Inappropriate medications for the elderly

Specialties Geriatric

Published

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.

I hate seeing elderly patients on haldol. I also question the use of statins in the elderly, the side effects can be pretty significant. Does it really matter if a ninety-year old LOL has high cholesterol? In the grand scheme of things?

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Specializes in ABMT.

Oh, and I really want to point something out:

Delirium=fast onset, temporary, fluctuating altered mental status due to a treatable cause (such as lack of sleep, UTI, medication, dehydration, on and on)

Dementia=gradual onset, permanent, continually worsening altered mental status due to brain changes and, sadly, not yet treatable

You can have delirium on top of dementia--yikes! But important to recognize the difference between the two, and to know your patient/resident's baseline mental status so you can pick up on a change when it happens.

Check out this awesome site in case you haven't: consultgerirn.com. Phenomenal resource. Here's a great article about delirium, one among many!

http://consultgerirn.com/topics/delirium/need_help_stat/

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Thank you all for the replies and the links! I have really enjoyed the learning.

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I hate seeing elderly patients on haldol. I also question the use of statins in the elderly, the side effects can be pretty significant. Does it really matter if a ninety-year old LOL has high cholesterol? In the grand scheme of things?

Well, state surveyors might object, they seem to think these folks will NEVER die, and can't be hospice, and should get full treatment for all co-morbidities

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