Tuesday, November 29, 2011

How Common Drugs Cause ER Visits For Seniors - How Food Drug Combinations May Contribute

The vitamin K in kale can decrease the effectiveness of the common blood thinner, warfarin!

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Common Drugs Responsible for Most ER Visits by Seniors
A new study shows that two diabetes and two blood-thinning drugs account for two thirds of all emergency room visits by older Americans. The biggest culprit was the drug warfarin (Coumadin, Jantoven), commonly prescribed to prevent blood clots, which was responsible for one third of emergency hospitalizations. The other medications are insulin, antiplatelet drugs like aspirin and Plavix, and oral hypoglycemic agents. 

Why Seniors are at Risk
There are probably many reasons that seniors are at risk. Anyone who has an aging parent, friend or relative know how difficult it is for them to take medications correctly. To make things worse, doctors tend to overprescribe drugs to seniors. According to the authors of this study, 40% of U.S. adults over 65 years of age take 5 to 9 medications and 18% take 10 or more! No wonder seniors experience so many adverse drug reactions. Our kidneys, liver and other filtration organs in our bodies were not designed to handle this many foreign and toxic chemicals. In addition, no drug company can ever adequately test the vast combinations of all these medications.
If you are concerned about drug combinations that you or a loved one are taking, there are a number of websites where you can enter the drugs and they can tell you if there is an issue. Some of these include:
Drugs.com Drug interactions Checker (includes interactions of chosen drug(s) and food).
AARP Drug Interaction Checker (includes over-the-counter drugs, herbs and supplements).
Drugstore.com Drug Interaction Database (includes prescription, nonprescription, herbs, vitamins and supplements. 

Food and warfarin (Coumadin)
I wasn't surprised to see that warfarin was the drug most responsible for ER visits. It's difficult to get the dosage correct and it's effectiveness can increase or decrease significantly depending on what you eat and drink. According to Dr. Sheldon Sheps of the Mayo Clinic, vitamin K can reduce the effectiveness of warfarin so you need to carefully monitor how much of this vitamin you consume daily. He recommends that people taking warfarin avoid eating or drinking large amounts of:
* Kale
* Spinach
* Brussels sprouts
* Parsley
* Collard greens
* Mustard greens
* Chard
* Green tea
(Unfortunately, these are all incredibly important foods in our diet.)
On the other side of the spectrum, some foods increase the effect of warfarin which can lead to bleeding problems. Dr. Sheps recommends avoiding or limiting these drinks when taking warfarin:
* Cranberry juice
* Alcohol
(Be especially careful during the holiday season when there is no shortage of cranberries and alcohol!)

Watch Out for your Loved Ones
If you have a loved one who is a senior, take the time to find out how many prescription drugs they are on and ask the doctor if they are really necessary. Years ago, when my mother-in-law came to live with us in a near-by nursing home, she was on about 15 medications. When we asked the staff why she was taking each one, they didn't have a good answer. Many times they prescribe drugs as a precaution and to avoid future lawsuits. By the time they carefully examined her medications, they reduced them to just a handful of prescriptions.
Once my uncle came to visit and he brought out a huge plastic bag of prescription drugs. I went on one of the drug interaction websites and discovered than several of the drugs he was prescribed should not be taken together! But he had several different doctors and they obviously weren't talking to each other.
So take things into your own hands. Challenge each prescription. Make sure they are taken regularly and consistently and check for interactions with other drugs, vitamins, herbs and food. 


hannahmarie said...

Thanks so much for bringing attention to this issue! You're absolutely right about Vitamin K's ability to interfere with the action of warfarin, however that does not mean that people who are using warfarin necessarily have to limit Vitamin K. The issue is more related to patients changing their Vitamin K levels after the right level of warfarin has been prescribed. So if you have a relative who usually eats a big kale salad every day, he or she just needs to try to keep the amounts of leafy greens stable. That being said, I can definitely see how all this concern might deter people from eating those good healthy foods. Thanks again for bringing this up; I love reading your blog!

Dr. Joanne L. Mumola Williams said...

You're absolutely right. Thanks for clarifying this very important point!
The difficulty is consistently eating the same amount of vitamin K rich food each day. For example: A person eating a big kale salad every day (rich in vitamin K which helps your blood clot) would require a higher dosage of warfarin. If that person skipped his daily salad for a few days, the high dosage of warfarin might cause excess bleeding. Rather than deal with having to precisely monitor high amounts of vitamin K rich foods every day, doctors feel it is easier and safer to just avoid them. Personally, I would opt to monitor them so that I would get the benefit of these good foods but that might be very difficult for some of the elderly to do.

Journal T. Living said...

This is an incredible statistic.

Herryponting said...

This is awesome article....