DOCSLIB.ORG

HIGH RISK MEDICATIONS As Specified by NCQA’S HEDIS Measure: Use of High Risk Medications in the Elderly

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
HIGH RISK MEDICATIONS As Specified by NCQA’S HEDIS Measure: Use of High Risk Medications in the Elderly HIGH RISK MEDICATIONS as specified by NCQA’s HEDIS Measure: Use of High Risk Medications in the Elderly Description Prescription Antianxiety (includes • aspirin-meprobamate • meprobamate combination drugs) Antiemetics • scopolamine • trimethobenzamide Analgesics (includes • acetaminophen-diphenhydramine • ketorolac combination drugs) • diphenhydramine-magnesium salicylate Antihistamines (includes • APAP/dextromethorphan/diphenhydramine • dexchlorpheniramine-pseudoephedrine combination drugs) • APAP/diphenhydramine/phenylephrine • dextromethorphan-promethazine • APAP/diphenhydramine/pseudoephedrine • diphenhydramine • acetaminophen-diphenhydramine • diphenhydramine/hydrocodone/phenylephrine • atropine/CPM/hyoscyamine/PE/PPA/scopolamine • diphenhydramine-tripelennamine • carbetapentane/diphenhydramine/phenylephrine • diphenhydramine-magnesium salicylate • codeine/phenylephrine/promethazine • diphenhydramine-phenylephrine • codeine-promethazine • diphenhydramine-pseudoephedrine • cyproheptadine • hydroxyzine hydrochloride • dexchlorpheniramine • hydroxyzine pamoate • dexchlorpheniramine/dextromethorphan/PSE • phenylephrine-promethazine • dexchlorpheniramine/guaifenesin/PSE • promethazine • dexchlorpheniramine/hydrocodone/phenylephrine • tripelennamine • dexchlorpheniramine/methscopolamine/PSE Antipsychotic, typical • mesoridazine • thioridazine Amphetamines • amphetamine- • dextroamphetamine • pemoline dextroamphetamine • diethylpropion • phendimetrazine • benzphetamine • methamphetamine • phentermine • dexmethylphenidate • methylphenidate Barbiturates • amobarbital • mephobarbital • secobarbital • amobarbital-secobarbital • pentobarbital • butabarbital • phenobarbital Long-acting benzodiazepines • amitriptyline-chlordiazepoxide • chlordiazepoxide-clidinium • flurazepam (includes combination drugs) • chlordiazepoxide • diazepam Calcium channel blockers • nifedipine—short-acting only Gastrointestinal • dicyclomine • propantheline antispasmodics Belladonna alkaloids • atropine • belladonna/ergotamine/phenobarbital (includes combination drugs) • atropine/hyoscyamine/PB/scopolamine • butabarbital/hyoscyamine/phenazopyridine • atropine-difenoxin • digestive enzymes/hyoscyamine/ • atropine-diphenoxylate phenyltoloxamine • atropine-edrophonium • hyoscyamine • belladonna • hyoscyamine/methenam/m-blue/phenyl salicyl • belladonna/caffeine/ergotamine/pentobarbital • hyoscyamine-phenobarbital Skeletal muscle relaxants • ASA/caffeine/orphenadrine • aspirin-methocarbamol • metaxalone (includes combination drugs) • ASA/carisoprodol/codeine • carisoprodol • methocarbamol • aspirin-carisoprodol • chlorzoxazone • orphenadrine • aspirin-meprobamate • cyclobenzaprine Oral estrogens (includes • conjugated estrogen • esterified estrogen • estropipate combination drugs) • conjugated estrogen- • esterified estrogen- medroxyprogesterone methyltestosterone Oral hypoglycemics • chlorpropamide Narcotics (includes • ASA/caffeine/propoxyphene • meperidine-promethazine combination drugs) • acetaminophen-pentazocine • naloxone-pentazocine • acetaminophen-propoxyphene • pentazocine • belladonna-opium • propoxyphene hydrochloride • meperidine • propoxyphene napsylate • cyclandelate • ergot mesyloid Vasodilators • dipyridamole—short-acting only • isoxsuprine Others (including androgens • methyltestosterone • nitrofurantoin macrocrystals- and anabolic steroids, thyroid • nitrofurantoin monohydrate drugs, urinary anti-infectives) • nitrofurantoin macrocrystals • thyroid desiccated .
