Inappropriate medications for the elderly

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In one of my pocket guides there is a list of inappropriate medications for the elderly. They are classified as "always avoid", "rarely appropriate", and "often misused". The list is based on 1997 Beers Criteria & Classification. https://www.dcri.org/trial-participation/the-beers-list

On the "rarely appropriate" list is Methocarbamol and on the often misused is Amitriptyline, and hydroxyzine. I regularly give these meds.

I did a quick google search to find more info about the listed drugs and why they are inappropriate for the elderly but I couldn't find specific reasons. I will keep on digging because I am really curious to have some reasons/rationals as to why the drugs on this list may be inappropriate but I figured I would ask here because one of you might know the answer or be able to point me in the right direction to find the answers.

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Specializes in LTC.

I guess for some medications for the elderly the risks outweigh the benefits. I had the same questions as you especially when it came to nephrotoxic antibiotices and seroquel extended release and haldol.

Its sad to see how much medication these poor residents are on. Sometimes the medications cause more harm than good and sometimes these meds are REALLY helpful.

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Specializes in LTC.

Mulitvitamins.

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Mulitvitamins.

are inappropriate?

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Probably not much help, but some meds(especially those that mess with the kidneys) can cause elderly people to become dehydrated and they can get confused when dehydrated.

I guess one has to weight the benefits and risks and decide based on that.

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Specializes in Emergency Medicine.

I know that promethazine will knock gramma's/grandpa's shoes off sometimes.

Instant dementia in a shot. We don't give it as much now but we did.

All Zofran and Anzemet these days.

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Specializes in ABMT.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1298101/pdf/11089480.pdf

Anticholinergic effects are amplified in the elderly related to a variety of factors. The article above is really informative.

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Specializes in Med-Surg, Home Health, LTC.

I think a good pharmacist may help you? these are who I usually ask about meds.

And some medications are used routinely for conditions other than what they are markets

for. example, Singular is used by some plastic surgeons to help decrease the formation

of scar tissue. Go figure. .... we are all an experiment ;-)

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Some medications are inappropriate for the elderly because of increased risk of falls-haldol and ativan come to mind, but my facility uses them regularly :-(

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awesome links and info...thanks!

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Specializes in NeuroICU/SICU/MICU.

In my experience, Ambien and IV pepcid are bad for elderly patients. Like another poster said, instant dementia and a HUGE fall risk. My unit manager banned IV pepcid on our unit because of this effect.

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Specializes in ED, Informatics, Clinical Analyst.

If I had a nickel for every elderly patient I've encountered who was on an anti-psychotic with a black box warning stating that it is inappropriate for elderly patients with dementia and has been linked to increased morbidity and mortality, I'd have a lot of nickels :D

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