Everyone knows the dangers of sunburn. However, did you know that for people taking certain medications, there is an entirely different sun disorder to worry about? Photosensitivity is an inflammation of the skin caused by the combination of sunlight and certain medications. While photosensitivity might look like sunburn, it’s actually quite different. There are two types of photosensitivity – phototoxic and photoallergic.
In a phototoxic reaction, the drug absorbs UV light and then releases it into the skin, causing cell damage. This causes a rash on sun-exposed skin, which typically clears up after the drug is out of your system. In a photoallergic reaction, UV light actually alters the structure of the drug, which makes your body think the drug is an invading force. Therefore, it produces antibodies against it, which cause inflammation of the skin in both sun-exposed and non-sun-exposed areas.
One additional factor to consider when taking certain medications is sensitivity to heat. Certain medications affect your body’s ability to regulate its temperature, meaning that you could quickly become overheated and suffer heat exhaustion or heat stroke. In severe cases, this can lead to organ failure or death.
Luckily, just because you are taking medications that make you sensitive to the sun does not mean you have to stay sequestered. Simply using plenty of sunscreen, frequenting shady areas, and avoiding outdoor activity during the hottest parts of the day can keep you safe and sound.
Here is a list of common medications that cause problems in the sun. If you are taking one of these, ask your home health nurse for more information about how to stay safe. He or she can better explain the side effects of sun sensitivity as well as come up with a plan to keep you protected.
|Allergy drugs (loratadine, promethazine)
||Antibiotics (quinilones, tetracyclines, sulfonamides)
||Sunscreens (para-aminobenzoic acid, oxybenzone, cyclohexanol, benzophenones, salicylates, cinnamate)
|Muscle spasm drugs (atropine, scopolamine)
||Anti-microbials (chlorhexidine, hexachlorophene, dapsone)
||Malaria medications (quinine, chloroquine, hydroxychloroquine)
|Mental illness drugs (thioridazine, chlorpromazine, prochlorperazine)
||Cancer chemotherapy drugs (5-fluorouracil, vinblastine, dacarbazine)
||Cancer chemotherapy drugs (5-fluorouracil)
|Major tranquilizers (phenothiazines, butyrophenones, thioxanthenes)
||Cardiac drugs (amiodarone, nifedipine, quinidine, diltiazem)
||Fragrances (musk, 6-methylcoumarine)
|High blood pressure drugs (mecamylamine )
||Diuretics (furosemide, thiazides)
|High blood pressure drugs (beta blockers)
||Diabetic drugs (sulfonylureas)
|Migraine drugs (triptanes)
||Painkillers (non-steroidal anti-inflammatory drugs)
|Ephedrine/pseudoephedrine (OTC decongestant, Sudafed)
||Skin medications (photodynamic therapy for skin cancer)
||Acne medications (isotretinoin, acitretin)
|Attention-Deficit Hyperactivity Disorder (ADHD) drugs (amphetamines)
||Psychiatric drugs (phenothiazines, tricyclic)
Part 3 in a series. Click here to read part 1 on Home Modifications and part 2 on Exercise.
One often overlooked area of fall prevention is medication. 75% of older adults take one or more prescription drugs, and 25% take five or more drugs regularly. While most medications do not typically cause problems, there is always a risk that any new medication can cause severe side effects. These side effects, such as dizziness, weakness, vision impairment, or sleepiness can contribute to the risk of a senior falling. What’s worse, aging affects the absorption, distribution, metabolism, and elimination of medications. Age can also increase sensitivity to potential side effects.
In particular, antidepressants, pain medications, antipsychotics, and antihypertensives put seniors at the biggest risk. Even some over the counter medications, such as diphenhydramine and naproxen, have side effects which can affect patients. Additionally, if a senior is taking several of these drugs at one time, they can interact with one another negatively.
Always follow your doctor’s advice when taking your medications, and let your doctor know if you feel any side effects from your meds. Follow the rest of these tips to keep yourself safe and lower your risk of falling due to medication.
Tips for Preventing Medication-Related Falls
- Ask your pharmacist to review your prescriptions to ensure they won’t clash with each other. This is standard procedure, but if you are receiving prescriptions from two different doctors, they may not realize what the other doctor is prescribing you.
