The Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, commonly called the Beers List, are guidelines for healthcare professionals to help improve the safety of prescribing medications for older adults. Table. 2015 American Geriatrics Society (AGS) Beers Criteria for Potentially Inappropriate Medication Use in Older Adults Brompheniramine. Carbinoxamine. Chlorpheniramine. Clemastine. Cyproheptadine. Dexbrompheniramine. Dexchlorpheniramine. Dimenhydrinate. Serotonin-norepinephrine reuptake inhibitors were added to the list of drugs to avoid among adults with a history of falls or fractures. Although most antipsychotic medications should be avoided among patients with Parkinson disease, quetiapine, clozapine, and pimavanserin may be preferred in this setting. The AGS Beers Criteria® include the same five main categories as in 2015: (1) potentially inappropriate medications in older adults; (2) potentially inappropriate medications to avoid in older adults with certain conditions; (3) medications to be used with considerable caution in older adults; (4) medication
Beers Criteria: Some Medications to Avoid in the Elderly AVOID IF POSSIBLE IN THE ELDERLY Class Drug antiarrhythmic drugs amiodarone flecainide procainamide sotalol quinidine disopyramide (and others) Non-COX selective NSAIDS Aspirin > 325mg/day Ibuprofen Naproxen Piroxicam Indomethacin (and others)
Tricyclic antidepressants, especially amitriptyline and dothiepin, 16 are known to pose a high risk of death in overdosage. These drugs should therefore be avoided in older people whose medication is not supervised and who are at risk of taking an overdose.
There is consistent suggestion that ibuprofen has a lower risk of GIB than naproxen does; in fact, ibuprofen does not appear in the Beers List. GIB risk with NSAID use is dose-dependent, may be highest early in the first week to month, and persists with use (duration).
The most commonly used definition for polypharmacy was five or more medications daily, with 46. 4% (n = 51) of studies using this definition [11, 24–73]. The second most common definition for polypharmacy was six or more medications, with ten studies using this definition [10, 74–82].
The most recent 2012 Beers list includes prescription and OTC sleep aids including Ambien, Lunesta, Sonata, Benadryl, and benzodiazepine medications such as Klonopin, Ativan, and Xanax.
“Older” is preferred over "elderly, " but both are equally imprecise; > 65 is the age often used, but most people do not need geriatrics expertise in their care until age 70, 75, or even 80. Gerontology is the study of aging, including biologic, sociologic, and psychologic changes.
Buspirone is an anti-anxiety drug that has been shown to be effective for older adults. Benzodiazepines, another anti-anxiety drug, are effective but should be prescribed carefully to older adults because of risk of memory impairment, unsteadiness, and falls.
High risk medicines are those medicines that have a high risk of causing significant patient harm or death when used in error. Standards and policy directives prescribing flowchat (PDF 71KB) Safe prescribing of new oral anticoagulants: apixaban, rivaroxaban and dabigatran (PDF 488KB)
Because they cause CNS depression, several skeletal muscle relaxants are on the Beers list, including carisoprodol, chlorzoxazone, cyclobenzaprine, metaxalone, methocarbamol, and orphenadrine.
Across its five lists, the 2019 AGS Beers Criteria® includes: 30 individual medications or medication classes to avoid for most older people. For example, glimepiride—a medication to control high blood sugar for people with type 2 diabetes—is new to the AGS Beers Criteria® in 2019.
The goal of Beers Criteria is to enhance older adult clinical outcomes by limiting use of potentially inappropriate medications (PIMs) in older adults.
Haldol may have gotten a “bad” rap because it, along with many medications (and many other antipsychotic medications), has appeared on the “Beers Criteria for Potentially Inappropriate Medication Use in Older Adults” in the past. All the medications on the Beers List are potentially inappropriate.
talk to your doctor about the risks and benefits of taking hydroxyzine if you are 65 years of age or older. Older adults should not usually take hydroxyzine because it is not as safe as other medications that can be used to treat the same condition. you should know that this medication may make you drowsy.
that began in 2012. 1, 2 The AGS Beers Criteria. ® are an. explicit list of PIMs that are typically best avoided by older adults in most circumstances or under specific situations, such as in certain diseases or conditions.