Medications to Avoid in the Elderly
Mr. J is an 85-year-old man who visits his primary care physician with complaints of excessive drowsiness, confusion, and difficulty walking. He has a history of hypertension, insomnia, and chronic back pain. His current medications include:
Diazepam 5 mg at bedtime for insomnia
Lisinopril 10 mg daily for hypertension
Ibuprofen 400 mg twice daily for back pain
Over the past few months, Mr. J’s family has noticed that his memory has worsened, and he has become more prone to falls. Upon reviewing his medication list, it is found that diazepam, a benzodiazepine, and ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), are contributing to his symptoms. In elderly patients, benzodiazepines increase the risk of confusion, falls, and cognitive decline, while NSAIDs may increase the risk of gastrointestinal bleeding and kidney impairment.
The physician decides to discontinue diazepam and ibuprofen, replacing them with safer alternatives, while closely monitoring Mr. J for improvements in his cognitive and physical function.
A). Lisinopril
B). Diazepam
C). Ibuprofen
D). None of the above
A). They can cause heart problems
B). They increase the risk of confusion, falls, and cognitive decline
C). They have no effect on elderly patients
D). They cause liver damage in all elderly patients
A). Kidney impairment and gastrointestinal bleeding
B). Increased risk of blood clots
C). Increased blood sugar levels
D). Liver toxicity
A). Increase the dose of diazepam to help with his insomnia
B). Discontinue diazepam and ibuprofen and replace with safer alternatives
C). Reduce his Lisinopril dose
D). Continue his current medications and monitor his symptoms
