Beers criteria for medications to avoid in the elderly are updated.

2004 JAN 1 - (NewsRx.com & NewsRx.net) -- Forty-eight medications or classes of medications to avoid in adults age 65 or older have been identified by a expert panel in the U.S. charged with updating widely used criteria for potentially harmful medications in older adults.

Estrogen in older women and the popular over-the-counter antihistamine, Benadryl, were among those on the list to avoid in the update of the 1997 Beers Criteria, published in the December 8, 2003, issue of the Archives of Internal Medicine.

Nonsteroidal anti-inflammatory agents (NSAIDs) such as Motrin and Advil (both brand names for ibuprofen) made a second list of medications to avoid in older adults with certain medical conditions; NSAIDs and aspirin, known to increase the risk of bleeding, were listed as potentially inappropriate for people with gastric or duodenal ulcers.

Researchers also added to this list of conditions that increase patients' risk for adverse drug events. Additions included cognitive impairment, depression, Parkinson's disease, anorexia, malnutrition, and obesity.

"We realize that aging is an individualized process and there are some 65 year olds who are healthy and do fine on these medications," said Donna M. Fick, MD, a geriatric clinical nurse specialist and associate professor of medicine at the Medical College of Georgia in Augusta and principal author on the paper.

She and other geriatric practitioners also know that older people are at increased risk for medication-related problems, called adverse drug events, such as depression, confusion, falls, and even death.

"I don't know that there is enough evidence to tell us exactly what the reasons are, but my theory would be because generally older people are on more medicines, because they have more chronic diseases, so it's an interaction of multiple diseases plus aging changes plus the drugs they take for those diseases," said Fick, who also directs MCG's Center for Health Care Improvement.