- Never take someone else’s medication! You don’t know what effect it will have on you.
- Use a magnifying glass to read prescription labels. Taking the wrong pill or the wrong dose could lead to disastrous consequences.
- Use a tablet box to keep your pills organized. This will decrease your chance of mixing things up and also of missing doses.
- Whenever starting a new stress or anxiety medication, also be sure to take extra caution. These medications in particular can mess with your perception, mood, and reflexes. Monitor your condition and if you feel like the new pills are making you too sluggish, immediately alert your doctor.
- Keep a list of all your current medications with you. Since you may receive different prescriptions from different doctors, they might be unaware of what the other one has prescribed for you. Having a list will keep them up to date and aware of potential problems.
- Ask your doctor if you can wean off of any medications that are giving you side effects. While some medications are vital for survival, many others can be adjusted or switched out for less harmful meds. See if you have any of these options available.
- Be aware of all the possible side effects you may experience with a new prescription. You may be able to prepare for some of the side effects. For example, if a particular prescription increases your need to use the restroom, be sure to have a night light on so you can see the way to the bathroom at night.
As you grow older, you may get more forgetful. Many people attribute this to age-related mental decline and consider it inevitable. However, not all memory loss is caused by an aging brain. A lot of forgetfulness in the elderly can actually be caused by the medications and drugs they are taking.
Older adults are more susceptible to the harmful side effects of medications because their livers are less efficient at metabolizing drugs. Therefore, the kidneys eliminate them from the body more slowly, allowing them to accumulate over time. And unfortunately, the older a person gets, the more medications they are generally prescribed. It’s a vicious cycle.
There are many different kinds of medications that cause forgetfulness. To know for certain if your pills are likely to cause you memory loss, ask your nurse next time they come to visit. They can give you more information and facilitate a talk with your doctor if you would like to change medications. Do keep in mind that many of the following medications are life-saving drugs, and memory loss may be something you have to accept if you can’t switch drugs.
1. Antianxiety Drugs
Prescribed for anxiety, agitation, delirium, muscle spasms, insomnia and seizure prevention.
This medicine works by dampening activity in key parts of the brain, especially those involved in the transfer of events from short-term to long-term memory. As an alternative, your doctor may recommend melatonin or another non-drug treatment.
Common Medications: Xanax, Librium, Klonopin, Valium, Dalmane, Ativan, Versed, Doral, Restoril, Halcion
2. Cholesterol-lowering Drugs
Prescribed for high cholesterol.
These drugs help lower cholesterol throughout the body – including the brain. This can pose a problem, as brain cholesterol is vital to the formation of connections between nerve cells. As an alternative, your doctor may recommend vitamin B12, folic acid, or vitamin B6.
Common Medications: Lipitor, Lescol, Mevacor, Pravachol, Crestor, Zocor
3. Antiseizure Drugs
Prescribed for seizure prevention, nerve pain, bipolar disorder, mood disorders, and mania.
This is another kind of drug that dampens the flow of signals within the central nervous system. As an alternative, your doctor may recommend Dilantin or Effexor.
Common Medications: Diamox, Tegretol, Potiga, Neurontin, Lamictal, Keppra, Trileptal, Lyrica, Banzel, Topamax, Depakote, Zonegran
4. Antidepressant Drugs
Prescribed for depression, anxiety, eating disorders, OCD, chronic pain, smoking cessation, severe menstrual cramps, and hot flashes.
Antidepressants cause memory loss by blocking the action of serotonin and norepinephrine in the brain. As an alternative, your doctor may recommend non-drug therapies or a lower dose of your current medication.
Common Medications: Elavil, Anafranil, Norpramin, Sinequan, Tofranil, Pamelor, Vivactil, Surmontil
5. Narcotic Painkillers
Prescribed for moderate to severe chronic pain.
Painkillers stem the flow of pain signals within the brain and also numb the brain’s emotional reaction to pain. As an alternative, your doctor may recommend NSAID therapy or Ultram.
Common Medications: Duragesic, Norco, Vicodin, Dilaudid, Exalgo, Astramorph, Avinza, OxyContin, Percocet
6. Parkinson’s Drugs
Prescribed for Parkinson’s disease, pituitary tumors, and restless legs syndrome.
