50%
Older adults who sometimes
forget to take their medicine fall
more often than those who take
their medication as prescribed.
for people in their 40s and 50s,” says
Mukaila A. Raji, M.D., chief of geriatric medicine at the University of Texas
Medical Branch in Galveston. “Most
drugs are eliminated from the body
through the kidneys and liver, but
starting around the fourth decade we
start accumulating fat and lose muscle
mass, accompanied by a progressive
decline in the ability of our kidneys
and liver to process and clear medications. All of this makes us more prone
to drug toxicity.” According to findings from the Baltimore Longitudinal
Study of Aging, age-related loss of
kidney function often starts even
earlier, in your 30s, and gets worse
with each passing decade.
Despite the well-established con-
nection between aging and drug
toxicity, physicians sometimes fail
to equate patients’ symptoms with
an adverse drug reaction, attributing
them instead to a new medical con-
dition. “As doctors, we see a lot of
patients who come in with a general
‘I don’t feel well’ complaint, or may-
be they’re confused and dehydrated,
and we attribute it to a viral illness,
when it’s caused at least in part by
the medication they’re taking,” says
medical toxicologist Kennon Heard,
M.D., an associate professor at the
University of Colorado School of
Medicine in Denver.
Three classes of medications—anticoagulants (warfarin, aspirin, clopidogrel),
antidiabetic agents (insulin, metformin, glyburide, glipizide, chlorpropamide),
and narrow therapeutic agents (digoxin, phenytoin, lithium, theophylline, valproic
acid)—account for almost half of all emergency-room visits for adverse drug events in
older patients. Other medications that are problematic for seniors:
Drugs With the Highest Potential for Harm
BARBITURATES
FLURAZEPAM
MEPROBAMATE
PENTAZOCINE
TRIMETHOBENZAMIDE
BELLADONNA ALKALOIDS
DICYCLOMINE
HYOSCYAMINE
AMITRIPTYLINE
IMIPRAMINE
