Académique Documents
Professionnel Documents
Culture Documents
Class
Associated Risks
General
Recommendations
BEERS
STOPP/START
Benzos
Short- Alprazolam,
Lorazepam,
Estazolam,
Temazepam
-Excessive sedation
-Daytime drowsiness
-Cognitive
impairment
-Disinhibition
-Weakness
-Falls
-Similar to benzos
-recommended
dose for drugs
containing zolpidem
d/t risk of nextmorning impairment
-dose for women in
1/2
-Elderly more
sensitive to SEs
Long-Clonazepam,
Diazepam,
Chlordiazepoxide,
Flurazepam
Non-Benzo Hypnotics
Lunesta, Zolpidem,
Zaleplon
Anticholinergics
TCAs
Anticholinergics
Antihistamines
-Dry mouth
-Blurred vision
-Urinary retention
-Constipation
-Confusion/ delirium
-Cardiac arrhythmia
-Falls
See above
Neuropathic pain:
nortriptyline,
desipramine- less
anticholinergic
-Gaba or duloxetine
-Elderly more
sensitive to SEs
Avoid
diphenhydramine for
sleep
-use non-sedating:
Loaratadine,
Fexofenadine,
Avoid
diphenhydramine for
sleep
-use non-sedating:
Loaratadine,
Fexofenadine,
Geriatric Pharm
Anticholinergics
Ceftirizine
-review regularly
-Avoid use altogether
Ceftirizine
-review regularly
BEERS
STOPP/START
See above
-Poorly tolerated
-Questionable
efficacy
Class
Associated Risks
General
Recommendations
Anticholinergics
See above
-Avoid in pts w/
dementia, XR and
newer agents better
tolerated
-try non-drug tx 1st
-Avoid in pts w/
dementia, XR and
newer agents better
tolerated
-try non-drug tx 1st
Antipsychs
-Confusion
-HoTN
-Falls
-Extrapyramidal SEs
Narcotics
-Sedation
Urinary
Antispasmodics
Old- Oxybutin
(crosses BBB),
Tolterodine
New-Tros[ium,
Darfenacin (highly
M3 selective),
Solidenacin(highly
M3 selective)
-Same as BEERS
Geriatric Pharm
-Respiratory
depression
-Cognitive
impairment
-Constipation
-Falls
NSAIDS
-Considered rarelt
and w/ extreme
caution
-If mod-severe pain
or QOL d/t pain
opiod
-Acetaminophen
should be initial
choice for tx of
persistent pain
Digoxin
Used for
symptomatic
improvement in HF,
rate control in afib
Warfarin
Numerous drug
interactions
-N/V
-Visual disturbances
-Palpitations
-Bradycardia
-Death
-Renally
eliminatedaccumul
ation & toxicity
Therapeutic rangs0.5-2.0 ng/mL
-Age >65 risk for
warfarin-related
bleeding
Other RF:
->75 YO
-Variable dietary
metabolite
accumulates in pts
w/ renal fxn
Preferred: Lortab,
Oxy, Morphine,
hydromorphone
USE CAUTION W/
DURAGESIC
-lowest dose for
shortest time
-GI PPX w/ PPI
-Monitor for adverse
effects
-Avoid Indomethaciner risk GI bleed,
CNS SEs
-Avoid Toradol- er GI
bleed
-Add laxative
-Doses >0.125
mg/day not
recommended
-Doses >0.125
mg/day not
recommended
-Same as BEERS
Geriatric Pharm
intakepoor anticoag
control
-Comorbids
- fxnl capacity