Pocket Guide for Medication Prescribing for Older Adults Polypharmacy Quick Facts ≥6 meds80% chance of drug-drug interaction 1/5 admissions for patients ≥65 years old is linked to adverse drug event Highest risk: anticoagulants, DM meds, digoxin General Considerations Try non-pharmacologics first With any new med: Start Low, Go Slow Avoid prescribing cascades Medication appropriateness guide: AGS Beers List (http://www.americangeriatrics.org/files/documents/beers/2012AGSBeersCriteriaCitations.pdf) Suggested Medications for Common Complaints Constipation Docusate, senokot, polyethylene glycol Depression/ anxiety Sertraline, citalopram Diarrhea/IBS Psyllium GERD PPIs Insomnia Trazodone 25-50 mg or mirtazapine 7.5-15 mg Nausea Ondansetron Pain Acetaminophen, topical anesthetics Pruritus Topical steroids

Pocket Guide for Medication Prescribing for Older Adults Medications Causing Common Complaints Medications to Avoid Supported by the Geriatric Medicine Donald W. Reynolds Foundation Constipation/impaction CCB, anticholinergics, opiates, incontinence meds Delirium/AMS TCAs, anticholinergics, benzos, opiates, steroids, sleep aids Falls Anticholinergics, antiHTNs, sleep aids, antipsychotics, TCAs, SSRIs Urinary Retention Anticholinergics, incontinence meds, a-blocker deficiency Card Digoxin, clonidine GI/GU H2 blockers, oxybutynin, metoclopramide, prochlorperazine, promethazine, diphenoxylate/atropine Pain Chronic NSAIDs, ketorolac, meperidine, muscle relaxants Pulm Theophylline Psych Benzos, TCAs, antipsychotics Misc Doxepin, meclizine, diphenhydramine