Load more

Recommended publications
  • Table 2. 2012 AGS Beers Criteria for Potentially
    Table 2. 2012 AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults Strength of Organ System/ Recommendat Quality of Recomm Therapeutic Category/Drug(s) Rationale ion Evidence endation References Anticholinergics (excludes TCAs) First-generation antihistamines Highly anticholinergic; Avoid Hydroxyzin Strong Agostini 2001 (as single agent or as part of clearance reduced with e and Boustani 2007 combination products) advanced age, and promethazi Guaiana 2010 Brompheniramine tolerance develops ne: high; Han 2001 Carbinoxamine when used as hypnotic; All others: Rudolph 2008 Chlorpheniramine increased risk of moderate Clemastine confusion, dry mouth, Cyproheptadine constipation, and other Dexbrompheniramine anticholinergic Dexchlorpheniramine effects/toxicity. Diphenhydramine (oral) Doxylamine Use of diphenhydramine in Hydroxyzine special situations such Promethazine as acute treatment of Triprolidine severe allergic reaction may be appropriate. Antiparkinson agents Not recommended for Avoid Moderate Strong Rudolph 2008 Benztropine (oral) prevention of Trihexyphenidyl extrapyramidal symptoms with antipsychotics; more effective agents available for treatment of Parkinson disease. Antispasmodics Highly anticholinergic, Avoid Moderate Strong Lechevallier- Belladonna alkaloids uncertain except in Michel 2005 Clidinium-chlordiazepoxide effectiveness. short-term Rudolph 2008 Dicyclomine palliative Hyoscyamine care to Propantheline decrease Scopolamine oral secretions. Antithrombotics Dipyridamole, oral short-acting* May
    [Show full text]
  • CHLORZOXAZONE- Chlorzoxazone Tablet DIRECT RX ------CHLORZOXAZONE
    CHLORZOXAZONE- chlorzoxazone tablet DIRECT RX ---------- CHLORZOXAZONE DESCRIPTION SECTION Chlorzoxazone USP is a centrally acting skeletal muscle relaxant, available as tablets of 500 mg for oral administration. Its chemical name is 5-Chloro-2-benzoxazolinone, and its structural formula is: C7H4CINO2 MW 169.57 Chlorzoxazone USP is a white or practically white, practically odorless, crystalline powder. Chlorzoxazone is slightly soluble in water; sparingly soluble in alcohol, in isopropyl alcohol, and in methanol; soluble in solutions of alkali hydroxides and ammonia. Chlorzoxazone tablets contain the inactive ingredients Docusate Sodium, Lactose (hydrous), Magnesium Stearate, Microcrystalline Cellulose, Pregelatinized Starch, Sodium Benzoate, and Sodium Starch Glycolate. CLINICAL PHARMACOLOGY SECTION Chlorzoxazone is a centrally-acting agent for painful musculoskeletal conditions. Data available from animal experiments as well as human study indicate that chlorzoxazone acts primarily at the level of the spinal cord and subcortical areas of the brain where it inhibits multisynaptic reflex arcs involved in producing and maintaining skeletal muscle spasm of varied etiology. The clinical result is a reduction of the skeletal muscle spasm with relief of pain and increased mobility of the involved muscles. Blood levels of chlorzoxazone can be detected in people during the first 30 minutes and peak levels may be reached, in the majority of the subjects, in about 1 to 2 hours after oral administration of chlorzoxazone. Chlorzoxazone is rapidly metabolized and is excreted in the urine, primarily in a conjugated form as the glucuronide. Less than one percent of a dose of chlorzoxazone is excreted unchanged in the urine in 24 hours. INDICATIONS & USAGE SECTION Chlorzoxazone is indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions.
    [Show full text]
  • LORZONE- Chlorzoxazone Tablet Vertical Pharmaceuticals , LLC ---For Painful Musculoskeletal Conditions PRESCRIBING INFOR
    LORZONE- chlorzoxazone tablet Vertical Pharmaceuticals , LLC ---------- For Painful Musculoskeletal Conditions PRESCRIBING INFORMATION DESCRIPTION Each 375 mg Lorzone® tablet contains: chlorzoxazone USP 375 mg. Each 750 mg Lorzone® tablet contains: chlorzoxazone USP 750 mg. Chemical Name: 5-Chloro-2-benzoxazolinone. Structural Formula: Molecular Formula: C7H4CINO2 Molecular Weight: 169.56 Chlorzoxazone USP is a white or practically white, practically odorless, crystalline powder. Chlorzoxazone is slightly soluble in water; sparingly soluble in alcohol, in isopropyl alcohol, and in methanol; soluble in solutions of alkali hydroxides and ammonia. Inactive ingredients: anhydrous lactose, croscarmellose sodium, docusate sodium, magnesium stearate, microcrystalline cellulose, pregelatinized corn starch and sodium benzoate. CLINICAL PHARMACOLOGY Chlorzoxazone is a centrally-acting agent for painful musculoskeletal conditions. Data available from animal experiments as well as human study indicate that chlorzoxazone acts primarily at the level of the spinal cord and subcortical areas of the brain where it inhibits multisynaptic reflex arcs involved in producing and maintaining skeletal muscle spasm of varied etiology. The clinical result is a reduction of the skeletal muscle spasm with relief of pain and increased mobility of the involved muscles. Blood levels of chlorzoxazone can be detected in people during the first 30 minutes and peak levels may be reached, in the majority of the subjects, in about 1 to 2 hours after oral administration of chlorzoxazone. Chlorzoxazone is rapidly metabolized and is excreted in the urine, primarily in a conjugated form as the glucuronide. Less than one percent of a dose of chlorzoxazone is excreted unchanged in the urine in 24 hours. INDICATIONS AND USAGE Lorzone® is indicated as an adjunct to rest, physical therapy, and other measures for the relief of discomfort associated with acute, painful musculoskeletal conditions.