These drugs activate pathways for dopamine, which can trigger negative side effects. As an alternative, your doctor may recommend another drug or over-the-counter medication.
Common Medications: Apokyn, Mirapex, Requip
7. Hypertension Drugs
Prescribed for high blood pressure, congestive heart failure, abnormal heart rhythms, chest pain, migraines, tremors, and glaucoma.
This medication interferes with the action of key chemical messengers in the brain such as norepinephrine and epinephrine. As an alternative, your doctor may recommend benxothiazepine calcium channel blockers or Trusopt.
Common Medications: Temormin, Coreg, Lopressor, Toprol, Inderal, Betapace, Timoptic
8. Sleeping Aids
Prescribed for insomnia, sleep problems, and mild anxiety.
These drugs are similar to antianxiety drugs and act in the same manner to cause side effects. As an alternative, your doctor may recommend melatonin or other non-drug treatment.
Common Medications: Lunesta, Sonata, Ambien
9. Incontinence Drugs
Prescribed for overactive bladder and urge incontinence.
Incontinence drugs block the action of acetylcholine, which inhibits activity in the memory and learning centers. As an alternative, your doctor may recommend lifestyle changes, Kegel exercises, or adult diapers.
Common Medications: Enablex, Myrbetriq, Ditropan XL, Gelnique, Oxytrol, Vesicare, Detrol, Sanctura
Prescribed for allergy symptoms, motion sickness, nausea, vomiting, dizziness, and anxiety.
This medication also inhibit acetylcholine in a manner similar to incontinence drugs. As an alternative, your doctor may recommend newer-generation antihistamines, such as Claritin or Zyrtec.
Common Medications: Dimetane, Clistin, ChlorTrimeton, Tavist, Benadrul, Vistaril
Remember that only your doctor or pharmacist can alter your medication regimen. Your nurse will be happy to contact your doctor for you about any side effects you are having, but they cannot write you a new prescription. Ask your home health professional about alternative ways to reduce the risk of side effects, such changes in diet, exercise, or health supplements.
Medication Safety Week is April 1-7. Most of our patients are on at least one kind of medication, so medication safety is of the utmost importance to us. Making a mistake with your medications is no laughing matter. Ingesting the wrong medication or taking the wrong amount could result in a whole array of harmful side effects, requiring hospitalization, and in some cases resulting in death. According to a 1999 report, as many as 98,000 people die every year due to a medication error.
Today in particular is Transitional Care Awareness Day. When you come home from the hospital, your medications can change and you might be responsible for doling out your own dose for the first time. This can be a bit scary initially, which is why we are here to help you! We will double check your medications according to your doctor’s orders to make sure everything is as it should be.
However, even with our superb assistance, it is still important to know some basic tips about medication safety. We may not be with you every time you take your pills, so you have to know exactly what to take and when. Unlike the hospital, a nurse will not come around to administer your pills every hour on the hour. While we will help as much as we can, your medication is your responsibility now. So here are some tips to help you stay safe and healthy!
1. Discard of old medications
Medication does have a shelf life, which means it can be ineffective after a certain period of time. This can be potentially deadly if you require this medication to survive. Always check the expiration date on the bottle, and dispose of pills that are past their prime.
2. Avoid herbal or dietary supplements
Herbal and dietary supplements on their own aren’t bad for you, but they can have an adverse reaction with other medication you are taking. Always inform your doctor or pharmacist about anything non-prescribed pills you are taking. Only they can confirm whether or not you may have a negative reaction to the combination.
3. Give your doctor and pharmacist all of your information
If you know you are allergic to certain drugs, inform your healthcare professionals immediately! Also be sure to tell each of your doctors all the drugs you are taking, as they may not be aware of drugs that other doctors have prescribed for you. And while you are giving your doctor your information – be sure to get theirs. Write down their name and contact information and put it in a same place in case you do have an adverse reaction.
4. Always read the label
The label provides valuable information, so be sure to ask your pharmacist if there is anything you don’t understand. Some labels also include a description of what the pill should look like, so be sure to compare it to the pills inside the bottle. If they don’t match, call your pharmacist to verify you have received the correct prescription. Additionally, keep an eye out to see if your medication contain acetaminophen. Many over-the-counter pain killers contain acetaminophen as well, and cannot be taken together as this could cause an overdose. Lastly, read how many pills you should have received and count how many are inside to make sure you have enough.
