammatory drug, Indocin, which is used for gout.

    All of the drugs have the potential for serious side effects in the elderly. They can cloud the senses, throw a person off balance, and in the case of indocin, cause renal failure or gastrointestinal bleeding. So why do doctors prescribe them? Sometimes, they have no choice. The old generation anti-depressants are sometimes used for sleep disorders and for peripheral neuropathy. They're safer for sleep disturbances than tranquilizers. They're also used at times for urinary incontinence. There are, to be sure, other drugs that can be used for these disorders, but when others fail, sometimes the only choice is to turn to these sorts of drugs.

    Indocin is better at kicking the pain of gout than most other anti-inflammatory drugs - and it's only used for a few days at at time. The dangers of using it increase with duration of use. When used appropriately, its dangers should be minimal.

    And finally, there are the tranquilizers. In many cases, the elderly who are taking these have been on them since their young adult years. They're the refugees of the "mother's little helper" era. But years of using them leaves the body physically dependent on them. It's notoriously difficult to wean someone off of them after such long use - and dangerous. (Withdrawl can cause seizures, among other things.)

    To be sure, there are some doctors who are reckless in prescribing these sorts of drugs, but for most doctors, it's more a matter of weighing the costs and benefits of the drugs for each patient, and coming down on the side of prescribing them - despite their potential side effects.

    posted by Sydney on 8/10/2004 08:35:00 PM 0 comments


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