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  #1   ^
Old Sun, May-07-17, 09:08
JEY100's Avatar
JEY100 JEY100 is offline
To Good Health!
Posts: 9,499
 
Plan: IF Fung/LC Westman/Primal
Stats: 222/171/169 Female 5' 9"
BF:45%/25.3%/24%
Progress: 96%
Location: NC
Default The Beers List

Another new book by Andrew Weil, MD. Mind over Meds: Know When Drugs Are Necessary, When Alternatives Are Better – and When to Let Your Body Heal on Its Own

https://www.amazon.com/Mind-Over-Me...s/dp/0316352977

It does just what the title says in 18 chapters: statins, GERD, antibiotics, Sleep Aids, etc. etc. The Beers List is the most important information I learned in the whole book, although there are many good tips on drug, inc OTCs, side effects and alternatives. There is an entire chapter on overmedicating the Elderly, and another chapter with an example of overmedication of a 68 yo woman from a pharmacist's experience.

Potentially Harmful Drugs in the Elderly: Beers List

In 1991, Dr. Mark Beers published a methods paper describing the development of a consensus list of medicines considered to be inappropriate for long-term care facility residents.
1 The Beers criteria or “Beers list” is now in its fourth permutation.
2 The latest version is intended for use by clinicians in outpatient as well as inpatient settings to improve the care of patients age 65 years and older. [That would be me and DH ] The new version includes medications that should be used with extra caution, as well as medications that should be avoided, either in all elderly or in certain populations.
3 An additional tool for improving prescribing in the elderly is the START and STOPP criteria. Neither has been convincingly shown to reduce morbidity, mortality, or cost but are often used by organizations as measures of the quality of prescribing. Use these criteria to identify red flags that might require intervention or close monitoring, not the final word on medication appropriateness. Prescribing decisions must be individualized.

4 The following chart summarizes the updated Beers list and provides potential therapeutic alternatives and other considerations.


http://www.americangeriatrics.org/f...iaCitations.pdf

It's a long chart and uses the medical name, not the brand name. Dr. Weil's book is easier to digest but then not as complete.


A Washington Post article this morning:
How I almost killed my mom with a simple anti-itch pill
https://www.washingtonpost.com/nati...m=.b1e639a086bb

Dr. Weil addresses Benedryl in the sleep aids chapter. I use it very occasionally if sleep is disrupted..but there are a bunch of scary side effects I had been clueless about.

Last edited by JEY100 : Sun, May-07-17 at 09:55.
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  #2   ^
Old Fri, May-12-17, 21:38
gonwtwindo's Avatar
gonwtwindo gonwtwindo is offline
Posts: 6,628
 
Plan: General Low Carb
Stats: 164/162.6/151 Female 5'3"
BF:Sure is
Progress: 11%
Location: SoCal
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The link to the chart didn't work for me, but I found this...is it the same? https://www.guideline.gov/summaries/summary/49933

I'll be 65 in October!

Last edited by gonwtwindo : Fri, May-12-17 at 21:47.
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  #3   ^
Old Sat, May-13-17, 04:04
JEY100's Avatar
JEY100 JEY100 is offline
To Good Health!
Posts: 9,499
 
Plan: IF Fung/LC Westman/Primal
Stats: 222/171/169 Female 5' 9"
BF:45%/25.3%/24%
Progress: 96%
Location: NC
Default

"Relocated Page" in the past week, right after Weil published his book? Maybe they had a senior moment

But Yes, thank you! That is the same Beers list, with all the latest updates on opioids too.
Not an easy chart to use, but Weil also suggested people should use their pharmacist more. They are trained to Review drugs for interactions, can look for cheaper alternatives, or maybe non-drug options. Something GPs should do but often don't. He had case studies of someone who ends up with five drugs by time they are 65 and don't know what they are for, if they are doing any good, or even know the side effects, if there are better options, etc. Example was a woman on thyroid meds for decades, add some hormones, then a sleep aid during menopause, then a NSAID for arthritis, a statin just because 65, etc.
Make an appointment with a pharmacist to review everything together.
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  #4   ^
Old Sat, May-13-17, 04:58
cotonpal's Avatar
cotonpal cotonpal is offline
Posts: 3,254
 
Plan: very low carb real food
Stats: 245/128/135 Female 62
BF:
Progress: 106%
Location: Vermont
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In my limited experience with my mother who had alzheimers and heart disease, hospitals and nursing homes don't pay attention to this list. While hospitalized and very anxious and confused she was administered Haldol to calm her down. It was done in the nursing home too. This is a potent antipsychotic drug. It's on the list. My sister and I requested that Haldol never be given to her but since we weren't there every minute of every day and we didn't have authority any way, I don't know whether this request was honored. My mother was in her early 90's at the time

When she was in her 80's and functioning very well a doctor prescribed her ativan to help her sleep. This doctor didn't explain either how addictive this benzodiazepine was or how you had to wean off it slowly. Benzodiazepines are on the list also. While I was visiting her she decided to stop taking it cold turkey. I was unaware of this when she first stopped it. Of course she could not sleep at all and she became extremely anxious. I had to explain to her that this was the effect of going cold turkey off the drug. This was before there were any obvious signs of dementia.

I find this all pretty horrifying. I already stay away from doctors as much as possible but there may come a day when I can't protect myself from the harmful effects of what is called healthcare, but as Dr Davis points out in "Undoctoring", really has nothing to do with health and is in fact harmful.

Jean
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