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The Beers Criteria is an essential guideline for reducing inappropriate prescribing and mitigating the risks associated with polypharmacy in older adults. It is a high-yield topic for the USMLE Step 1, focusing on the careful selection of medications for geriatric patients to prevent adverse events.
Drug Class | Examples | Risks in the Elderly |
---|---|---|
α-blockers | Doxazosin, Terazosin | Increased risk of hypotension. |
Anticholinergics | Diphenhydramine, Amitriptyline | Increased risk of delirium, sedation, falls, constipation, urinary retention. |
Antidepressants | Tricyclic antidepressants | Same as anticholinergics. |
Antihistamines | Chlorpheniramine | Same as anticholinergics. |
Opioids | Morphine, Hydrocodone | Increased risk of delirium, sedation, falls. |
Benzodiazepines | Lorazepam, Diazepam | Increased risk of delirium, sedation, falls. |
NSAIDs | Ibuprofen, Naproxen | Increased risk of gastrointestinal bleeding (especially with anticoagulants). |
Proton Pump Inhibitors (PPIs) | Omeprazole, Esomeprazole | Increased risk of Clostridium difficile infection. |
Key Drug Risk | Example | Potential Harm |
---|---|---|
Sedation and Falls | Benzodiazepines | Delirium, hip fractures. |
Cognitive Decline | Anticholinergics | Memory impairment. |
GI Bleeding | NSAIDs | Life-threatening bleeding. |
Infections | PPIs | C. difficile infection. |