BEERS Flashcards
(22 cards)
Anticholinergic Burden
cumulative effect of taking one or more anticholinergic drugs. Is a strong predictor or physical and cognitive impairment in elderly.
Anticholinergic Drugs
medications that block the action of acetylcholine (a neurotransmitter). (a large number of drugs)
Extrapyramidal symptom-causing agents
(aka Drug Induced Movement Disorders, EPS)
Common side effect of dopamine-receptor blockers. (antipsychotics, lithium, SSRI’s, TCA tricyclic antidep, stimulants). Esp. Lithium and risperidone.
Extrapyramidal Symptoms
dystonia, parkinsonism, lip smacking, neck twisting, tardive dyskinesia.
Anticholinergic Burden Scale (ABS)
Scale that distinguishes risk of drugs by 1,2,3 points. >= 3 is clinically relevant risk.
BEERS
Anticholinergic drug:
First-generation Antihistamines
“ine” suffix.
s/s: confusion, dry mouth, constipation
Rec: avoid
BEERS
Anticholinergic Drug
Antiparkinsonian Agents
Benztropine, trihexyphenidle
Rec: Avoid
BEERS
Anticholinergic drug
Antispasmotics
“ine” suffix
BEERS, CV
Digoxin
rec: NOT first line of defense against Afib or CHF. Especially bad for Kidneys.
BEERS, CV
Amiodarone
- works to maintain sinus rhythm (afib) however high toxicity risk.
BEERS, CNS
Antidepressants
alone, or in combination rec: Strongly avoid Amoxapine Clomipramine Desipramine Doxepin >6 mg/d Imipramine Nortriptyline Paroxetine Protriptyline Trimipramine
BEERS, CNS
Antipsychotics
rec: strongly avoid
Risk: CVA, cognitive decline, increased rate of dementia.
BEERS, CNS
Barbituates
“barbitol” suffix
sedative, sleep-inducing
Rec: strongly avoid
Risk: risk of OD at low doses
BEERS, CNS
Benzodiazepines
“epam” suffix
lowers brain activity, anxiety, insomnia, seizures.
Rec: strongly avoid
Risk: falls, fractures, delirium, cognitive impairment. Remains in system for a long time.
BEERS, endocrine
Estrogen
rec: Strongly avoid
Risk: increased risk of breast CA,
BEERS, endocrine
Growth Hormone
Rec: strongly avoid
Risk: edema, arthralgia, impaired fasting glucose
BEERS, endocrine
Insulin, sliding scale
Rec: moderately avoid
Risk: high for hypo or hyper glycemia.
BEERS, GI
Proton-Pump Inhibitor
Rec: strongly avoid
Risk: C-diff, bone loss, fracture
BEERS, Pain medications
NSAIDS
Rec: avoid chronic use
Risk: peptic ulcers and GI bleed.
BEERS, pain medications
Indomethacin, Ketorolac
Rec: moderately avoid
Risk: Indomethacin - CNS side effects
Ketorolac - Inc. GI bleed, Kidneys
BEERS, pain medications
Skeletal mm relaxants
Rec: moderately avoid
Risk: anticholinergic effects, sedation, fractures
BEERS, Genitourinary
Desmopressin
Rec: moderately strong
High Risk: Hyponatremia
