Medication mismanagement can be prevented
COURIER LIFE, F DT EB. 15–21, 2019 37
t’s that time of year again
when everyone seems to
be sick and when coughing
can be heard in the hallway,
on the street, and in the
subway. Although it is perfectly
normal to experience
coughing during a seasonal
virus, consistent coughing
and difficulty breathing could
be indicative of a much more
serious condition — chronic
obstructive pulmonary disease
(COPD). COPD encompasses
two respiratory diseases
that are often present
together: emphysema, which
inhibits air exchange in the
lungs, and chronic bronchitis,
a perpetual state of irritation
in the tubes that carry air to
the lungs Although there is
not a cure for COPD, it can be
prevented and managed.
COPD is caused by exposing
lungs and airways to
chemical irritants on a consistent
basis. Although some
cases are caused by prolonged
exposure to chemical fumes
and genetic factors, the vast
majority—approximately 85 to
90 percent—of COPD cases are
caused by smoking. “The most
important thing to remember
about COPD is that is almost
always preventable,” said Anthony
Saleh, MD, pulmonologist
at NewYork-Presbyterian
Brooklyn Methodist Hospital.
The ideal way to prevent
COPD is to not smoke in the
first place. For people who are
smokers, cessation of smoking
as soon as possible is the best
way to thwart the development
of COPD. Another way to
prevent COPD is to avoid exposure
air pollution, such as
that caused by fireplaces and
occupational pollutants like
chemical fumes and concrete
dust. Finding out if there is a
family history of COPD can
help determine if somebody is
at risk for developing it even
without irritant exposure, as
a small number of people inherit
a genetic condition that
hinders production of Alpha-1,
a protein that protects the
lungs. This can be determined
through a blood test.
Early symptoms of COPD
can include frequent coughing
and excessive phlegm. As the
disease progresses, wheezing,
fatigue and breathlessness
during every day activities
may occur. If a current or former
smoker, or someone with
a family history of the disease,
experiences these symptoms,
he or she should get a lung
function test called a spirometry.
This entails the patient
blowing into a device called a
spirometer, which measures
the force with which the patient
can blow air out of their
lungs. A spirometry can detect
even a slight decrease in
lung function.
Treatment for COPD varies
by case, but the first step in
most cases is smoking cessation.
Symptoms can be treated
through medications that can
facilitate breathing, such as
bronchodilators, which relax
muscles of the airways, and
corticosteroids, which prevent
inflammation of the airways.
These are usually administered
through inhalers,
but may also be taken in pill
form. Pulmonary rehabilitation
can also help people with
COPD improve their lung
function over time through
breathing techniques and aerobic
exercises. Severe cases of
COPD may require the use of
supplemental oxygen and lung
surgery.
Even with treatment, managing
COPD also requires being
aware of and avoiding certain
circumstances that may
trigger flare-ups. Second-hand
smoke, smoke from an open
wood fire and common allergens
such as dust or dust mites
can make it difficult to breath.
Weather extremes can also be
triggering, and people with
COPD may find winter to be
a particularly difficult time.
Limiting exposure to cold, dry
air and wearing a cold air face
mask or warm scarf around
the nose and mouth can make
breathing easier.
To schedule an appointment
with a physician affiliated
with NYP Brooklyn
Methodist Hospital, please
call 718-499-2273 or visit www.
nyp.org/brooklyn.
—New York-Presbyterian
Brooklyn Methodist Hospital
Wellness
Medication management is an important
issue for seniors and
their families. Failure to properly
manage medications can threaten
the lives of seniors, highlighting the
emphasis families must place on ensuring
seniors take their medications
in strict adherence to their physicians’
instructions.
Polypharmacy, or the taking of multiple
medications for different conditions,
can be a potential health hazard
for the thousands of seniors who
must manage health conditions with
prescription drugs. Harmful drug interactions
are a result of the confusion
that can arise when seniors take multiple
medications at the same time. The
American Society of Health-System
Pharmacists estimates that more than
34 percent of senior citizens are prescribed
medications by more than one
physician, and 72 percent use medications
they were prescribed more than
six months prior. Many people also
have begun “pharmacy shopping” to
save money. According to a study published
in 2010 in American Nurse Today,
44 percent of men and 57 percent
of women older than age 65 take fi ve or
more medications per week, with some
taking as many as 10.
Medication confusion is one risk,
but older adults also metabolize medications
differently than young people.
As a result, they may be more susceptible
to overdose or other ill effects. Families
looking to help seniors effectively
manage their medications should consider
the following tips:
Keep a running list of medications.
Maintain a list of all medications
being taken, noting both prescription
and over-the-counter medications and
any supplements and herbs. Provide a
copy to any new doctors you visit and
any new pharmacies you patronize.
Use pill sorters. Medication sorters
can keep medications organized
and eliminate some of the personal error
in medication management. Organizers
have daily slots and may also
differentiate between nighttime and
daytime medications.
Understand why each medication
is being prescribed. Ask your
pharmacist and doctor to explain why
each medication is prescribed. This information
should be printed on the prescription
label. Some drugs designed
for one symptom may actually be used
to treat other issues as well.
Ask for help. Some seniors may
benefi t from friendly reminders from
a loved one regarding when to take
certain medications, especially if they
need to take multiple doses throughout
the day. Cognitively impaired seniors
may require the services of a visiting
nurse or another caregiver.
Recognize that not all medications
are right for seniors. The American
Geriatrics Society maintains a list
of medications that older adults should
avoid or take with extreme caution.
Some drugs pose a high risk of side effects
or interactions, while others are
less effective. Discuss alternatives with
your physician if you are prescribed
one of these medications.
Keep a medication diary. Record
any side effects that occur and how the
medications make you feel. Always
bring up issues promptly with a doctor.
Proper medication management
can help seniors avoid drug-related accidents
or worse.
Though people who cannot afford to fi ll their prescriptions often feel helpless, there are a
handful of ways they can cut the costs of their medications and start feeling better.
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