Walking Under the Influence of Drugs

Heli Patel PharmD Candidate 2011

Consumer Health Information Corporation and

 Bernard J. Dunn School of Pharmacy, Shenandoah University

“I’ve fallen and I can’t get up!” Many people remember these words of Steve Urkel from the television show Family Matters. However, these words can be a reality for some people, especially the elderly.

Studies show that that more than 30% of people over the age of 65 fall each year. The numbers are higher for people who fall in hospitals and nursing homes.  The third most common reason for hospital bed occupancy is injuries from falls.

Many people fall, because they do not know their medicines can make them dizzy, drowsy, or cause blurred vision.

Which medications can increase the risk of falling?

The chart below gives the drug groups and  side effects  that could increase the risk of falling.

The more of these types of drugs a patient is taking at one time the higher the chances of falling.  If you are on any of these drugs and are worried about falling, you should speak with your doctor. 

What should you speak to your physician about?

The first step when starting a new medication is to find out from your doctor or pharmacist if your medicine might cause side effects that could cause a fall. Then you need to find out about how to prevent and manage these side effects.

If you develop any of these side effects it is important to tell your doctor if you are having any symptoms.  Your doctor will decide if a different drug can be prescribed that does the same thing without side effects. It is important to note if medications are to be stopped or changed, the dose is slowly reduced over time and not suddenly stopped.  If you suddenly stop a drug, you could feel nervous, have problems sleeping, and feel irritable. Anxiety medications can even lead to seizures. Suddenly stopping drugs that treat mental illnesses and anxiety can cause these effects.    

Tips to manage the side effects of drugs

Dizziness, confusion, fainting, weakness, and blurry vision all can be symptoms of low blood pressure which can lead to orthostatic hypotension. Orthostatic Hypotension is low blood pressure from standing after sitting or lying down.  It is important to see your doctor if these symptoms are frequently experienced because it could point to a more serious problem.

Below are extra tips to manage certain side effects:

Dizziness

• Wiggle your toes several times before standing to get your blood flowing. This moves the blood that has collected in the legs, and helps prevent dizziness
• Make slow changes in position while getting up. Don’t get up too quickly because it could cause dizziness. This is due to blood collecting in the legs.
• Wear compression stockings to keep blood pressure in the legs. This helps increase blood flow to other parts of the body.  If you have a history of heart disease, diabetes, or kidney disease you should make an appointment with your doctor every six months. 
• Drink more fluid  to prevent muscle cramps and dizziness.        
• Avoid caffeine, tobacco, and alcohol.
• Ask your doctor if the drug that is making you dizzy could be taken closer to bedtime.

Drowsiness  

• Take a brief nap during the day.   
• Get mild exercise.  Walk instead of driving if possible.
• Ask your doctor if the drug that is making you drowsy could be taken closer to bedtime.

Vision Problems

• Have an eye exam to rule out other possible causes.
• Ask your doctor for eye drops that may reduce dryness. Having dry eyes can cause blurry vision which can lead to falling.

Steps to reduce the risk of falling

Other precautions to take to prevent you from falling include:

•  Exercise each day to keep your muscles strong.
•  Remove all loose rugs.
•  Put handrails for support in the bathroom and beside beds.
•  Have enough light
•  Have flooring that does not cause people to slip or loose balance.
•  Check your shoes to make sure there is enough traction on the soles.
•  Keep a call button or cell phone  by your  side to contact   someone for help if  they are unable to move.
•  Keep the bed at the lowest height to make it easier to get on and off the bed.

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