These three drugs could have you ER-bound
When it comes to seeing the inside of an emergency room, most of us with a little snow on the roof think it will be a slip on the steps or tripping over the cord of our television that will land us there.
If you think along those lines, you might miss a threat that is right under your nose: the medicines you're taking.
The three biggest offenders sending seniors to the ER are insulin for diabetes, warfarin for thinning the blood, and digoxin used to treat various heart conditions. These are commonly prescribed drugs, which can lull doctors and patients alike into a sense of complacency.
Never underestimate the potential for harm of any pharmaceutical—it's not your average vitamin C tablet. And these three drugs accounted for 58,000 emergency room visits a year for people over the age of 65, according to the study findings. That's one-third of all the emergency room visits for this age group.
The reason? Reactions to the medications. According to one of the study authors, it can be a challenge to determine the right dose for each of those drugs, so they require a lot of necessary fine-tuning by the doctor and patient.
Researchers started out looking for potential for harm to elderly people from a list of 41 drugs that have been deemed "potentially inappropriate" for older folks. They looked at surveys of emergency room visits covering two years to see what part these drugs played, if any.
They discovered that the 41 drugs only accounted for 3.6 percent of a total of 177,000 annual visits. But these three drugs, only one of which is on the list of 41, caused the bulk of the trouble.
It turns out that blood thinners can do their job a little too well, thinning the blood to the point that it can cause excessive bleeding. Digoxin can cause a list of problems such as vomiting, confusion and visual disturbances. And insulin can lead to a drop in blood sugar levels that border the danger zone.
Insulin and coumadin are often necessary drugs. If you're a diabetic on insulin, as you may know you are suffering from fairly advanced disease. Your pancreas can no longer produce enough insulin on its own. Most people can get by with less insulin through aggressive dieting and exercise, thus reducing their risk of running a dangerously low blood sugar.
The benefits of coumadin, mainly stroke and clot prevention, are well supported by research. Everybody agrees it's a dangerous drug requiring intense management. Researchers are busy trying to come up with a safer, easier-to- administer alternative. A recent attempt, a drug called Exanta, was recalled due to discovery of serious liver damage. It's a pity more research is not devoted to potential natural blood thinners, such as nattokinase, a fermented form of soy.
Digoxin is a drug used to control a fast heart rate. It also helps the heart pump stronger. Studies, however, have shown that it is overused—especially in the elderly. It is fraught with side effects, including serious nausea, low potassium and a dangerously fast heart rate. If you're on this drug, special attention should be paid to avoiding depletion of potassium and magnesium. You should also be asking your doctor if you truly need this drug.
What the researchers recommend (and it makes perfect sense to me) is only a finger-prick away: a very easy blood test. This will measure your levels of these drugs and help keep an eye on what's going on in your body. The key point is to work with your doctor until the dose that's right for you is found. It may take a couple of extra visits to his office, but if it saves you a trip to the emergency room, it's worth the trouble.
