The Most Dangerous Medicines for Seniors
on June 13th, 2017 in Body, Education | No Comments
As people get older, they naturally need more medical care to stay healthy. Part of that care is prescription medicines. With so many new drugs on the market, and new ones being released seemingly on a daily basis, keeping track of which ones are safe for our elderly loved ones is a necessity. Unfortunately, doing so is not always easy.
The American Geriatrics Society regularly updates a list of medicines that have been proven to be dangerous. This list, called the Beers List (after the doctor who originally created it), is used by medical professionals all over America. However, it is a good idea to be aware of the medicines on the list to make sure your loved one isn’t taking a drug that could be unnecessarily harmful.
How the List Is Organized
The Beers List was first created by Dr. Mark Beers in 1991. It is currently in its fifth rendition, which was published in 2015. The list is reviewed and updated by a panel of experts in geriatric care and pharmacotherapy (medical treatment with drugs) at the American Geriatrics Society.
There are three general categories in the Beers List: Medicines that are inappropriate for seniors, medicines that could make pre-existing conditions worse, and medicines that should be used cautiously. If you or your elderly loved one takes any of the drugs on this list, speak with a physician immediately to make sure it is safe for them to do so.
These lists are not intended as medical advice, and should in no way be taken as such. Rather, it is simply a presentation of the current Beers List. Before starting or stopping any pharmacotherapy, you should consult with your physician.
It is recommended by the American Geriatric Society that these drugs should never be used by seniors, regardless of their current health. There are too many possible side effects for them to be truly beneficial. The list presented here contains some of the most common drugs in this category; you can find the full list here.
- Antispasmodics: Blocks the passage of certain neurotransmitters (anticholinergic), and has questionable effectiveness
- First-generation antihistamines: Also highly anticholinergic, and can cause dry mouth, confusion and other issues
- Ticlopidine: Can present severe side effects; safer alternative medicines are available
- Nitrofurantoin: Can cause pulmonary toxicity (lung damage)
- Barbiturates: Have been proven to be highly addictive
- Estrogens: Has few benefits, and is potentially carcinogenic
- Alpha-1 blockers: May cause blood pressure to drop too much when used to treat hypertension
- First- and Second-generation antipsychotics: Presents an increased risk of stroke and death for those with dementia
- Pentazocine: Can have adverse effects on the central nervous system
- Sliding scale insulin: Increases risk of hypoglycemia, without having any real positive effect on hyperglycemia
Potentially Inappropriate Drugs
While medicines listed above should generally be avoided by seniors, the ones here should be avoided if your loved one has certain medical conditions, according to the American Geriatric Society. These drugs may dangerously exacerbate those underlying conditions. Listed by common medical conditions:
- Heart failure: Avoid NSAIDs, COX-2 inhibitors, cilostazol, thiazolidinediones like pioglitazone and rosiglitazone, and dronedarone. Additionally, avoid nondihydropyridine CCBs like diltiazem and verapamil if your loved one suffered heart failure with reduced ejection fraction.
- Epilepsy/chronic seizures: Avoid tramadol, chlorpromazine, bupropion, clozapine, olanzapine, maprotiline, thiothixene, and thioridazine.
- Dementia/cognitive impairment: Avoid benzodiazepines, eszopiclone, anticholinergics, H2-receptor antagonists, zaleplon, nonbenzodiazepine, antipsychotics and zolpidem.
- Parkinson’s Disease: Avoid antiemetics, promethazine, prochlorperazine, metoclopramide and all antipsychotics except clozapine, quetiapine and aripiprazole.
- Chronic kidney disease (stage IV or less): Avoid NSAIDS (COX-Selective and non-COX, taken either parenterally or orally).
- Urinary incontinence in women: Avoid doxazosin, prazosin, peripheral alpha-1 blockers, terazosin, and estrogen – transdermal or oral (this does not include intravaginal estrogen).
This is not a complete list of potentially inappropriate drugs. If you or a loved one are currently taking a potentially inappropriate drug, DO NOT STOP TAKING IT without speaking with your doctor about your concerns first. The benefits of the drug may outweigh the risk of side effects in your unique case, which may be why the doctor prescribed it. Again, this list is not intended as medical advice in any way.
Use with Caution
In some cases, there are certain drugs that may not be beneficial for seniors to take. According to the American Geriatric Society, these drugs should be used with caution:
- Aspirin to prevent cardiac events: Evidence shows the risks outweigh the benefits for adults over 80 years old.
- Prasugrel: May increase the risk of bleeding in adults over the age of 75. However, for some older adults, the benefits may outweigh the risk.
- Dabigatran: For adults over the age of 75, dabigatran may pose a greater risk of gastrointestinal bleeding than warfarin.
- Antipsychotics and diuretics: Certain drugs in these categories may exacerbate or cause hyponatremia or antidiuretic hormone secretion.
- Vasodilators: For some patients with a history of syncope, these drugs could exacerbate episodes of syncope.
If you are currently taking any medicines on the Beers List, it is important that you speak with your doctor about it. The lists on this blog are not intended to be medical advice in any way. Only your doctor can accurately say whether you should keep taking any medicines you’re on, or if you should stop taking them.
At Dogwood Forest, we work closely with our residents’ doctors to ensure they are getting the most beneficial medical care possible. Our staff is also highly trained to ensure that care is administered correctly. It is all part of our goal to create an environment in which our residents can thrive.
If your loved one is ready to move into an assisted living community in Dunwoody, we can help you prepare for that transition. Contact us today to learn more about the Dogwood Difference!