23 Mar
2009

A group of drugs that are often overused by older individuals are sleeping pills, or hypnotics. Sleep is a complex process, and whenever possible, sleep disorders should not be treated with these preparations. Barbiturates should not be used at all in older people. Many physicians prefer to use chloral hydrate instead. In recent years it has become common to use flurazepam, and other preparations that are similar to diazepam, commonly used as a tranquilizer.

All the hypnotics are habit forming. Because their effects diminish in time, the sleep disorder may become aggravated. It is more important to discover the cause for the sleep disturbance and deal with it at its source, rather than changing hypnotics or increasing their dosage. They all can cause mental confusion.

Medications for emotional disturbances are frequently prescribed for older people. The use of minor tranquilizers, such as diazepam, has reached almost epidemic proportions. Although they occasionally may be helpful, for the most part they are taken excessively. Major tranquilizers are used for serious mental illness or in cases of severe agitation. The most common drugs of this group are the phenothiazines. Although they have a calming effect, they sometimes increase mental symptoms, and they can cause or aggravate the symptoms of Parkinson’s disease. They can also cause the blood pressure to fall, and some people develop abnormalities in liver function, which is reversible when the medication is stopped.

Antidepressant medications are beneficial for depressive illnesses, but they must be used with great discretion. Usually, a small dose is given and gradually increased in order to avoid side effects such as mental confusion and irregular heart rhythms. Some people complain of an excessively dry mouth, and this often occurs with phenothiazines as well.

Diabetes mellitus, a common ailment, improves with dietary changes. However, some people require insulin. This is more likely if the illness was acquired at an earlier age and if you are not overweight. The main problem with the use of insulin is excessive dosage, which may result in a hypoglycemic (low blood sugar) reaction. You will learn how to adjust your insulin dosage according to your diet and amount of exercise.

Some people benefit from hypoglycemic tablets, which increase the feeling of well-being and decrease the symptoms of diabetes. The two main families are the sulfonylureas and biguanides. Chlorpropamide, tolbutamide, glyburide, and glipizide are examples of commonly used hypoglycemic pills. Controversy has arisen over whether these medications should be used because some researchers think that they may increase the tendency to certain types of heart disease. This has not been verified, and their use appears to be safe and their effect beneficial in many individuals.

Your physician cannot be expected to know the details of every medication, and he will frequently consult his desk references for information. You can help your physician by knowing your own medications. You should know the family to which they belong and the reason they were prescribed. If possible, you should know the generic name and the dosage. Review your medications periodically with your physician. It is worthwhile bringing them in their containers to your doctor for a thorough review on each visit if you take many medications or from time to time if your medical conditions and medications are stable. It is your responsibility, as well as your physician’s, to use medications accurately and carefully to obtain the maximum benefit.

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