Adults over 65 are the largest consumers of prescription medications in the United States, taking an average of 5–7 medications daily. In Las Vegas, with its large and growing senior population — particularly in communities like Summerlin, Sun City, and Henderson — medication management for older adults is one of Advantixx Pharmacy's most important clinical services.
What is Polypharmacy?
Polypharmacy is typically defined as taking 5 or more medications simultaneously. While multiple medications are often medically necessary for seniors managing several chronic conditions, polypharmacy significantly increases the risk of drug interactions, adverse effects, falls, hospitalizations, and reduced quality of life. Studies show that 30–40% of hospitalizations in elderly patients are medication-related.
The Beers Criteria: Medications to Avoid in Older Adults
The American Geriatrics Society Beers Criteria is a list of medications that are potentially inappropriate for adults 65 and older — either because the risks outweigh the benefits in this population, or because safer alternatives exist. Advantixx Pharmacy pharmacists are trained to identify Beers Criteria medications and work with physicians to find safer alternatives.
Anticholinergic Medications (High Risk)
Anticholinergic drugs block acetylcholine and cause confusion, memory impairment, constipation, urinary retention, and falls in older adults. Many common medications have anticholinergic properties: diphenhydramine (Benadryl), oxybutynin (Ditropan), certain antidepressants (amitriptyline, paroxetine), and some antihistamines. Cumulative anticholinergic burden is associated with increased dementia risk.
Benzodiazepines and Z-Drugs
Benzodiazepines (Xanax, Ativan, Valium, Klonopin) and Z-drugs (Ambien, Lunesta) are on the Beers Criteria for older adults due to significantly increased risk of falls, fractures, motor vehicle accidents, and cognitive impairment. Older adults metabolize these drugs more slowly, leading to accumulation. Tapering and discontinuation, with CBT-I for insomnia or non-pharmacological anxiety management, is preferred.
NSAIDs in Older Adults
NSAIDs (ibuprofen, naproxen) are on the Beers Criteria due to increased risk of GI bleeding, peptic ulcer disease, acute kidney injury, and fluid retention in older adults. If NSAIDs are necessary, they should be used at the lowest effective dose for the shortest duration, with a proton pump inhibitor (PPI) for GI protection.
Sliding Scale Insulin
Reactive insulin dosing based on blood sugar readings (sliding scale) without a basal insulin component is associated with increased hypoglycemia risk in older adults. Hypoglycemia in seniors can cause falls, cardiac events, and cognitive impairment. Basal-bolus insulin regimens or simpler oral regimens are generally preferred.
Physiological Changes That Affect Drug Metabolism in Seniors
- Reduced kidney function — most drugs are renally cleared; doses must be adjusted
- Reduced liver function — slower drug metabolism; drugs last longer
- Decreased body water — higher drug concentrations for water-soluble drugs
- Increased body fat — fat-soluble drugs (benzodiazepines) accumulate
- Reduced albumin — more free (active) drug for highly protein-bound medications
- Reduced GI motility — slower drug absorption; increased constipation risk
Deprescribing: The Art of Safely Stopping Medications
Deprescribing — the systematic process of reducing or stopping medications that are no longer beneficial or are causing harm — is an important part of geriatric pharmacy care. It requires careful tapering (never abrupt discontinuation for most drugs), monitoring for withdrawal or disease recurrence, and close coordination with the prescribing physician.
Advantixx Pharmacy's Senior Medication Services
We offer comprehensive medication reviews specifically designed for older adults — reviewing for Beers Criteria medications, drug interactions, inappropriate dosing, and opportunities for deprescribing. Our free home delivery service is especially valuable for seniors who have difficulty traveling to a pharmacy. Call 702.665.8797 to schedule a senior medication review.
Advantixx Pharmacy — Las Vegas
Questions about your medications? Our expert Las Vegas pharmacists are here to help — free same-day delivery throughout Southern Nevada.