How Many Medications are Excessive? July 12, 2021 10:37

There's no doubt that many medications, such as those used to lower blood pressure or cholesterol, have saved lives and kept people healthier for longer. But is it possible to have too much of a good thing?

You certainly can, and the issue is known as "polypharmacy." Polypharmacy is defined as the use of five or more medications by two-thirds of older adults. It's not uncommon for someone to take two or three times that amount these days, especially if they have a complicated medical condition.

Polypharmacy is not always a bad thing. According to Pharmacy Times, "therapeutic polypharmacy" refers to the use of multiple drugs in a coordinated effort to treat a specific condition. It used digoxin, ACE inhibitors to relax veins and arteries, and a diuretic as examples in the treatment of heart failure. It is the doctor's and pharmacist's responsibility to ensure that these combinations are appropriate and effective.

Polypharmacy that is potentially harmful involves the use of multiple drugs for the same condition or drugs that have adverse interactions with other drugs. And the problem is becoming more widespread as patients are more likely to see multiple specialists and obtain medications from multiple sources.

According to Pharmacy Times, more than 75% of adverse drug reactions that necessitate hospitalization are caused by "inadequate monitoring, inappropriate prescribing, and a lack of patient education and compliance." According to the journal, when eight or more medications are taken at the same time, the risk of a negative drug interaction increases to 100 percent.

Older people, whether you or a loved one, are particularly vulnerable. Last year, a Medicare data analysis found that "potentially inappropriate medication use among older adults is both common and costly."

It was estimated that 7.3 billion doses of potentially inappropriate medications were dispensed in 2018, with protein pump inhibitors (such as Prilosec and Prevacid) being the most common; benzodiazepines (Xanax and other drugs used to treat anxiety and sleeplessness); and tricyclic antidepressants being the least common (such as Amitriptyline and Amoxapine). More than $25 million was spent.

These psychoactive drugs, which act on the central nervous system and affect brain function, are especially dangerous in the elderly. Several of my clients have developed dementia-like symptoms as a result of the medications they were taking. They should be closely monitored.

Fortunately, many health-care providers recognize polypharmacy as a problem, and a new movement known as "deprescribing" has emerged. A long-term care facility and post-acute caregivers association has launched a Drive to Deprescribe campaign to encourage their members to reduce polypharmacy.

You must be your own best friend when it comes to your health care. Always consult your doctor if you have any concerns. Here are a few suggestions:

• Bring all of your medications, or a list of them, to every doctor's appointment, whether with your primary care physician or a specialist. This is especially important if you are responsible for the care of an elderly family member.

• Request that your primary care physician or a trusted pharmacist review your medications to ensure that they are appropriate for you to be taking. Inquire if there are any that you can discontinue. A patient advocate with a pharmacy background can assist you and your health care providers in taking a more integrated approach to your medications.

• If your doctor wants to prescribe a new medication, look at what it's supposed to do and ask your doctor if it might interact negatively with something else you're taking.

• Keep an eye out for drug reactions, especially if you're caring for someone else. This can range from a rash to dementia-like symptoms. Consult your doctor right away if you notice any behavioral changes.

You can contribute to the anti-polypharmacy campaign. Not only will you save money, but you may also improve your health.