We can all embrace the idea that many of us are taking too many medications to the point that it is doing more harm than good. The term that best describes this is polypharmacy, and in this episode, Carrie Miller speaks with Dr. Holly Holmes to give us a great view of it. Dr. Holmes is the Director of the Division of Geriatric and Palliative Medicine at McGovern Medical School. A former Geriatrician and Pharmacist, Dr. Holmes, shares her expertise about polypharmacy and how it has been affecting our health, most especially those who are 65 and older. She names the drugs that can be harmful to our body and brain and where the risks outweigh any potential benefits for the elderly. Going further, Dr. Holmes then taps on medications for patients with dementia and gives some key strategies to know what drugs are good for you and who to ask for help.
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Listen to the podcast here:
Polypharmacy: Understanding The Appropriate Use Of Medication With Dr. Holmes
We’ve got a special guest here on the show. I met this young lady at a presentation she was giving at The Hope and Healing Center & Institute here in Houston, Texas. She’s a geriatrician and former pharmacist. Her research and clinical interest focus on the appropriate use of medications in older patients particularly those approaching end of life. She’s the Director of the Division of Geriatric and Palliative Medicine at McGovern Medical School. She joined UT Physicians in 2015 and is a Joan and Stanford Alexander Chair in Gerontology. Please help me welcome, Dr. Holly Holmes.
Thank you, Carrie.
How are you?
I’m very good. It’s very good to be here.
I’m so excited to talk with you. I believe that our readers are going to receive some valuable information on the topic of polypharmacy. Since you have extensive knowledge of drugs as a former pharmacist, you are the drug expert.
I know that the pharmacists are the experts.
Before we talk about our drugs that can be harmful to our body and brain, please first tell us the definition of polypharmacy.
That’s a difficult question to answer. There’s not a great consensus about what polypharmacy is. We all agree that the word doesn’t even mean what we think it means. A lot of people would say polypharmacy means too many pharmacies. It’s a term that we haven’t embraced very well but I like the definition proposed by Lown Institute. I served on a working group to define polypharmacy, which is medication overload. We can all embrace the idea that many of us are taking too many medications. We feel burdened by them. We feel burdened by the side effects and costs. Traditionally, polypharmacy has been defined as the use of 5 to 10 or more medicines than indicated or using medicine to treat the side effects of other medicines. The reason to define it that way is so that we can research it, but the idea of medication overload is much more understandable to the people who are experiencing it.
Let’s talk about these medications that are potentially harmful to people who are 65 and older. Let’s talk one by one. If you could please give examples and why they would be harmful. Let’s begin with anti-histamines.
Antihistamines cause sedation or sleepiness. Those old school anti-histamines like diphenhydramine, chlorpheniramine and brompheniramine, those ones that are over-the-counter. Those are on a list of drugs to avoid because they cause excessive sleepiness and confusion. They have other side effects that are those anticholinergic-called effects. You mentioned a list of medications. I want to back up and say that there are lists of medications that are reco...