POTENTIALLY INAPPROPRIATE DRUGS FOR ELDERLY BEERS LIST 1 use low - PDF document

POTENTIALLY INAPPROPRIATE DRUGS FOR ELDERLY (BEERS LIST)* 1) (use lowest effective dose) (may cause arrhythmias; questionable efficacy in older adults) (anticholinergic effects and AMPHETAMINES (may cause dependence, (may cause depen-BARBITURATES, except phenobarbital or for effects in elderly than most other hypnotic/ (anticholinergic effects and questionable effectiveness; avoid its (bowel dysfunction with long- analgesics) (poorly tolerated due to anticholinergic effects and possibly less effec- (bowel dysfunction CHLORAZEPATE (prolonged sedation; short-acting benzodiazepines are preferred) (prolonged sedation; (anticholinergic effects and prolonged sedation; (causes anticholiner-gic effects; non-anticholinergic antihistamines preferred for treating allergic reactions) CHLORPROPAMIDE (may cause prolonged (poorly tolerated by elderly due to anticholinergic effects and possi-bly less effective at tolerated doses) (may cause confusion, other CNS adverse effects) ( anticholinergic effects, prolonged sedation; short-acting benzodiazepines preferred) clidinium is of questionable effectiveness; avoid its use, (may cause orthostatic hypotension, adverse CNS effects) (uncertain efficacy at doses studied) (poorly tolerated by elderly due to anticholinergic effects and possibly less effective at tolerated doses) CYPROHEPTADINE (causes anticholinergic effects; non-anticholinergic antihistamines preferred for treating allergic reactions) (causes anticholinergic effects; non-anticholinergic antihistamines preferred for treating allergic DIAZEPAM (prolonged sedation; short-acting (causes anticholinergic effects and is of questionable effectiveness; avoid its (increased risk of toxic effects with (causes anticholinergic effects and sedation; non- anticholinergic antihis-tamines preferred for treating allergic reactions; should be used only at lowest effective dose if used for allergic reactions; should not be used short-acting (may cause ortho-static hypotension) (may cause heart failure and anticholinergic effects; avoid its use) (hypotension, dry mouth, urinary (anticholinergic effects and Ergot mesyloids (uncertain efficacy at doses Estrogens only, oral forms (carcinogenicity and lack of cardioprotective effect in older (may cause hypertension, alternatives) Ferrous sulfate (doses over 325mg/day are constipation) daily use forms (may cause disturbances; use safer alternatives) Adapted from: Updating the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Results of a US Consensus Panel of Experts. (Table 1). Fick, DM, et. al. Arch Intern Med. 2003;163:2716-2724. denotes “high severity” (Rev. 2/20

06) POTENTIALLY INAPPROPRIATE DRUGS FOR ELDERLY (BEERS LIST)* 2) FLURAZEPAM (prolonged sedation may result (orthostatic hypotension) (orthostatic hypotension) HALAZEPAM (prolonged sedation; shortacting (causes anticholinergic effects; non-anticholinergic antihistamines pre-ferred for treating allergic reactions) HYOSCYAMINE (causes anticholinergic effects and is of questionable effectiveness; (causes the most CNS side effects among NSAIDs) (uncertain efficacy) (avoid immediate and long-term use in elderly, because they may have asymp-LORAZEPAM (use lowest effective dose) (may cause confusion; is of questionable efficacy at commonly used oral MEPROBAMATE (very addicting and sedat- (CNS and extrapyramidal adverse effects) METAXALONE (poorly tolerated by elderly due to anticholinergic effects; possibly less effective at tolerated doses) (poorly tolerated by elderly due to anticholinergic effects; possibly less effective at tolerated doses) METHYLDOPA and METHYLDOPA-HCTZMETHYLTESTOSTERONE (may cause prostatic hypertrophy, cardiac problems) (potential for aspiration and other adverse effects; use safer alternatives) (avoid long-term, full-dose use high BP, heart failure) (bowel dysfunction with long- short acting (may cause (may cause renal impair- (sedation, anticholinergic effects; use safer alternatives) (avoid long-term, full-dose use high BP, heart failure) OXAZEPAM (use lowest effective dose) (poorly tolerated by elderly due to anticholinergic effects; possibly less effective at tolerated doses; do not consider PENTAZOCINE (may cause more CNS adverse effects than other narcotics) (anti-lin ergic effects, sedation) (avoid long-term, full-dose use high BP, heart failure) (causes anticholinergic effects; non-anticholinergic antihistamines preferred for treating allergic reactions) PROPANTHELINE (causes anticholinergic effects and is of questionable effectiveness; Propoxyphene and combination products QUAZEPAM (prolonged sedation; short-acting (may cause depression, impo-TEMAZEPAM (use lowest effective dose) (greater potential for CNS and extrapyramidal adverse effects) THYROID, DESSICATED (possible cardiac effects; use safer alternatives) (aspirin, or other alternative drugs, may be preferable due to efficacy and (use lowest effective dose) (less effective, and (causes anticholinergic effects; non-anticholinergic antihistamines preferred for treating allergic reactions) Adapted from: Updating the Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. Results of a US Consensus Panel of Experts. (Table 1). Fick, DM, et. al. Arch Intern Med. 2003;163:2716-2724. denotes “high severity” (Rev. 2/2006)