1. Medication Issues in the Elderly
Keith T. Breedlove, PharmD
Clinical Pharmacist
Broughton Hospital

2. Problems with medication management are the primary reason that people can no longer live on their own.
Medication errors lead to: placement in nursing homes and readmission to the hospital within 30 days due to drug interactions or not following prescription instructions.
The average senior takes between medications daily.

4. Dispose of expired and unused medications by:
Trash
Flushing
Medication Dropboxes ( local pharmacies or Sheriff’s Dept.)

9. Tips to Improve Medication Compliance
A. Use a personal medication record – see example. Be sure to update after doctor’s appointments and or hospital visits.
B. Pill boxes
C. Med Sync: getting medications filled all at one time.
D. Dispill: medications packaged into individual doses.
E. Reminder Apps: My Med Schedule Plus

10. Lisinopril (Zestril) 10mg 1000mg 40mg 2 puffs 12.5mg Medication Name
Medication Name
Dosage
How Often
Time of Day
Start/Stop Dates
Reasons for Use 1
Lisinopril (Zestril)
10mg
Once daily
Morning
1/1/19 BP 2
 Metformin (Glucophage)
1000mg
Twice daily
Morning & bedtime 
Diabetes 3
 Atorvastatin (Lipitor)
40mg
Cholesterol 4
 Albuterol inhaler (ProAir)
2 puffs
Every 4 hours as needed
As needed
wheezing 5
 Amlodipine (Norvasc)
1/8/19 6
 HCTZ
12.5mg
1/9/19 7 8 9

11. Medications to avoid in the elderly:
Medications that increase risk of falls
Medications that cause increased confusion
Medications that cause increased drowsiness
Examples of common medications to avoid (Beers List)
Diphenhydramine (Benadryl)-sedation/confusion
Certain antidepressants (Elavil, Pamelor, Paxil)-cause sedation and low BP, confusion
Benzodiazepines (Ativan, Klonopin, Xanax)-cause cognitive impairment, falls, fractures, motor vehicle accidents

12. (August 15, 2016) Recent article in the Washington Post…
This is America’s other drug problem — polypharmacy,” said Maristela Garcia, director of the inpatient geriatric unit at UCLA Medical Center in Santa Monica, Calif.
“There are a lot of souvenirs from being in the hospital: medicines they may not need,” said David Reuben, chief of the geriatrics division at UCLA School of Medicine.
“And the problem is huge
Ken Covinsky, a researcher and physician at the University of California at San Francisco, said many doctors who prescribe drugs in hospitals don’t consider how long those medications might be needed. “There’s a tendency in medicine every time we start a medicine to never stop it,” Covinsky said.

13. Deprescribing – getting rid of unnecessary medications
Reduces the risk of drug interactions
Decreases cost
Reduces risk of side effects
Less medications to keep up with
There’s a tendency in medicine every time we start a medicine to never stop it.” Ken Covinsky, UCSF