Taking medicine safely – avoiding side effects

Summary

As a carent, caring for an ageing parent, one of the best things you can do to keep them safe and well, is to help them to organise and take their medicines as safely as possible to avoid any unpleasant or dangerous side effects.

Introduction

If you are caring for an older relative, you are probably involved in helping them to organise their prescriptions for their various medicines, creams, inhalers etc. This can be quite a busy job because across the UK, over one-third of adults aged over 75 take four or more medicines regularly, and this rises to eight per day for adults in a nursing home.

You can help to keep them safe and well by ensuring that their prescriptions are up to date and their medicines are taken as safely as possible.

When things are stable, the whole process can be automated but a change in medication relating to a new illness, hospital stay or specialist appointment can disrupt the process and you might need to get involved.

You might also consider getting more involved if you suspect that your parent is experiencing unpleasant or potentially dangerous side effects from their various treatments or medication.

Common medication side effects and their risks

Although modern medicine has transformed our health, even the most common medication can be risky.  The risks are higher in older adults because as we age, our bodies find it harder to process and digest medicines, and so toxic chemicals can build up in our bloodstream.

Side effects vary between individuals and also between medicines.  Some of the most common side effects include dry mouth, blurred vision, drowsiness or dizziness.  In themselves these symptoms might be unpleasant, but they are also risky because they can lead to falls and other injuries.

Some side effects might not be obvious to you in the early stages, for example some medicines might affect the kidneys or the liver, causing long term damage.

Around 7% of all emergency admissions to hospital are linked to the toxic effects of medicine.

Medicines to look out for

Although any medicine has the potential to be dangerous if used unsafely, some of the main culprits include.

• Blood thinners (antiplatelets and anticoagulants such as aspirin, clopidogrel or warfarin)
• Diuretics (water tablets such as furosemide – but there are numerous types)
• Common anti-inflammatory painkillers (such as ibuprofen, naproxen or diclofenac)

Helping someone to take medicines safely

When it comes to taking medication safely it is helpful to understand how to minimise any risks relating to:

• Safety information about each medicine
• Alcohol intake
• Dehydration
• Illnesses such as a temperature, vomiting or diarrhoea
• Allergies

These topics are explore more fully below.

Safety: Read the patient information leaflet (PIL)

Every medicine pack includes a patient information leaflet (PIL), which provides information on using the medicine safely, essentially outlining safe medication administration guidelines.   These leaflets are often difficult to read simply because the font size is so small.

Luckily, the same PIL information can be accessed online  – where it is much easier to read.

We recommend the following sites to give you expert information about medicines:

Avoid alcohol

Avoiding excess alcohol  – or avoiding it all together  – is common advice for many medicines and even more important for older adults in maintaining medicine safety. This is partly because alcohol and medicine can interact to increase the side effects and dangers of each.  It is also because, as we grow older, we are less able to process alcohol and so it stays in the blood stream for longer. Finally, older adults are much more likely to be more vulnerable to any medication side effects.

1. Alcohol itself can cause you to feel drowsy or light headed and can therefore intensify these side effects increasing the risk of falls and injuries especially amongst older people
2. Some medicines such as common painkillers, cough, cold, and allergy remedies—contain more than one ingredient that can react with alcohol to cause more toxic effects
3. Some medicines  – such as cough syrups or laxatives – might also contain alcohol
4. The biological ageing process slows the rate at which both alcohol and medicines are digested and cleared from the bloodstream so the combined risks from both are higher in later life

Beware dehydration

Some medicines can cause serious problems in older people if they become dehydrated, understanding this is a crucial part of safe administration of medicine. Dehydration can rapidly occur during a period of illness involving a fever, diarrhoea or sickness.

Dehydration can also arise if an older adult does not drink sufficient fluids. This is a common problem because the ageing process naturally dulls our thirst sensation. So, in a warm home or environment, or in hot weather, an older adult might not naturally drink enough to offset any loss of fluid.

Similarly, some common heart or blood pressure medicines (water tablets) are designed to generate more urine and might result in dehydration in the absence of adequate fluid intake. You can check with a doctor or pharmacist how best to take medicines during periods of illness and if so, ask for written sick day rules.

Illnesses and Sick day rules

Any illness can affect how well the body digests a medicine. Any illness which causes a temperature, vomiting or diarrhoea can lead to dehydration and make a medicine more dangerous.

Pharmacists and doctors can help you understand what to do about medicines during illnesses by issuing a Medicine Sick Day Rules card. It will explain how to manage medicines during periods of illness. It is especially important for medicines like water tablets or pain killers. This leaflet from NHS Scotland gives more helpful information about medicine sick day rules.

Allergies

Although uncommon, allergies to medicines can cause life-threatening problems – make sure you know if your loved one has any allergies and make sure that this information is passed on to anyone involved in prescribing or issuing medicines to them for any purpose. This is a critical aspect of ensuring medicine safety.