DRUGS CAUSING FALLS AMONG SENIORS

High risk drugs

Moderate risk

Low risk

Antidepressants, esp. tricyclics such as amitriptyline; SSRIs are less problematic

ACE inhibitors, esp. when combined with diuretics

Calcium channel blockers; lower for once daily dihydropyridine such as felodipine

Antipsychotics, esp. phenothiazines; risk of hypotension and Parkinson symptoms; atypicals cause less Parkinson

Alpha blockers due to hypotension

Nitrates; dizziness may be due to postural hypotension – advise patient to sit when using nitro spray or tablets

Benzodiazepines & Hypnotics, especially long-acting type; zopiclone presents less hangover effects

Anti-arrhythmics, e.g. digoxin and flecainide; dizziness

Oral anti-diabetic drugs, esp. long acting sulfonylureas (e.g. chlorpropamide); dizziness from hypoglycemia

Dopaminergic drugs used in Parkinson disease, e.g. levodopa causing sudden sleepiness; use lower maintenance dosage in seniors

Anti-epileptics, e.g. carbamazepine & phenytoin; drowsiness and dizziness

Proton pump inhibitors & H2 antagonists; dizziness, drowsiness, confusion

Anticholinergics used in urinary incontinence and Parkinson disease; oxybutynin may cause acute confusion in elderly

Antihistamines, e.g. chlorpheniramine & diphenhydramine; drowsiness

Anti-emetics; metoclopramide associated with dizziness, drowsiness, Parkinson and movement disorders

Beta blockers; postural hypotension & dizziness

Diuretics; postural hypotension, dizziness, and nighttime urination

Opiate analgesics; drowsiness and sedation; less likely with codeine