5. Follow your prescribed regimen
Always follow the instruction provided by your doctor. Do not try to adjust your pill schedule, especially if you miss a dose or take a double dose. Instead, call your doctor or ask your nurse to see what you should do. Never increase, decrease, or stop taking your medicine without talking to your doctor first. Also, never split pills in half to try and make your pills last longer – this could be hazardous in several different ways.
6. Store your medications safely
Keep all medications in their original containers so you don’t accidentally mix them up. Put them in a cold, dry place where they cannot be contaminated, overheated, moistened, or frozen. Try to store them in a place other than the bathroom cabinet, such as a linen closet or dresser drawer. The bathroom is ineffective because of the high level of humidity, which can damage the pills. Keep them out of reach of children.
7. Keep a record and stay on schedule
Many people have trouble remembering if they took their pills, so create a calendar where you can mark down exactly when you took each dose. Some people also forget when to take their pills, so set an alarm to remind you or always take them at the same time of day (for example, before or after a meal or before you go to sleep). This should help you stay on schedule and avoid missing doses.
As you get older, two things happen: you become more forgetful, and you have to take more medications.
Unfortunately, these two problems combine to create an even bigger issue – problems with medication management.
Forgetting to do the laundry is one thing, but forgetting to take your pills? That’s a dangerous scenario that could jeopardize your physical and mental health.
Luckily, with some careful precautions, it is possible to manage your medications without falling prey to forgetfulness. The extra steps might be frustrating, but they will be worth it if they help to keep your medical issues under control.
Adherence = Compliance + Persistence
First of all, it’s important to understand what it means to regularly take pills. Adherence is essential for a drug regimen because without it, you are on a path to disease progression, disease complications, reduced functional abilities, a lower quality of life, and even death. Non-adherence leads to 125,000 deaths annually and includes up to 10% of all hospital admissions.
In order to adhere to your medication regimen, you need to be compliant and persistent. Follow the exact instructions provided by your medical professional, especially over time. Around 55% of the elderly community is non-compliant with their prescriptions, a number which could easily be decreased with proper education.
Use a Calendar
Though this may seem like a mundane way to keep track of your pills, it will help. Often times, you simply can’t remember if you’ve already taken your pills for today. The situation becomes even more complicated if you have morning and evening pills to take. Use the calendar to mark the exact time you took your pills. That way, you will know when you’ve taken them, which is important if you have timed doses.
A pill organizer is absolutely essential for someone who battles forgetfulness. It helps to separate your pills into doses by day, and sometimes even by morning and night. That way, you know if you’ve taken your pills for today because they will be gone. A drawback of this system is the fact that seniors might forget what day it is, leading to them accidentally taking pills from the wrong day. Luckily, there are new computerized pill dispensers that sound an alarm if the appropriate pills are not taken.
Set an Alarm
If an electronic pill organizer is a little too high-tech for you, why not try using a more familiar device to remind you about your pills? Set a watch, clock, or phone alarm to ring whenever it is time to take your pills. Be sure that the alarm is a different and recognizable sound that you will automatically associated with pill-taking time. Also, make sure it is set loud enough for you to hear regardless of where you are.
Take Your Pills at the Same Time Every Day
Try to associate taking your pills with a certain time of day, such as breakfast or bedtime. This makes it easier to remember, as it will become a daily habit. Many pills should be taken together with a meal anyway, so you are doing yourself multiple favors. Additionally, be sure to place the pills somewhere you will see them when it is time to take them. If you want to take them at breakfast, place them next to the coffeepot.
Reminders From a Loved One
Ask your family and friends to help remind you when it is time to take your pills. Have them call you or visit at a certain time each day so that you remember it is medication time. This option is not foolproof, however, as sometimes family members will not remember themselves to remind you. They are busy living their own lives and might not have the time to dedicate to your pill management. Therefore, while relying on a family member to help you with your pills is a convenient option, it should not be your only method to remember.
Don’t Be Afraid to Ask for Help
Do not be ashamed of asking for help for managing your medications. It’s not something to take lightly, as a double dose could cause a serious adverse reaction. If all else fails, ask your doctor or nurse for aid. He or she can help you develop a system that will work perfectly for your needs.