Older adults, these seven categories of drugs may increase the risk of falls

With the onset of fall and winter, there has been a gradual increase in the number of older people seeking medical attention for falls. Falls are a common injury in the elderly, causing fractures and head injuries, which can seriously affect their physical and mental health and quality of life.

There are thousands of reasons for falls, but have you ever thought that the elderly fall, may be caused by drugs? Let Liu Juan, a clinical pharmacist in the pharmacy department of Shanghai Seventh People's Hospital, tell you about these drugs.

Sedative and hypnotic drugs

This is often referred to as "sleeping pills", sedative and hypnotic drugs are mainly divided into two categories:

The first category is the benzodiazepine, such as eszopiclone, clonazepam, diazepam, alprazolam and so on. The second major category is the non-benzodiazepines, such as dexzopiclone, zopiclone, and zolpidem.

Sedative-hypnotics may cause drowsiness, dizziness, and slowed reflexes in older adults, which can lead to falls. To prevent falls caused by sedative-hypnotics and to treat insomnia in older adults, it is recommended that a non-pharmacologic approach be preferred.

The risk of falls from benzodiazepines is relatively higher compared to the two major classes of sedative-hypnotics. If medication is necessary, it is recommended that non-benzodiazepines be preferred, that long-term use be avoided, and that medication be taken at night, preferably after bedtime. Falls from sedative-hypnotics generally occur when the medication is changed, when the dose is altered, when one goes to the bathroom at night, and when one gets out of bed in the morning, so older adults should be especially aware of the risk of falls during these times.

Antidepressants

Studies have shown that patients taking antidepressants are half as likely to have recurrent falls as those not taking them!

Common side effects of these drugs, such as sedation, dizziness, upright hypotension, and bradykinesia, tend to trigger falls.

Of the commonly used antidepressants on the market today, amitriptyline and mirtazapine have a higher risk of triggering a fall, and older people should try to avoid these two drugs. All antidepressants require slow dose adjustments, use the smallest effective dose, and be given at bedtime.

Antipsychotics

There are many different types of antipsychotics, each of which causes falls for different reasons, such as haloperidol, which triggers Parkinson's disease-like symptoms, delayed dyskinesia, and olanzapine and clozapine, which tend to produce sedation. Older adults need to use the smallest possible dose of antipsychotic medications, as well as individualize the choice of medication under the guidance of medical staff.

Antiepileptic drugs

Epilepsy disorders themselves are prone to the occurrence of falls, and antiepileptic drugs can cause adverse effects such as confusion, blurred vision, unsteady gait, dizziness, drowsiness, and sleepiness, which increase the risk of falls.

In addition antiepileptic drugs in the long-term use of the process will occur in bone loss, further increasing the risk of falls and even fractures, the family has the use of antiepileptic drugs in the elderly, need to regularly monitor the bone mineral density, prevention and treatment of osteoporosis.

Digoxin

Digoxin can increase the risk of falls by causing adverse effects such as sudden arrhythmia, dizziness, and psychiatric disorders. Older adults have a lower tolerance for digoxin and need to be careful to reduce the dose used. To prevent falls, it is recommended that the daily dose of digoxin in the elderly should not exceed 0.125 mg.

Blood pressure-lowering medications

Blood pressure-lowering medications cause falls mainly because of low blood pressure, especially upright hypotension, which is characterized by dizziness, blackness, and even fainting when standing up quickly.

Therefore, it is important to monitor blood pressure during the use of antihypertensive medications, especially within 2 weeks of changing or adjusting the type or dose of antihypertensive medication, as the risk of falls is greatest within 2 weeks. In order to avoid upright hypotension, the elderly should pay attention to slowly change the position in daily life, such as when getting up, sit in bed for a while before standing up.

Glucose-lowering medications

The most common adverse effect of glucose-lowering medications is hypoglycemia, which can lead to falls, especially in patients using insulin and sulfonylureas (medications with the word "gli" in the name such as gliclazide and glimepiride).

During the use of hypoglycemic drugs, it is necessary to monitor blood glucose frequently, adjust the dose of hypoglycemic drugs under the guidance of medical personnel, and in order to prevent hypoglycemia, it is recommended to keep some candies or chocolates with you.

In short, when the elderly take the above medicines, it is important to follow the doctor's instructions, use the medicines reasonably, and understand the possible adverse reactions and precautions of various types of drugs, so as to minimize the risk of falling.

Responsibility Yang Linyu

Source Pudong Publishing