Criterios de Beers

Question 1

Avoid initiating for primary prevention of cardiovascular
disease. Consider deprescribing in older adults already
taking it for primary prevention.

Answer 1

Aspirina

Question 2

risk of confusion, dry
mouth, constipation, and other anticholinergic effects or toxicity.
Cumulative exposure to anticholinergic drugs is associated with
increased risk of falls, delirium, and dementia, even in younger
adults.

Answer 2

QChlorpheniramine
QCyproheptadine
Q Dimenhydrinate
Q Diphenhydramine
(oral)
Q Doxylamine
QHydroxyzine

Question 3

Avoid in individuals with CrCl <30 mL/min or for long-term
suppression

Answer 3

Nitrofurantoína

Question 4

Avoid for
treatment of
nonvalvular atrial
fibrillation or venous
thromboembolism
(VTE)

Answer 4

Warfarin

Question 5

Avoid for
long-term treatment
of nonvalvular atrial
fibrillation or venous
thromboembolism
(VTE)

Answer 5

Rivaroxaban

Question 6

Non-selective
peripheral
alpha-1 blockers
for treatment of
hypertension
Q Doxazosin
QPrazosin
QTerazosin

Answer 6

Avoid use as an antihypertensive.

Question 7

Avoid
Potential for hypotension; risk of precipitating myocardial ischemia

Answer 7

Nifedipino

Question 8

Avoid as first-line therapy for atrial fibrillation unless patient has
heart failure or substantial left ventricular hypertrophy.

Answer 8

Amiodarona

Question 9

Avoid in individuals with permanent atrial fibrillation or severe or
recently decompensated heart failure. Use caution in patients with
HFrEF with less severe symptoms (NYHA class I or II).

Answer 9

Dronedarona

Question 10

Avoid for for first-line
treatment of atrial
fibrillation or heart
failure

Answer 10

Digoxina

Question 11

Avoid Antidepressants with
strong anticholinergic
activity, alone or in
combination

Answer 11

QAmitriptyline
QAmoxapine
QClomipramine
Q Desipramine
Q Doxepin >6 mg/day
QImipramine
Q Nortriptyline
QParoxetine

Question 12

Antiparkinsonian
agents with strong
anticholinergic
activity

Answer 12

QBenztropine (oral)
QTrihexyphenidyl

Question 13

Avoid, except in FDA approved indications such as schizophrenia,
bipolar disorder, Parkinson disease psychosis (see Table 2),
adjunctive treatment of major depressive disorder, or for short-term
use as antiemetic.

Answer 13

Aripiprazole
QHaloperidol
QOlanzapine
QQuetiapine
Q Risperidone
QOthersd

Question 14

Avoid- exposes users to risks of abuse, misuse,
and addiction. Concomitant use with opioids may result in profound
sedation, respiratory depression, coma, and death.
Older adults have increased sensitivity and
decreased metabolism of long-acting agents; the continued use
may lead to clinically significant physical
dependence. In general, all increase risk of
cognitive impairment, del

Answer 14

Benzodiazepinas

Question 15

Avoid
Nonbenzodiazepine benzodiazepine receptor agonist hypnotics
(“Z-drugs”) have adverse events similar to those of benzodiazepines

Answer 15

Q Eszopiclone
QZaleplon
QZolpidem

Question 16

Avoid unless indicated for confirmed hypogonadism with clinical
symptoms.

Answer 16

Androgens
QMethyltestosterone
QTestosterone

Question 17

Do not initiate systemic estrogen (e.g., oral tablets or transdermal
patch). Consider deprescribing among older women already using
this medication. Vaginal cream or vaginal tablets: acceptable to
use low-dose intravaginal estrogen for management of dyspareunia,
recurrent lower urinary tract infections, and other vaginal symptoms.
Evidence of carcinogenic potential (breast and endometrium); lac

Answer 17

Estrogens with or
without progestins
(includes natural and
synthetic estrogen
preparations)

Question 18

Avoid
Higher risk of hypoglycemia without improvement in hyperglycemia
management regardless of care setting

Answer 18

Avoid insulin regimens that
include only short- or rapid-acting insulin dosed according to current
blood glucose levels without concurrent use of basal or long-acting
insulin.

Question 19

Avoid sulfonylureas as first- or second-line monotherapy or add-on
therapy unless there are substantial barriers to use of safer and
more effective agents. If a sulfonylurea is used, choose short-acting
agents (e.g., glipizide) over long-acting agents (e.g., glyburide,
glimepiride).

Answer 19

Sulfonylureas (all,
including short- and
longer-acting)
QGliclazide
QGlimepiride
QGlipizide
QGlyburide
(Glibenclamide)

Question 20

Megestrol
Hormona de crecimiento

Answer 20

Avoid, except for patients rigorously diagnosed by evidence-based
criteria with growth hormone deficiency due to an established
etiology.

Question 21

Avoid scheduled use for >8 weeks unless for high-risk patients (e.g.,
oral corticosteroids or chronic NSAID use), erosive esophagitis,
Barrett’s esophagitis, pathologic hypersecretory condition, or
demonstrated need for maintenance treatment (e.g., because of
failure of drug discontinuation trial or H2-receptor antagonists).

Answer 21

Proton-pump
inhibitors
Q Dexlansoprazole
Q Esomeprazole
Q Lansoprazole
QOmeprazole
QPantoprazole
Q Rabeprazole

Question 22

Avoid, unless for gastroparesis with duration of use not to exceed
12 weeks except in rare cases.

Answer 22

Metoclopramida

Question 23

Avoid for treatment of nocturia or nocturnal polyuria

Answer 23

Desmopresina

Question 24

Avoid chronic use unless other alternatives are not effective and
patient can take gastroprotective agent (proton-pump inhibitor or
misoprostol). Avoid short-term scheduled use in combination with
oral or parenteral corticosteroids, anticoagulants, or antiplatelet
agents unless other alternatives are not effective and patient can
take gastroprotective agent (proton-pump inhibitor or misoprostol)

Answer 24

Non-COX-2-selective
NSAIDs, oral:

Question 25

Avoid Increased risk of GI bleeding/peptic ulcer disease and acute kidney injury in older adults. Of all the NSAIDs, indomethacin has the most adverse effects, including higher risk of adverse CNS effects

Answer 25

Indomethacin Ketorolac (oral and parenteral)