Q:Dear Dr. Si, My Grammy is 88 and for the last three years she has been experiencing occasional leg pain that comes & goes. It shows up when she’s on her feet a lot but the pain goes away if she rests for a while. Other than that she has been in great shape and very sharp mentally until recently. A neurologist prescribed high dose ibuprofen for the leg pain but her family doctor told her not to take it but I don’t know why. She has lived with the pain convinced that ibuprofen was “bad for her.” She visited her family doc again a month ago with the concern that she might have Alzheimer’s disease but he didn’t think she has it. He gave her three prescriptions which she has been taking for the past month. They are: Tramadol with Tylenol, Cymbalta, and Aricept. The whole family thinks Grammy has taken a huge slide down hill in the last month. She is more frail and tired and not as sharp mentally and she has had a couple of falls. We don’t think that she has been eating well but are also concerned that her medicines are doing more harm than good. Are there questions that I should be asking her doctor? – MJ, Kingston, RI
Amitriptyline in the elderly
Q:Should amitriptyline be used in the elderly? – DS, Sausalito, CA
My husband is taking 30 different medicines. How can I correct that?
Q:Dr. Si–My 48-year-old husband is on 30 medications. His four doctors know about all his meds, but they never suggest taking him off anything–even when I’ve suggested they do it. How can I find a doctor who knows enough about interactions and will look at his meds and start weaning him off of some? – KFL
What is a Senior Care Pharmacist?
Q:Dear Dr. Si, What is a senior care pharmacist? – TB, Albany, NY
How do I find a certified geriatric pharmacist pharmacist in my area?
Dear Dr. Si. How do I find a certified geriatric pharmacist in my area, Las Vegas, NV. My husband, age 96, is on so many medications and his doctors continue to pile them on. He has no energy, suffering memory loss and has changed in many ways since robotic heart bypass surgery, which was 100% successful, on one artery in 2005. I feel he could be helped if someone qualified could look at his meds and pare them down. His BP is excellent; doesn’t even take BP medication, but many others and now seems to have a continuing UTI and has been on and off antibiotics, without success, for the past four months. He currently takes 13 prescription and non-prescription drugs. Thank you. – DJR, Las Vegas, NV
What is a Certified Geriatric Pharmacist?
Q:Dear Dr. Si. What is a Certified Geriatric Pharmacist? – RTW, Alexandria, VA
Osteoporosis medicines – How should I take Actonel?
Q:I have a patient who likes to take her Actonel® with a glass of orange juice in the morning, but the administration instructions state that it should only be given with water. Does it really make a difference whether I give it with water or juice? – SM
Q:If someone has already experienced a Shingles infection would it be appropriate to give them the shingles vaccine? – CC, St. Louis, MO
Cholesterol lowering drugs – when should I take them?
Q:One of my colleagues said that the statin drugs for cholesterol lowering should always be administered in the evening but some of the references that I have looked at have conflicting information. Could you please clarify this? – RT, Salem, OR