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Millions of older Americans use risky drug combos

By LINDSEY TANNER, AP Medical Writer (yahoo news 24, Dec. 2008)

CHICAGO – At least 2 million older Americans are taking a combination of drugs or supplements that can be a risky mix — from blood thinners and cholesterol pills to aspirin and ginkgo capsules — a new study warns.

Among older men, the numbers are particularly alarming — one in 10 are taking potentially harmful combinations, according to the study.

The results aren't always disastrous, but older people are more vulnerable to side effects and drug-to-drug interactions. And patients need to know that just because lots of medicines and supplements don't require prescriptions doesn't mean they're harmless. Nor are some of these safe to take when you're prescribed other medications.

Experts say the take-home advice is to ask about any side effects of prescription drugs, and tell your doctor before taking other medicines.

The report showing just how many older people are using risky combinations comes from a study of nearly 3,000 interviews with people aged 57 to 85. The research, funded by the National Institutes of Health and University of Chicago, appears in Wednesday's Journal of the American Medical Association.

It's well-known that as people age, their medication use goes up. But the study highlights the potential problems with some sobering statistics.

Ninety-one percent in this age group use at least one medication, often for heart disease and related problems. That translates to more than 50 million people. More than half use at least five remedies, including prescriptions, over-the-counter medicines or supplements.

Virtually every medicine can have side effects, and with so many being used by so many older adults, the potential for harm is high.

For example, warfarin, a potent prescription clot-fighting drug, was often taken with aspirin. Both increase the risk of bleeding, so the odds are even higher when both drugs are taken. The researchers said these risks also occur when warfarin is taken with garlic pills, which some studies have suggested can benefit the heart and help prevent blood clots.

Signs of bleeding problems include bruising easily, hard-to-stop bleeding from the gums or from cuts and blood in the urine.

Other commonly used and risky combinations included:

_Aspirin taken with over-the-counter ginkgo supplements, increasing chances for excess bleeding.

_Lisinopril, a blood pressure drug, taken with potassium, which combined can cause abnormal heart rhythms. Potassium is often prescribed to restore low levels of this important mineral caused by certain blood pressure drugs.

_Prescription cholesterol drugs called statins taken with over-the-counter niacin, a type of vitamin B that also lowers cholesterol. This combination increases risks for muscle damage.

"Patients need to know that while medications are often beneficial, they're not always safe," said lead author Dima Qato, a University of Chicago pharmacist. "If they need to self-medicate with over-the-counter or dietary supplements, they should definitely consult with their physicians or pharmacists."

The study relied on data from in-person interviews with 2,976 adults questioned about which medications they routinely used. The nationally representative survey was done between June 2005 and March 2006, and results were extrapolated to the general population.

The researchers assessed how many people routinely used at least two medications of any type known to have dangerous or even fatal interactions. The number totaled at least one in 25, corresponding to 2.2 million nationwide.

Those interviewed weren't asked if they'd ever had a bad reaction from taking those combinations. And the study didn't assess whether patients were taking medications inappropriately.

Dr. Jerry Gurwitz, chief of the geriatric medicine division at University of Massachusetts Medical School, said taking multiple medications, despite possible bad interactions, isn't necessarily a bad idea as long as patients are in close contact with their doctor.

"There are definitely many instances where if they're monitored carefully and there's good reason for using them, that they could be used safely," said Gurwitz, who wasn't involved in the study.

Prescription drugs were the most commonly used and nearly one-third used at least five prescription drugs.

Michael Cohen, a pharmacist and president of the Institute for Safe Medication Practices, called the study an important snapshot of medication use in older Americans. But as someone who takes at least five medications himself, Cohen said the widespread prevalence isn't surprising.

Cohen said his group recently launched a new Web site, that will allow consumers to enter names of their medications to check for any potentially dangerous interactions.


On the Net:


Institute for Safe Medication Practices:

Advices from Medical Specialist for Those Who Have Nasal Problem

Alexander Chong

Aaron had a bad sinus infection after returning from oversea. He said he always had a sinus problems and rhinitis, but never asked advices from any medical specialist. This time, the infection was so bad that he had to consult ear, nose and throat specialist. This trip to the specialist is very valuable because the specialist gave him a lot of daily useful tips, which help him to recover from his infection and also teach him how to prevent infections in the future. According to him, the specialist not only gives him antibiotics but also advices how to avoid habits that will further irritate his nasal membranes. Added by Aaron are fragile and sensitive nasal membranes may be irritated by simple things such as sniffing and blowing the nose too hard, coughing too hard, rubbing nose and stuffing things such as tissues and hand�kerchiefs up to the nostrils. Other good habits that had been recommended by his specialist are getting enough sleep and emptying half the stomach before sleep to avoid refluxing (back up) stomach acids, which will irritate the nose membranes. Besides these, his specialist also told him that for a person who had flu (infection) should not dive and swim. This is because diving and swimming may cause the infection in the nose traveling up to the sinuses through the water, where this person swim in.

