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Potentially Inappropriate Medications for Older Adults: 65 and Older with -HIGH Severity Rating- Independent of Diagnoses or Conditions
Contents |
Potentially inappropriate medication use in adults 65 years and older in the United States based on revised and updated 2000 Beers criteria.
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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).
Table Definitions
Drug Name: is the Drug Brand Name Other Name (Generic): is the generic name of the drug Drug Class & Similarity: drug class is listed if the whole class considered high risk Doses, Exceptions & Other: ranges for high-risk doses, exceptions, and/or other applicable conditions.
Aiman Alrawabdeh 5/27/2006
References
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The Rule
The Patient: is Male or Female in the USA
And
Age : 65 years and older
And
Condition : patient has Only the condition(s) that are intended to be treated by one or
more drug listed below
And
Drug : Brand name, the Generic name or – a drug – from the listed drug classes
And
Condition (if any) are met under Field “Doses, Exceptions & Other”
Then
Click on the Link under the Hyper-Link “Concern and Rules” Field marked with the
Brand Name: Generic Name
To view the concerns about this drug and possible rules use and alternatives
List of Drugs By Brand Name
Adalat
|
Drug Name |
Other Name (Generic) |
Drug Class & Similarity |
Doses, Exceptions & Other |
|
Adalat |
Nifedipine |
Similar to:Procardia |
Short acting |
|
Concerns and Rules |
Potential for hypotension and constipation. |
||
|
Drug Name |
Other Name (Generic) |
Drug Class & Similarity |
Doses, Exceptions & Other |
|
Aldomet |
Methyldopa |
Similar to:Aldoril |
NA |
|
Concerns and Rules |
May cause bradycardia and exacerbate depression in elderly patients. |
||
|
Drug Name |
Other Name (Generic) |
Drug Class & Similarity |
Doses, Exceptions & Other |
|
Aldoril |
Methyldopa-hydrochlorothiazide |
Similar to:Aldomet |
NA |
|
Concerns and Rules |
May cause bradycardia and exacerbate depression in elderly patients. |
||
|
Drug Name |
Other Name (Generic) |
Drug Class & Similarity |
Doses, Exceptions & Other |
|
Aleve |
Naproxen |
Non–COX-selective NSAIDs (Non-Cyclooxygenase-Selective Nonsteroidal Anti-Inflammatory Drugs) |
Long-term use of full-dosage, longer half-life |
|
Concerns and Rules |
Have the
potential to produce (GI: gastrointestinal) bleeding, renal failure, high
blood |
||
|
Drug Name |
Other Name (Generic) |
Drug Class & Similarity |
Doses, Exceptions & Other |
|
Amphetamines |
Amphetamines |
Excluding : Methylphenidate hydrochloride and Excluding : Anorexics |
NA |
|
Concerns and Rules |
(CNS:central nervous system) stimulant adverse effects. |
||
|
Drug Name |
Other Name (Generic) |
Drug Class & Similarity |
Doses, Exceptions & Other |
|
Amphetamines agents |
Amphetamines agents |
Amphetamines agents |
NA |
|
Concerns and Rules |
These drugs have potential for causing dependence, hypertension, angina, and myocardial infarction. |
||
|
Drug Name |
Other Name (Generic) |
Drug Class & Similarity |
Doses, Exceptions & Other |
|
Android |
Methyltestosterone |
Similar to:Virilon and Testrad |
NA |
|
Concerns and Rules |
Potential for prostatic hypertrophy and cardiac problems |
||
|
Drug Name |
Other Name (Generic) |
Drug Class & Similarity |
Doses, Exceptions & Other |
|
Anorexic agents |
Anorexic agents |
Anorexic agents |
NA |
|
Concerns and Rules |
These
drugs have potential for causing dependence, hypertension, |
||
|
Drug Name |
Other Name (Generic) |
Drug Class & Similarity |
Doses, Exceptions & Other |
|
Atarax |
Hydroxyzine |
Anticholinergics and antihistamines |
NA |
|
Concerns and Rules |
All nonprescription and many prescription antihistamines may have potent anticholinergic properties. Nonanticholinergic antihistamines are preferred in elderly patients when treating allergic reactions. |
||
