Within the past two weeks the Food and Drug Administration (FDA) has issued a number of warnings that concern me as a geriatric care manager, and they should concern caregivers and the elders in their charge as well. The FDA has announced new warnings for three different classes of medications, those for pain and inflammation, those that lower cholesterol and those that help treat anemia in some patients. In my next three postings, I am going to tackle each, so that you will have a clearer picture of how to safeguard your own health as well as the health of an elder for whom you may be a caregiver.
I am going to start with a group of drugs commonly called non-steroidal anti-inflammatory drugs or NSAIDs. You would recognize the brand names, Aleeve, Motrin, Advil, or Nuprin as well as their generic names, naproxen or ibuprofen, and a lot of people use them to good effect. Many people use these medications for their arthritis or other acute and chronic pain, and they are available over the counter (OTC) as well as by prescription. You may remember from an earlier posting (Please see: Bad Medicine) that older Americans consume about twice as many prescription medications as younger people and they buy about 40-50% of all the OTC drugs sold.
In an international study titled INVEST, 22,576 people were followed for nearly three years, and the American portion of this large group was followed nearly 8 years. The overall study group included chronic and nonchronic NSAID users as well as people who were on no such medications. Those using NSAIDs were more likely to suffer a non-fatal stroke, a myocardial infarction or heart attack or death from any cause than those not using NSAIDs. In the long term follow-up, researchers found that people who already had a history of either blocked arteries to the heart or high blood pressure were even more at risk for an adverse event that the others.
The researchers suggested that people with high blood pressure or heart disease should look for some other alternative for their aches and pains. Fortunately there are some alternatives for pain. I recommend a sit-down session with the patient’s primary care physician to do a medication audit. As a geriatric care managere, we can do these audits, but only your physician can prescribe medications. If the doctor is not aware of the OTC pain meds a patient is on, then it is hard to make a good decision. The other obvious right steps would be diet and exercise. For high blood pressure and for arterial blockage, minimizing bad cholesterol in the diet and reducing weight are real winners. As always, consult with a physician before embarking on any exercise or diet program.
Charlotte Bishop is a Geriatric Care Manager and founder of Creative Case Management, certified professionals who are geriatric advocates, resources, counselors and friends to older adults and their families throughout metropolitan Chicago. Please email your questions to Charlotte Bishop.