Nasal and sinus diseases caused by infections or allergies are the common symptoms that lead people to the consultation of ear, nose and throat specialist. According to ear, nose and throat specialist, airborne particles or air pollution from the environment can cause nasal and sinus diseases. However, for those who have family history of an allergic nose, they have higher possibility inheriting allergic disorders. Ear, nose and throat specialist noted that the people who came to see him mostly had symptoms such as runny nose, blocked nose, sneezing and sensitive nose, eyes and throat. Some of them may come with loss of smell. Specialist explained that if nose infections were left untreated or poorly handled, it can cause problems to the sinuses, eyes, throat and lungs. Cavities surrounding the nose are known as sinuses. Your sinus can be infected from a simple nose infection. Since the eyes are located close to the sinuses, it can be infected too. Specialist added that the lungs infection caused by the nose infection was the excessive mucous secreted from the nose flown into the throat and further gone deep into the lungs. However, by staying away from the allergen, which is a substance that triggers allergy, one person's nose allergies can be reduced.

According to specialist, to clean your nose by sniffing, blowing or picking your nose is not the right way when you had a flu or allergy. The following tips have been given by the specialist for you to care for your nose. The most common cause of nasal problems is allergy, which medical term is allergic rhinitis.

To get rid of the allergic triggered substances is the best way to prevent these symptoms. One of the allergic triggered substances is dust mites. Due to their occupying in mattresses, carpets and pillows, runny nose and sneezing in the morning are caused by them. Nevertheless, medications such as acaricides can be used to destroy dust mites. Besides this, dust mites can be kept away by using medication impregnated bed sheets. Once a week, put your bed sheets and pillows under that sun is a more economical way. Your bedroom has to be mopped and cleaned it using vacuum regularly. The load of dust mites can be reduced using these simple methods; however, it is not an easy task to totally eradicate dust mites. To check whether some of the common allergens out there are the cause of your allergy, you can take blood and skin tests to confirm it. Prevent the foods that cause your allergy for a period of time before retry them again if you have allergy to foods. Sometimes, some people allergies can be got over with time. If pets cause your allergy, try to remove them. Allergic reactions may be caused by fungus in the air-conditioning and ventilation vents. To solve this problem, just use fungicides, which are the chemicals that can kill fungus to clean the systems.

Bad habits such as sniffing, blowing or picking your nose will exasperate or extend the infection to surrounding organs during an infection period. Your symptoms may aggravate if you drink cold drinks. Therefore, you should take warm drinks instead of cold drinks. You should not blow your nose too hard when you have runny nose. Nose blocked is due to the swollen lining tissue inside the nasal cavity. Hence, blowing your nose hard is not going to clear the mucous. Moreover, it will cause the infection to go to the surrounding areas such as sinuses and ears. The proper way is sniffing gently to bring the mucous down to the throat and after that spit or cough it out from the mouth. You should not teach your children how to blow their nose if they don't know how to do it. So, if they have any discharge, just use handkerchief or tissue to wipe their nose gently. Mucous or phlegm should not be swallowed because it may cause irritation to your stomach.

Anybody can have nosebleeds at any age. Nosebleeds in children are mostly due to the damage of the blood vessels in the anterior part of their nose. This is due to their bad habit - like to pick at their nose. Apply pressure on the bleeding nostril for a few minutes and use the other nostril or mouth to breathe temporarily if you have nosebleed. Don't hold your head back because this will cause the blood drip down into your throat. Instead hold your head up straight and sit up. You may unaware that you are actually still bleeding if you hold you head back. This is because the blood dripping down through your throat but not trickling down from your nostrils. Consequently, it may cause a breathing difficulty because your airways may be blocked by the bleeding. Ice can be used to apply on your nose if the nosebleed doesn't stop. Nosebleeds in adults can be caused by infection or tumors in their nose. Other factors that will cause nosebleeds are high blood pressure and the hardening of the blood vessels in the nose. Both diseases are due to ageing. Therefore, you need to check with doctors to double confirm what is the problem with your nose if it is bleeding.

Alexander Chong Author of "How to cure your incurable nasal allergy without using any synthetic drugs, herbs and expensive devices".
Many people will walk in and out of your life,
but only true friends will leave footprints in your heart.

Deep As The Rose Is Red

I'll give you my heart; I'll open it up,
Will you listen to its small still voice?
For soft and quiet my heart will speak
To the one I'll call my wife.

Did you hear it dear? Did you listen well?
Do you understand what it said?
For deep is the love that it speaks to you,
Deep as the rose is red.

So, take my heart and treat it well
And forever in this life,
Come walk with me, your hand in mine,
The one I'll call my wife.

- Melvin D. Sharrar -

Every Second Beat

If I had a thousand pages,
I could never name them all,
The reasons that I love you,
For the list would be too tall.

I love you for the melody,
I hear within your voice.
The way your blue eyes hold me,
A captive, but by choice.

I love you for your gentle hands,
That melt away my pain.
I love you for your loving heart,
That made mine beat again.

I love you for your loving smile,
With which my old heart soars.
These are some of the reasons,
Every second beat is yours.

- Mark Liverance -