At Virginian Rehabilitation and Wellness, we have a proud tradition of raising up the next generation of physical, occupational, and speech therapists and therapist assistants. This Fall/Winter we have been fortunate enough to have Student Occupational Therapist, Carrie Mead, serving and learning alongside her clinical instructor Katelyn Liamos, MSOT, OTR/L and the rest of our team. As her parting gift Carrie looks at the challenges of medication management and how occupational therapists can help. Thank you, Carrie, Best wishes as you head out on your new career.
By: Carrie Mead, OTS
As we age, it is not uncommon to take more than one medication-in fact, there is a term for taking multiple medications: polypharmacy. While medications help manage chronic conditions from high blood pressure to heart burn, keeping track of multiple medicines can be a challenge. Most of us know that individual medications can cause side effects, but did you that medicines also interact with one another to cause distinct effects? Here are a few common drug-drug interactions to be aware of as well as a few tips to safely manage your medicines.
Diuretics
One of the more commonly prescribed medications for high blood pressure is a diuretic, or water pill. A diuretic helps clear extra fluid and sodium from the body, leaving less fluid to strain the circulatory system. As you might expect, taking diuretics often leads to frequent trips to the bathroom. Common negative side effects include dehydration and loss of electrolytes, such as potassium. If you are also taking albuterol sulfate, a common asthma medication, the chance of potassium loss increases (McEvoy & Snow, 2019). Similarly, escitalopram oxalate (Lexapro), is an often-prescribed antidepressant that can increase the risk of excess sodium loss when taken with diuretics (McEvoy & Snow, 2019). How would you know if you were getting too low in electrolytes? Symptoms include confusion, fatigue, headaches, muscle cramps, muscle weakness, nausea, vomiting, and numbness or tingling of the extremities (Cleveland Clinic, 2022). If you have a sudden onset of these symptoms, let your physician know.
Blood Thinners
Physicians often prescribe blood thinners to older adults who are at risk of blood clots to reduce the risk of serious illness, including stroke and heart attack. Blood thinners range from over-the-counter medications such as aspirin to prescriptions including Eliquis and warfarin. The most common side effects are prolonged bleeding times. If your doctor has prescribed you with a regular blood thinner, it is important to be cautious of mixing other medications and substances that also reduce clotting. For example, if you doctor has prescribed Eliquis, use caution with pain relievers such as Goody’s, Alka Seltzer, Excedrin, and Bayer- all of which contain aspirin and increase the risk of excess bleeding. For adults taking aspirin routinely, alcohol can also increase your risk of bleeding and even hemorrhage. If you are taking blood thinners and start to notice increased dizziness, unusual bleeding or bruising, black stool, or weakness, alert your physician.
Tips for Managing Multiple Medications
If you find yourself balancing multiple medications, you are not alone. 54% of adults 65 and older take four or more prescription drugs (Kirzinger et al., 2019). One of the most important ways to manage your medicine is to ensure your physician knows all the medications you are taking, including supplements and those taken over the counter. Keep a running list of your medications and take it with you to all your doctors to ensure they are on the same page. If you want to know more about potential side effects of taking one or more medications, you can talk to your pharmacist or research online using drugs.com
Occupational Therapy and Medication Management
For adults with chronic illness, taking medication in a timely manner is an essential part of everyday living. As occupational therapists, we work with clients to maintain independence in their medication management, which includes everything from communicating with pharmacists, to reading prescription labels, to making a habit of taking the right medicine at the right time of day. We partner with clients, including those with low vision, limited coordination, and memory difficulties, to safely manage their medication. If you are having difficulty with medication management, talk to your occupational therapist about finding solutions to stay in charge of your health.
References
Cleveland Clinic. (2022). Electrolyte imbalance: Types, symptoms, causes & treatment. Cleveland Clinic. Retrieved December 1, 2022, from https://my.clevelandclinic.org/health/symptoms/24019-electrolyte-imbalance
Kirzinger, A., Neuman, T., Cubanski, J., & Brodie, M. (2019, August 9). Data note: Prescription drugs and older adults. KFF. Retrieved December 1, 2022, from https://www.kff.org/health-reform/issue-brief/data-note-prescription-drugs-and-older-adults/#:~:text=Older%20adults%20are%20also%20more,18%2D29%20(7%25).
McEvoy, G. K., & Snow, E. K. (2019). Drugs. In AHFS Drug Information Essentials. American Society of Health-System Pharmacists.