Potentially Inappropriate Medications for Older Adults: 65 and Older with -HIGH Severity Rating- Independent of Diagnoses or Conditions
Potentially inappropriate medication use in adults 65 years and older in the United States based on revised and updated Beers criteria.
The Beers criteria are based on expert consensus developed through an extensive literature review with a bibliography and questionnaire evaluated
by nationally recognized experts in geriatric care, clinical pharmacology, and psychopharmacology using a modified Delphi technique to reach consensus.
The Beers criteria have been used to survey clinical medication use, analyze computerized administrative data sets, and evaluate intervention studies to decrease medication problems in older adults.
With the continuous arrival of new drugs on the market, increased knowledge about older drugs, and removal of older drugs from the market, these criteria go through updates on a regular basis to remain useful. Since the criteria were published in 1997, there has been an increase in the number of scientific studies addressing drug use and appropriateness in older adults, but there is still a lack of controlled studies in the older population and particularly in patients older than 75 years and patients with multiple comorbidities.
An initiative by Donna M. Fick, PhD, RN, et al.to revise and update the Beers criteria for ambulatory and nursing facility populations older than 65 years in the United States aimed to:
(1) To reevaluate the 1997 criteria to include new products and incorporate new information available from the scientific literature.
(2) To assign or reevaluate a relative rating of severity for each of the medications.
(3) To identify any new conditions or considerations not addressed in the 1997 criteria.
The list below contains medications or medication classes that should generally be avoided in persons 65 years or older because they are either ineffective or they pose unnecessarily high risk for older persons and a safer alternative is available. They are concluded to be inappropriate to use independent of diagnoses or conditions and marked with HIGH Severity Rating of Adverse drug events (ADEs).
Aiman Alrawabdeh 5/27/2006
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References
List of Drugs By Brand Name
| Drug Name | Other Name (Generic) | Drug Class | Conditions | Concerns and Rules |
|---|---|---|---|---|
| Adalat | Nifedipine | Similar to:Procardia | Short acting | Adalat:Nifedipine |
| Aldomet | Methyldopa | Similar to:Aldoril | NA | Aldomet : Methyldopa |
| Aldoril | Methyldopa-hydrochlorothiazide | Similar to:Aldomet | NA | Aldoril : Methyldopa-hydrochlorothiazide |
| Aleve | Naproxen | Non-COX-selective NSAIDs (Non-Cyclooxygenase-Selective Nonsteroidal Anti-Inflammatory Drugs) | Long-term use of full-dosage, longer half-life | Aleve : Naproxen |
| Amphetamines | Amphetamines | Excluding : Methylphenidate hydrochloride and Excluding : Anorexics | NA | Amphetamines : Amphetamines |
| Amphetamines agents | Amphetamines agents | Amphetamines agents | NA | Amphetamines agents : Amphetamines agents |
| Android | Methyltestosterone | Similar to:Virilon and Testrad | NA | Android : Methyltestosterone |
| Anorexic agents | Anorexic agents | Anorexic agents | NA | Anorexic agents : Anorexic agents |
| Atarax | Hydroxyzine | Anticholinergics and antihistamines | NA | Atarax : Hydroxyzine |
| Ativan | Lorazepam | Benzodiazepines:Doses of short-acting | For doses greater than 3 mg | Ativan : Lorazepam |
| Avaprox | Naproxen | Non-COX-selective NSAIDs (Non-Cyclooxygenase-Selective Nonsteroidal Anti-Inflammatory Drugs) | Long-term use of full-dosage, longer half-life | Avaprox : Naproxen |
| Barbiturates | Barbiturates | All type except phenobarbital | Except when used to control seizures | Barbiturates : Barbiturates |
| Benadryl | Diphenhydramine | Anticholinergics and antihistamines | NA | Benadryl : Diphenhydramine |
| Bentyl | Dicyclomine | Gastrointestinal antispasmodic drugs | NA | Bentyl : Dicyclomine |
| Cascara sagrada | Cascara sagrada | Stimulant Laxatives | Long-term use Except in the presence of opiate analgesic use | Cascara sagrada : Cascara sagrada |
| Chlor-Trimeton | Chlorpheniramine | Anticholinergics and antihistamines | NA | Chlor-Trimeton : Chlorpheniramine |
| Cordarone | Amiodarone | Only This Drug | NA | Cordarone : Amiodarone |
| Dalmane | Flurazepam | Only This Drug | NA | Dalmane : Flurazepam |
| Daypro | Oxaprozin | Non-COX-selective NSAIDs (Non-Cyclooxygenase-Selective Nonsteroidal Anti-Inflammatory Drugs) | Long-term use of full-dosage, longer half-life | Daypro : Oxaprozin |
| Demerol | Meperidine | Only This Drug | NA | Demerol : Meperidine |
| Desiccated thyroid | Desiccated thyroid | Only This Drug | NA | Desiccated thyroid : Desiccated thyroid |
| Diabinese | Chlorpropamide | Only This Drug | NA | Diabinese : Chlorpropamide |
