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Medicines: The Good and the Bad

Sensational Seniors

An expert panel convened by the Federal Agency for Healthcare Research and Quality recently identified 33 drugs, including the common ones listed below, that seniors should always, almost always, or usually avoid except in a hospital; for all those drugs, there are safer, often more effective alternatives.

Different drugs in bottles

The drugs listed below can cause side effects and cause particular problems in seniors. If you are age 65 or older and take any of the drugs that seniors should avoid, call your doctor as soon as possible. If you take one of the other drugs, ask your doctor whether it is truly appropriate for you.

DRUG CHIEF RISKS COMMENTS
ALWAYS AVOID
Anti-Anxiety Drug:
Meprobamate (Equanil, Meprospan, Probate, Trancot)
Confusion
Dizziness
Risks always outweigh benefits
Antispasmodics:
Dicyclomine (Bentyl, Di-Spaz) Hyoscyamine (Anaspaz, Gastrosed, Levbid)
Same as above Same as above
Pain Reliever:
Pentazocine (Talwin, Talwin-Nx
Same as above Same as above
Sedatives:
Butabarbital (Butalan, Butisol Flurazepam (Dalmane) Pentobarbital (Nembutal) Secobarbital (Seconal)
Same as above Same as above
ALMOST ALWAYS AVOID
Anti-Anxiety Drugs:
Chlordiazepoxide (Librium) Diazepam (Valium)
Confusion, Falls Sedation May be used briefly to treat alcohol withdrawal, or, with diazepam, possibly muscle spasms.
Muscle Relaxants:
Carisoprodol (Soma, Vanadom) Cyclobenzaprine (Flexeril) Methocarbamol (Carbacot, Robaxin
Constipation, sedation, urine retention May possibly be used briefly to treat acute back pain in otherwise healthy senior citizens.
Pain Reliever:
Propoxyphene (Cotanal-65, Darvon)
Addiction
Sedation
Not suitable to treat new pain can by used by those who've already taken it without problems.
USUALLY AVOID
Antiarrhythmia:
Disopyramide (Persantine)
Constipation
Sedation
Urine Retention
Suitable only when alternatives have failed.
Anticlotting Drug:
Dipyridamole (Persantine)
Very low blood pressure, low white-blood-cell count. Dipyridamole sometimes suitable for people with artificial heart valves.
Antidepressants:
Amitriptyline (Elavil, Endep) Doxepin (Sinequan)
Constipation
Sedation
Urine Retention
Low doses of amitryptyline suitable for neuropathic pain and occasionally for urinary incontinence. Doxepin possibly suitable for agitated depression in otherwise healthy senior citizens.
Antihistamines:
Chlorpheniramine (Chlor-Trimeton Diphenhydramine (Benadryl Allergy, Sominex) Hydroxyzine (Atarax, Vistaril) Promethazine (Pentazine, Promet)
Same as above. Suitable for allergic reaction but not sedation.
Antispasmodic:
Oxybutynin (Ditropan)
Same as above. Possibly suitable for stress incontinence but not for stomach spasms.
Pain Reliever:
Indomethacin (Indocin, Indocin SR)
Confusion
Dizziness
Fluid Retention
Possibly suitable for gout, but there are better alternatives.

 

Did You Know?

You should be careful what we ask for. Ads are everywhere on television and in newspapers and magazines, "Ask your doctor" about a new medicine, they tell us. The ads extol the ability of the new product to cure everything from the life threatening to the trivial. What happens when people do ask their doctors about the drug? More often than not they get prescribed that very medication. Instead of asking your doctor about specific drugs, you are better off asking about your condition and seeing if the doctor thinks medications are needed.

The Food and Drug Administration found that when patients ask their doctors about a drug they have seen advertised, 69 percent of the time the doctor will prescribe the advertised medicine.

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