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“When you care for an aging relative, you may find yourself in the midst of situations for which you couldn’t plan or prepare. And, then you find yourself surrounded by bottles and bottles of medications. How overwhelming is that!

We asked Brian Wolstenholme, a Board Certified Geriatric Pharmacist, Senior Care Pharmacist and Fellow of the American Society of Consultant Pharmacists, to share his expertise in managing medications for older adults. Our questions and his answers follow.

1. What is a board-certified Geriatric Pharmacist? Do our local pharmacies staff geriatric pharmacists?
A Board-Certified Geriatric Pharmacist (CGP) has demonstrated the skills and knowledge of geriatric pharmaceutical care by taking and passing a written exam. There’s a little more than a thousand CGP’s in the U.S., so most pharmacies do not employ a CGP. The best way to find one is through the website,, which has a directory of practitioners.

2. Medications can be a god-send, but they also can be a messy mixture. How do we ensure our care recipients are prescribed medications that will help them?
Back in the 1960’s, there were only around 600 drug products on the market. Today, when you include biological drugs, that number today swells to well over 8,000. This makes it almost impossible for prescribers to provide optimal medication therapy management to patients. And, when you consider the current volume of prescriptions pharmacies handle, do not expect inappropriate prescribing to stop at the drugstore, either. This is where pharmacists with specialized training can step in to identify, prevent and resolve medication-related problems.

3. What are the signs that a care recipient may be over-medicated?
Obvious signs and symptoms can range from drowsiness and dizziness to agitation and anxiety. Others are less obvious, and include high- or low-blood pressure, increase or decreased blood sugar, depression, forgetfulness and malaise. Any time a patient falls, medications should be investigated.

4. How do we know if our care recipients’ medications may be causing an adverse reaction? Any signs we can be aware of?
There is a famous quote in my profession: “Any symptom in an elderly patient should be considered a drug side effect until proven otherwise.” -J. Gurwitz et al. Therefore, careful medication screening of elderly patients to detect medication-related problems is recommended. To rate the risk of medication-related problems, take this assessment, available at

5. Why do we have to more careful monitoring medications with older adults? What happens as we age?
As we age, the way we process medications changes. Medications take longer to be absorbed and may take longer to be removed from our bodies. For this reason, several medications that can potentially cause serious problems in the elderly, such as Darvocet and Benadryl, should be avoided in the elderly. Patients with chronic conditions, such as diabetes or Alzheimer’s disease, are at even greater risk to inappropriate prescribing.

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