ROCHESTER, Minn. ― Here are highlights from the December issue of Mayo Clinic Health Letter. You may cite this publication as often as you wish. Reprinting is allowed for a fee. Mayo Clinic Health Letter attribution is required. Include the following subscription information as your editorial policies permit: Visit http://healthletter.mayoclinic.com/ or call toll-free for subscription information, 1-800-333-9037, extension 9771. Full newsletter text: Mayo Clinic Health Letter December 2014 (for journalists only).
Myths and facts about how medications affect older adults
Older adults need to be especially vigilant about drug safety, according to the December issue of Mayo Clinic Health Letter. That’s because older adults are more likely to be taking more than one medication at a time. Interactions between drugs can cause side effects that might not occur if a drug were taken alone. And, physical changes in older adults can alter both the effectiveness of a medication and side effects, compared with what a younger adult might experience.
Consider these myths and facts:
Myth: If a drug works well at a certain dose, taking more will be better.
Fact: With many drugs, the benefit won’t increase after a certain dose, but the risks will. For example, taking two acetaminophen (Tylenol, others) provides pain relief with minimal risk of side effects. Taking four acetaminophen pills doesn’t improve pain relief and greatly increases the risk of harmful side effects and toxicity. Taking too high of a dose of some medications can be especially harmful in older adults. Liver and kidney functions can diminish over time and reduce the body’s ability to process and eliminate a drug.
Myth: A drug taken at a certain dose for years can’t cause new side effects.
Fact: A drug taken without problems for years could be the cause of troubling new side effects in older adults. With increased age, body weight may change. Digestion, circulation, and kidney and liver function may slow down. These changes can affect the processing, circulation and excretion of drugs and make the drug more or less effective than it was in the past. Adding new drugs, nonprescription medications, herbal or dietary supplements or alcohol could lead to interactions and possibly new side effects.
Myth: It’s obvious when something is a side effect of a drug or a symptom of a disease or condition.
Fact: Side effects of certain drugs can be mistaken for diseases or conditions associated with aging or even for symptoms that are chalked up to “getting older.” Side effects of certain drugs also can worsen symptoms of an existing disease or condition. Doctors and pharmacists can refer to lists of drugs that should be used with caution or avoided in older adults. But no list can account for every particular situation. Patients, doctors and pharmacists should always consider the possibility that any symptom or signs of “old age” such as weakness, drowsiness, confusion, anxiety or memory loss could be a drug side effect.
Tips for home oxygen therapy
Long-term home oxygen therapy can help people with chronic lung disease feel better, be more active and think more clearly. It can decrease the risk of complications, such as heart and blood vessel problems, as well as the need for hospitalization.
The December issue of Mayo Clinic Health Letter offers information and tips on home oxygen use.
Portability: Oxygen sources are easier to use, lighter and more portable than in the past. It used to be that large steel tanks kept people using oxygen largely homebound. While these stationary sources are still useful because of their capacity, there are now portable oxygen sources that include lightweight canisters of liquid oxygen or compressed gas. Another option is a portable oxygen concentrator — a machine that draws oxygen from the air. It requires a power source, with rechargeable batteries or a power adapter.
Comfort: Most people use a nasal cannula, a tubing system that runs between the nostrils and the oxygen source, to breathe in the oxygen. The tubing system consists of two small prongs that rest in the nostrils and connect to tubes that drop over the ears and merge under the chin. This method is convenient but can irritate nasal passages. A doctor can recommend a nasal spray or water-based lubricant such as K-Y Jelly to increase comfort. A humidifier can be added to a stationary oxygen unit in the home to decrease drying effects of oxygen.
Safety: Oxygen itself isn’t explosive but it can quickly accelerate a fire, even from a small ember or spark. Any type of open flame should be avoided when using oxygen. Flammable materials should also be avoided. They include petroleum products, rubbing alcohol, gasoline, paint thinners, cleaning fluids, aerosol sprays including bug spray and sunscreen, and oil- or alcohol-based face creams or hair products.
Oxygen containers should be stored in a well-ventilated area ― not in a closet, behind curtains or under clothes. Oxygen containers release small amounts of oxygen over time. If the oxygen builds up in a small space, it can be a fire hazard.
Nonallergic rhinitis: A possible cause for a long-term runny nose
A runny nose that goes on for months could be nonallergic rhinitis, also called vasomotor rhinitis. The December issue of Mayo Clinic Health Letter covers this condition, how it’s treated and how doctors distinguish this condition from allergies (allergic rhinitis) and chronic sinus infections.
The term rhinitis refers to inflammation of the mucous membranes in the nose. Nonallergic and allergic rhinitis share many of the same signs and symptoms ― sneezing, nasal congestion, a runny nose or mucus in the throat. The difference is that nonallergic rhinitis doesn’t involve the immune system. Instead, it’s an irritation of the lining of the nose, and as a result, is treated a bit differently from allergies.
Diagnosis: Doctors diagnose nonallergic rhinitis by ruling out allergies with skin prick tests or blood tests. To rule out chronic sinus infections or other sinus problems, a nasal endoscopy or computerized tomography (CT) scan may be appropriate.
Causes: Nonallergic rhinitis occurs when something irritates and inflames the lining of the nose. This causes blood vessels to dilate and increase the amount of fluid and blood in the lining of the nose. Triggers can include dust, strong odors, exposure to cold or dry air, complications from a cold, hot or spicy foods, alcoholic beverages, stress and certain medications including aspirin, ibuprofen (Advil, Motrin IB, others), some medication used to treat high blood pressure, sedatives, antidepressants, oral contraception and drugs used to treat erectile dysfunction.
Some triggers cause short-lived symptoms or can easily be avoided. Other triggers may cause chronic symptoms.
Home care: The best way to cure nonallergic rhinitis is to avoid its triggers, but that isn’t always possible. For mild symptoms, gently blowing the nose, setting up a humidifier and staying hydrated can help. Rinsing out nasal passages with a saline solution is helpful, too. The salt helps pull fluid out of the swollen nasal linking, shrinking the lining and making breathing easier. Rinsing removes mucus, dust and dirt.
Packets of saline powder or ready-made solutions are available at drug stores. Or, solutions can be made at home by combining 8 ounces of distilled purified water and 1/4 teaspoon each of noniodized salt and baking soda. The rinsing can be done with a specially designed squeeze bottle that comes with mixes or with a neti pot, a device used for nasal irrigation that resembles a small teapot.
Medications: When home remedies aren’t enough, a physician can recommend medications that might include a corticosteroid nasal spray, antihistamine nasal sprays, anti-drip anticholinergic nasal sprays and oral or nasal decongestants.
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Brian Kilen, Mayo Clinic Public Affairs, 507-284-5005,firstname.lastname@example.org