Questions for the Pharmacist

by | Caregiving, Health

Why you should build a relationship with your aging parent’s pharmacist. 

Our aging parents often have trouble with their medications. Taking the pills, staying organized, not taking too much or too little, as well as, making sure they don’t negatively interact with other medications or supplements they’re prescribed or taking on their own. 

Anna and Tony Kantzavelos have an Independent Compounding Pharmacy in Indianapolis. They talk with Kim and Mike Barnes of Parenting Aging Parents about the important role a pharmacist can play in the care of your parents, how to deal with large pills, understanding correct dosages and other problems that aging parents run into with medications. 

Read the full transcript

Transcript of Interview: “Questions for the Pharmacist”

Mike Barnes:

Yeah, I think all of us with aging parents have some sort of a problem, if you want to call it a problem, with pharmaceutical stuff. Whether it’s pills or medicine, just understanding everything and making sure our parents take it all correctly because it’s a hard job. I know my sister puts together a little list of everything for my dad, and somebody does it for your mom as well.

Kim Barnes:

Exactly, because it’s really important that they take their medicine correctly. So, we decided to bring in some experts today. We have Anna Kantzavelos and Tony Kantzavelos who own an independent pharmacy and compounding pharmacy in Indianapolis. Thanks so much for being with us. I think you all have such a great background because, Anna, you’re a physician’s assistant, and Tony, you’re a pharmacist, so together you make a wonderful team. Let’s start with helping us understand how important it is for us to know what medications our parents are taking.

Anna Kantzavelos:

Yes, it’s critically important. I love what you two have put together. Start just by creating a list of everything that your parents are on. Go to each individual physician, make sure that you have the authority to do so, and your parents have made you either power of attorney or given you the ability to contact their prescribers, whether they’re physicians, nurse practitioners, or PAs. Make sure you have a list in one area of their most up-to-date medication. Also, go to the pharmacies that they’re using. Sometimes they might go to one pharmacy for one thing and another for something else, so be sure everything is up-to-date and in one place, and have that communicated among anyone involved in your loved one’s care.

Tony Kantzavelos:

It’s extremely important to stick with one pharmacy. If you stick with one pharmacy, say Walgreens, that system will be linked nationwide. CVS, Walgreens, and even mom-and-pop pharmacies have systems that don’t communicate with each other. It’s very important to stick to one pharmacy and make sure that the pharmacists, the patients, and their physicians, whether it’s their family doctor or a specialist, are all communicating with each other about the medications.

Kim Barnes:

Right, because I think the confusing part is that you may have one doctor that says you need thyroid medicine, another says you need blood pressure medicine, and another says you need something for your memory. Now you have a slew of prescriptions potentially. It sounds like it would be really helpful to sit down with a pharmacist and say, “Here’s all the stuff, including over-the-counter, and make sure there aren’t interactions,” because that can happen, right?

Tony Kantzavelos:

Absolutely. Interactions happen daily. We sit down and consult with our patients, considering drug-to-drug interactions, drug-to-vitamin interactions, and drug-to-food interactions. As patients age, their metabolism changes, and they may not absorb, metabolize, or excrete medications as well. Constant communication with the physician and pharmacist is necessary, especially in the elderly population, to adjust doses as needed.

Mike Barnes:

For the adult children who haven’t been involved in their parents’ medication management before, it can be overwhelming. If you discover that your parent has 10 different bottles of pills, how do you handle that?

Anna Kantzavelos:

That’s a great question. More people are focusing on their health and taking time to understand their medications. If you have a local independent pharmacy or compounding pharmacy, they have the time and intention to help each patient independently. People have literally brought in boxes of medications, and we sit down and audit them. We’ve helped people achieve better outcomes with less medication. It’s crucial to have that conversation and relationship with your pharmacist.

Kim Barnes:

I think that in society, we often view the pharmacist as just the person who doles out the pills, but they have extensive training in how drugs work and interact. It’s important to bring the pharmacist in as a partner in healthcare.

Tony Kantzavelos:

Absolutely. The role of the pharmacist has changed drastically. Especially now, we help the geriatric population, who may not have loved ones to assist them. We help them manage their medications, even filling their pill boxes and providing checkpoints to ensure compliance. It’s essential to have that interaction and communication with the pharmacist.

Kim Barnes:

Are there any tips on managing medication to ensure compliance, such as using a pill box or other methods?

Anna Kantzavelos:

If you don’t have a loved one to help, go to your local pharmacy and ask if they offer a service to help fill your pill box. More often than not, they are happy to do that. Independent pharmacies often provide additional services to assist patients.

Kim Barnes:

How long do prescriptions last, and what should you do with old or unused medications?

Tony Kantzavelos:

Prescriptions generally have a shelf life of three to five years. If you have expired medications, bring them to your local pharmacy. They can be disposed of appropriately. Do not take medications that are not prescribed to you or are expired.

Mike Barnes:

If we’re worried about the dosage or the number of medications our parents are taking, who should we talk to first—the doctor or the pharmacist?

Tony Kantzavelos:

You can always ask the pharmacist first. Doses may need to be adjusted as patients age due to changes in metabolism and other factors. Pharmacists can help identify if a dose adjustment is needed and communicate with the physician.

Kim Barnes:

What about over-the-counter medications and supplements? They can interact with prescription medications too, right?

Tony Kantzavelos:

Yes, over-the-counter medications and supplements can interact with prescription medications. Always ask your pharmacist if it’s okay to take a new supplement or medication along with your current prescriptions. There are drug-to-drug, drug-to-vitamin, and drug-to-food interactions to consider.

Anna Kantzavelos:

Some medications deplete micronutrients in the body, which can cause side effects. It’s good to have a touchpoint with your pharmacist to ensure you’re taking the right supplements if needed.

Kim Barnes:

Prescription drugs can be expensive. Are there programs to help pay for them?

Tony Kantzavelos:

Yes, some pharmaceutical companies offer programs to help cover the cost of medications. Your doctor may need to help with a prior authorization. You can also reach out to the pharmaceutical companies directly to see if they offer any assistance programs.

Mike Barnes:

Vaccines have been a hot topic recently. How important are flu vaccines, shingles vaccines, and others for our aging parents?

Anna Kantzavelos:

Vaccines are important, but it’s essential to consider each patient’s individual risk factors. Have a conversation with your doctor and keep a list of when each vaccine was last administered. Not every patient needs every vaccine, so it should be tailored to their needs.

Mike Barnes:

Any pressing points we missed?

Tony Kantzavelos:

Just be aware of medications that might not be suitable for the geriatric population, like anticholinergics, which can have side effects such as dry mouth, urinary retention, constipation, and mental fog. Regularly assess and address the medications your loved ones are on, and don’t be afraid to tweak or change them as needed.

Anna Kantzavelos:

This shouldn’t be overwhelming. Pharmacists are here to help take a 360-view of your medications. Sit down with them regularly to ensure everything is in order. It’s a community effort to help manage healthcare.

Mike Barnes:

Thank you so much for answering all these questions and helping us not feel so overwhelmed.

Anna Kantzavelos:

Thank you for having us. We appreciate it.

Mike Barnes:

First, get that list of medications and understand the importance of compliance. Don’t be afraid to ask questions and seek advice from professionals. It’s better to be safe than sorry.

Kim Barnes:

Exactly. There are people trained to understand medications, so reach out to them for help.

Mike Barnes:

If you have any topics you’d like us to discuss with an expert, let us know at Parenting Aging Parents.

*This transcript is auto-generated. Please excuse any typos or mistakes.

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