If you have an elderly person in your home, like your mother, father, grandmother, or grandfather, you probably think a little about the medications you give them, right? Sometimes when we go to a doctor, they prescribe a variety of medications . But as we age, the way our bodies respond to medications changes, and some medications may not be suitable for them. There is a list of guidelines that help doctors take care of such things. That is what we call the 'Beers Criteria.' Let's talk about this simply today.
What is this 'Beers Criteria'?
Simply put, this is a list of guidelines developed by the American Geriatrics Society , a group of experts in the health of older adults. It tells us which medications may be harmful to people over the age of 65, or which medications may have more side effects than the benefits. This list is also known as the 'Beer's List'. Think about it, surveys have shown that more than 90% of people over the age of 65 use at least one medication per month, and more than 66% use more than three medications. So at a time like this, this list will be very helpful for doctors to prescribe medications safely.
What are the five main points in the 'Beers Criteria'?
This list is based on five main factors, which doctors especially consider when prescribing a medication for an older person:
- Medications that should not be given to people over the age of 65, especially those not receiving end-of-life care such as hospice or palliative care .
- Medications that may be harmful to people with certain medical conditions (for example, kidney disease, heart disease).
- Medications that cause problems by causing drug interactions when taken with other medications.
- Medications that can cause more harm than good due to side effects .
- Medications that affect kidney function (i.e., those with renal impairment) should be given in limited doses or stopped completely.
What kind of drugs are on the 'Beers Criteria' list?
There are close to 100 types of medications on this list. It's hard to talk about them all, but to give you an idea, let's look at a few examples from several categories. At the same time, let's look at the reasons why those medications can be harmful.
- Analgesics: For example, medications like meperidine. These can cause neurotoxicity and delirium .
- Antibiotics: Some antibiotics, for example ciprofloxacin, may increase the risk of bleeding when taken with warfarin (a blood thinner).
- Antiseizure medications: Medications like carbamazepine can cause a condition called SIADH - Syndrome of inappropriate antidiuretic hormone secretion, which disrupts the body's water and salt balance.
- Antihistamines (older types): Medications like brompheniramine can cause confusion, cognitive impairment , and delirium .
- Some medications for high blood pressure (Antihypertensives): Some medications, such as `(alpha-blockers),` can cause a sudden drop in blood pressure (`(Hypotension)`) .
- Antiplatelets or anticoagulants: Medications like edoxaban can sometimes affect the kidneys (renal impairment) .
- Antipsychotics: Any medication in this class can increase the risk of stroke, cognitive decline, and delirium when given to older adults.
- Anxiolytics: Medications in the benzodiazepines group (e.g. diazepam) can slow the body's breakdown of the drug, cause decreased alertness, and cause shakiness when walking .
- Some cardiac medications: Medications like disopyramide can worsen heart failure .
- Central nervous system agents: Dimenhydrinate (found in some antiemetics) can cause confusion, decreased consciousness, and delirium .
- Some diabetes medications: Older medications like chlorpropamide can cause dangerously low blood sugar levels (hypoglycemia) .
- Gastrointestinal medications: Some medications in the ``H2-blocker'' class can make delirium worse, especially if someone already has it .
- Hormones: When estrogen is administered externally, some women may be at increased risk of breast cancer and uterine cancer .
- Some sleeping pills (hypnotics): There is a risk of addiction to drugs like barbiturates and overdose can lead to dangerous conditions .
- Musculoskeletal agents (muscle relaxers): These can cause things like confusion, dry mouth, and constipation .
- Non-steroidal anti-inflammatory drugs (NSAIDs): Medications like aspirin (more than 325 milligrams per day) can cause serious conditions such as stomach ulcers, bleeding, or perforation .
- Some respiratory medications: Medications such as atropine can cause confusion, decreased consciousness, and delirium .
- Some urinary medications: ``desmopressin`` can cause low blood sodium levels (``hyponatremia``) , which is also dangerous.
- Some medications that dilate blood vessels (vasodilators): Medications such as `(ergoloid mesylates)` may not produce the expected results .
Important: These are just a few examples. Your doctor will decide which medication is best for you. Even if you have been prescribed a medication on this list, there may be a reason for it. So don't panic, always talk to your doctor.
How often will this 'Beers Criteria' list be updated? How is it done?
This is not a one-time list that is simply put aside. The American Geriatrics Society reviews and updates this list approximately every three years.
How is it done? This is done using the latest information from new medical research and clinical trials. A team of medical experts comes together, reviews the old list, and may remove some drugs, add new ones, or change existing recommendations based on new evidence.
When do doctors use the 'Beers Criteria'?
This list is a common tool that doctors use when prescribing medications for people over 65. But it's not something you just look at and make decisions about. Your doctor will consider your complete medical history, your current health, and any other medications, vitamins, and supplements you're taking . They will then decide whether a new medication or the dosage of a current medication is safe for you. They may also need to change the medication, dosage, or frequency of administration based on this list.
What are the things to consider when using the 'Beers Criteria'?
This is a very important question. The Beers Criteria are designed for a large population . Therefore, they are not ``person-specific'' . That is, this list does not take into account a person's general health, any other illnesses they may have, or the specific factors that led a doctor to choose a particular drug.
Therefore, this is just a good tool for doctors to use. It does not make decisions for a competent, experienced doctor.
For example, if a doctor wants to give you a drug on this list that is considered potentially harmful, he or she will consider many factors, including your health and the environment in which you are being treated. Only then will he or she make the final decision as to whether the drug is safe for you. In most cases, doctors can choose an alternative to a drug on this list. However, if a drug on this list is prescribed, the doctor will monitor you closely to see if there are any side effects.
Why does the way medications affect our bodies change as we age?
This is a very important point. As we age, our bodies undergo many changes. These changes can affect the way medications are absorbed and how they work in our bodies. Here are some examples:
- It takes longer for the body to break down (metabolize) and eliminate the drug. This means that the drug may stay in your body longer. This is why doctors sometimes give older people lower doses of medication.
- A medicine for one condition can affect another. Because some medications change the way our bodies respond, they can also affect how well other treatments work.
- Lifestyle changes. Things like your activity level and the diet you eat can affect how well some medications work. So when you see a doctor, it's important to talk about your daily routine, what you eat, and whether you exercise. That way, he or she can choose the treatment that's best for you.
Doctors know our bodies very well and how they change with age. If they prescribe you a medication, they will monitor how your body responds to it to make sure it is safe.
So, what are the things we should remember from this story?
Okay, so now you probably understand that the 'Beers Criteria' we talked about is a list of important guidelines that help doctors when prescribing medications to people over the age of 65.
This helps doctors focus on medications that may be harmful to an older person and choose safer alternatives.
Remember, this is a tool for doctors, not something you should use to stop or start your own medication. If you have any questions or concerns about a medication you are taking, please talk to your doctor. He or she is the best person to give you the best advice. Listening to your own feelings is the best way to stay healthy.
` Beers Criteria, Adult Health, Medications, Side Effects, Safe Medications, Aging
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න