Potentially Inappropriate Drugs for Older Adults

As the years add up, it’s not unusual for the number of daily medications we take to increase. Older persons may have trouble tolerating medications better suited for younger patients. One of the most important steps you can take to protect yourself is to supply all of your doctors, particularly specialists, with as complete a medical status as possible, including a list of conditions you have and the drugs and supplements you take. The following 33 drugs are considered to be potentially inappropriate for patients 65 years of age and older and may result in various adverse effects:

DRUG(generic/brand name) ADVERSE EFFECTS

  • Barbiturates(Nembutol, Mebarol, Amobarbital, Butabarbital, Pentabarbital, Secobarbital) Highly addictive, more adverse effects than most sedatives
  • Flurazepam(Dalmane, Somnol, Novo-Flupam, Apo-Flurazepam) May cause Central Nervous System (CNS) problems
  • Meprobamate(Equanil, Meprospan 200, Meprospan 400, Probate, Apo-Meprobamate Highly addictive
  • Chlorpropamide(Diabinese, NovoPropamide, Apo-Chlorpropamide)Prolonged hypoglycemia-Low blood sugar
  • Meperidine(Demerol) Confusion, CNS problems
  • Pentazocine(Talwin, Talwin Nx) Confusion, Hallucinations
  • Trimethobenzamide(Tigan, Stemetic, Tebamide, Tribenzagan, Trimazide) Can effect motor control
  • Belladonna alkaloids(Donnatal, Barbidonna) Hallucinations, confusion
  • Dicylomine(Bentyl, Bentylol, Spasmoban, Formulex) Nausea, Hallucinations
  • Hyoscyamine(Levsin,Hyosol, A-Spas-S/L, Cystospaz, Levbid, Levsinex Timecaps, Symax SL) Arrhythmia, dizziness, blurred vision
  • Propantheline(Pro-Banthine)Arrhythmia, dizziness, blurred vision
  • Carisoprodol(Soma, Vanadom) Poorly tolerated, weakness
  • Chlorzoxazone(Parafon Forte DSC, Remular-S, Paraflex) Poorly tolerated, weakness
  • Cyclobenzaprine(Flexeril)Poorly tolerated, weakness
  • Metaxalone(Skelaxin) Poorly tolerated, weakness, sedation
  • Methocarbamol(Robaxin) Poorly tolerated, weakness,s edation
  • Amitriptyline(Elavil) Poorly tolerated, sedative effects unpleasant
  • Chlordiazepoxide(Librium)Strong sedation, Adverse CNS effects
  • Diazepam(Valium) Prolonged sedation, risk of falls
  • Doxepin(Sinequan) Poorly tolerated, sedative effects unpleasant
  • Indomethacin(Indocin) Adverse CNS effects
  • Dipyridamole(Persatine) Sudden blood pressure drop
  • Ticlopidine(Ticlid) Anti-clotting, more toxic than aspirin
  • Methyldopa(Aldomet,Aldoril) Low resting heart rate, exacerbate depression
  • Reserpine(Harmonyl, Serpasil, Serpalan, Novoreserpine) Depression, sedation, blood pressure drop
  • Dispyramide(Norpace, Norpace CR) Could induce heart failure, other complications
  • Oxybutynin(Ditropan,Ditropan XL,Oxytrol) Weakness, sedation, poor tolerance
  • Chlorpheniramine(Chlor-Trimeton,Aller-Chlor, Chlorate, Chlo-Amine) Increased heart rate, disorientation
  • Cyproheptadine(Periactin) Increased heart rate, disorientation
  • Diphenhydramine(Benadryl,Nytol) Increased heart rate, disorientation
  • Hydroxyzine(Vistaril,Rezine, Atarax) Increased heart rate, disorientation
  • Promethazine(Pheneragan, Promacot) Increased heart rate, disorientation
  • Propoxyphene(Darvon, Darvon-N) Highly addictive; avoid if depressed with suicidal thoughts.
UCLA Medical Center, Division of Geriatrics and Johns Hopkins Medical Letter, Health After 50 September 2008

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