| Ditropan XL | Oxybutynin XL | Muscle relaxants and antispasmodics | NA | Ditropan : Oxybutynin |
| Ditropan | Oxybutynin | Muscle relaxants and antispasmodics | NA | Ditropan XL : Oxybutynin XL |
| Donnatal | Belladonna alkaloids | Gastrointestinal antispasmodic drugs | NA | Donnatal : Belladonna alkaloids |
| Dulcolax | Bisacodyl | Stimulant Laxatives | Long-term use Except in the presence of opiate analgesic use | Dulcolax : Bisacodyl |
| Elavil | Amitriptyline | Similar to: (Limbitrol) Chlordiazepoxide-amitriptyline and (Triavil) Perphenazine-amitriptyline | NA | Elavil : Amitriptyline |
| Equanil | Meprobamate | Similar to:Miltown | NA | Equanil : Meprobamate |
| Flexeril | Cyclobenzaprine | Muscle relaxants and antispasmodics | NA | Flexeril : Cyclobenzaprine |
| Halcion | Triazolam | Benzodiazepines:Doses of short-acting | For doses greater than 0.25 mg | Halcion : Triazolam |
| Hylorel | Guanadrel | Only This Drug | NA | Hylorel : Guanadrel |
| Indocin | Indomethacin | Only This Drug | NA | Indocin : Indomethacin |
| Indocin SR | Indomethacin | Only This Drug | NA | Indocin SR : Indomethacin |
| Ismelin | Guanethidine | Only This Drug | NA | Ismelin : Guanethidine |
| Levsin | Hyoscyamine | Gastrointestinal antispasmodic drugs | NA | Levsin : Hyoscyamine |
| Levsinex | Hyoscyamine | Gastrointestinal antispasmodic drugs | NA | Levsinex : Hyoscyamine |
| Librax | Clidinium-chlordiazepoxide | Gastrointestinal antispasmodic drugs | NA | Librax : Clidinium-chlordiazepoxide |
| Limbitrol | Chlordiazepoxide-amitriptyline | Similar to: (Elavill) Amitriptylinee and (Triavil) Perphenazine-amitriptyline | NA | Limbitrol : Chlordiazepoxide-amitriptyline |
| Macrodantin | Nitrofurantoin | Only This Drug | NA | Macrodantin : Nitrofurantoin |
| Mellaril | Mellaril | Only This Drug | NA | Mellaril : Mellaril |
| Miltown | Meprobamate | Similar to:Equanil | NA | Miltown : Meprobamate |
| Mineral oil | Mineral oil | Only This Drug | NA | Mineral oil : Mineral oil |
| Naprosyn | Naproxen | Non-COX-selective NSAIDs (Non-Cyclooxygenase-Selective Nonsteroidal Anti-Inflammatory Drugs) | Long-term use of full-dosage, longer half-life | Naprosyn : Naproxen |
| Neoloid | Neoloid | Stimulant Laxatives | Long-term use Except in the presence of opiate analgesic use | Neoloid : Neoloid |
| Norflex | Orphenadrine | Only This Drug | NA | Norflex : Orphenadrine |
| Norpace CR | Disopyramide CR | Similar to:Norpace | NA | Norpace : Disopyramide |
| Norpace | Disopyramide | Similar to:Norpace CR | NA | Norpace CR : Disopyramide CR |
| Paraflex | Chlorzoxazone | Muscle relaxants and antispasmodics | NA | Paraflex : Chlorzoxazone |
| Periactin | Cyproheptadine | Anticholinergics and antihistamines | NA | Periactin : Cyproheptadine |
| Phenergan | Promethazine | Anticholinergics and antihistamines | NA | Phenergan : Promethazine |
| Polaramine | Dexchlorpheniramine | Anticholinergics and antihistamines | NA | Polaramine : Dexchlorpheniramine |
| Pro-Banthine | Propantheline | Gastrointestinal antispasmodic drugs | NA | Pro-Banthine : Propantheline |
| Procardia | Nifedipine | Similar to:Adalat | Short acting | Procardia : Nifedipine |
| Prozac | Fluoxetine | Only This Drug | Daily Dose | Prozac : Fluoxetine |
| Restori | Temazepam | Benzodiazepines:Doses of short-acting | For doses greater than 15 mg | Restori : Temazepam |
| Robaxin | Methocarbamol | Muscle relaxants and antispasmodics | NA | Robaxin : Methocarbamol |
| Serax | Oxazepam | Benzodiazepines:Doses of short-acting | For doses greater than 60 mG | Serax : Oxazepam |
| Serentil | Mesoridazine | Only This Drug | NA | Serentil : Mesoridazine |
| Sinequan | Doxepin | Only This Drug | NA | Sinequan : Doxepin |
| Skelaxin | Metaxalone | Muscle relaxants and antispasmodics | NA | Skelaxin : Metaxalone |
| Soma | Carisoprodol | Muscle relaxants and antispasmodics | NA | Soma : Carisoprodol |
| Talwin | Pentazocine | Only This Drug | NA | Talwin : Pentazocine |
| Testrad | Methyltestosterone | Similar to:Android and Virilon | NA | Testrad : Methyltestosterone |
| Ticlid | Ticlopidine | Only This Drug | NA | Ticlid : Ticlopidine |
| Tigan | Trimethobenzamide | Only This Drug | NA | Tigan : Trimethobenzamide |
| Toradol | Ketorolac | Only This Drug | NA | Toradol : Ketorolac |
| Triavil | Perphenazine-amitriptyline | Similar to: (Elavill) Amitriptylinee and (Limbitrol) Chlordiazepoxide-amitriptyline | NA | Triavil : Perphenazine-amitriptyline |
| Tripelennamine | Tripelennamine | Anticholinergics and antihistamines | NA | Tripelennamine : Tripelennamine |
| Virilon | Methyltestosterone | Similar to:Android and Testrad | NA | Virilon : Methyltestosterone |
| Vistaril | Hydroxyzine | Anticholinergics and antihistamines | NA | Vistaril : Hydroxyzine |
| Xanax | Alprazolam | Benzodiazepines:Doses of short-acting | For doses greater than 2 mg | Xanax : Alprazolam |
