This is #5 in the series about why we should be concerned with seniors taking so many pills: Beer’s List of Potentially Inappropriate Medications – the Category II Drugs.
Category II has drugs that should be avoided because they may significantly worsen a disease or other condition. I’ve chosen a sample of some of the diseases, followed by a few of the problematic drugs and why they’re included; again, for the complete listing, go on-line and search for Beers Criteria.
Heart Failure: Anti-inflammatories, such as ibuprofen, because they promote fluid retention and make heart failure worse.
Syncope [fainting]: drugs that attempt to slow down the decline of Alzheimer’s disease, such as donepezil [Aricept]; certain anti-hypertensives, such as doxazosin [Cardura], terazosin [Hytrin], because they often drop blood pressure when standing up, causing dizziness and falling.
Delirium [confusion]: all anti-anxiety meds, like diazepam [Valium]; the antihistamines, like diphenhydramine [Benadryl]; all statins (drugs to lower cholesterol – like atorvastatin [Lipitor]); the steroids, like prednisone.
Dementia: antihistamines, like diphenhydramine [Benadryl]—and many more.
History of falls or fractures: anticonvulsants, like phenytoin [Dilantin]; all the anti-anxiety drugs and the hypnotics [sleeping pills]; all the anti-psychotics [like Seroquel].
Insomnia [can’t sleep]: decongestants with pseudoephedrine; any caffeine.
Parkinson’s Disease: all antipsychotics; anti-vomiting drugs, like metoclopramide [Reglan].
Chronic constipation: drugs for bladder urgency, like oxybutynin [Detrol]; antihistamines, like chlorpheniramine [Dramamine], diphenhydramine [Benadryl]; the anticholinergics and antispasmodics [muscle or bowel relaxants].
History of stomach ulcers: aspirin [ASA]; all anti-inflammatories, such as ibuprofen [Motrin].
Chronic kidney disease: any anti-inflammatory can make the kidney damage worse.
Remember, not everyone will have side-effects. But, sometimes it’s worthwhile stopping a particular drug for awhile and see if you feel better off it.
Next time: the Category III drugs.