    [Show full text]
  • Product Information
    PRODUCT INFORMATION NAME OF THE MEDICINE POLARAMINE® (dexchlorpheniramine maleate) DESCRIPTION Polaramine (dexchlorpheniramine maleate) is the dextro-isomer of chlorpheniramine maleate. It is an antihistamine with anticholinergic properties Dexchlorpheniramine maleate (CAS no. 2438-32-6) is described chemically as (+)-2-[p- chloro-α-[2-(dimethylamino)ethyl]benzyl]pyridine maleate (1:1). It has the empirical formula of C16H19ClN2.C4H4O4 and the following structural formula: Dexchlorpheniramine maleate is a white, odourless, crystalline powder which in aqueous solution has a pH of between 4 and 5. It is freely soluble in water, soluble in alcohol and in chloroform, but only slightly soluble in benzene or ether. PHARMACOLOGY Pharmacodynamics Mechanism of Action: Dexchlorpheniramine, the d-isomer of the racemic compound chlorpheniramine, is two times more active than chlorpheniramine. Dexchlorpheniramine does not prevent the release of histamine, but rather, competes with free histamine for binding at the H1-receptor sites, and competitively antagonizes the effects of histamine on H1-receptors in the GI tract, uterus, large blood vessels, and bronchial muscle. Blockade of H1-receptors also suppresses the formation of oedema, flare, and pruritus that result from histaminic activity. Since dexchlorpheniramine binds to central and peripheral H1-receptors, sedative effects are likely to occur. H1-antagonists are structurally similar to anticholinergic agents and therefore possess the potential to exhibit anticholinergic properties of varying
    [Show full text]
  • Report Update 1
    Drug Class Review on Newer Antihistamines Final Report Update 1 April 2006 Original Report Date: November 2004 A literature scan of this topic is done periodically The purpose of this report is to make available information regarding the comparative effectiveness and safety profiles of different drugs within pharmaceutical classes. Reports are not usage guidelines, nor should they be read as an endorsement of, or recommendation for, any particular drug, use or approach. Oregon Health & Science University does not recommend or endorse any guideline or recommendation developed by users of these reports. Oregon Evidence-based Practice Center Oregon Health & Science University Mark Helfand, MD, MPH, Director Copyright © 2006 by Oregon Health & Science University Portland, Oregon 97201. All rights reserved. Note: A scan of the medical literature relating to the topic is done periodically (see http://www.ohsu.edu/ohsuedu/research/policycenter/DERP/about/methods.cfm for scanning process description). Upon review of the last scan, the Drug Effectiveness Review Project governance group elected not to proceed with another full update of this report. Some portions of the report may not be up to date. Prior version of this report can be accessed at the DERP website. Final Report Update #1 Drug Effectiveness Review Project TABLE OF CONTENTS INTRODUCTION.............................................................................................................................................................4 SCOPE AND KEY QUESTIONS.............................................................................................................................6
    [Show full text]
  • Drugs to Avoid in Patients with Dementia
    Detail-Document #240510 -This Detail-Document accompanies the related article published in- PHARMACIST’S LETTER / PRESCRIBER’S LETTER May 2008 ~ Volume 24 ~ Number 240510 Drugs To Avoid in Patients with Dementia Elderly people with dementia often tolerate drugs less favorably than healthy older adults. Reasons include increased sensitivity to certain side effects, difficulty with adhering to drug regimens, and decreased ability to recognize and report adverse events. Elderly adults with dementia are also more prone than healthy older persons to develop drug-induced cognitive impairment.1 Medications with strong anticholinergic (AC) side effects, such as sedating antihistamines, are well- known for causing acute cognitive impairment in people with dementia.1-3 Anticholinergic-like effects, such as urinary retention and dry mouth, have also been identified in drugs not typically associated with major AC side effects (e.g., narcotics, benzodiazepines).3 These drugs are also important causes of acute confusional states. Factors that may determine whether a patient will develop cognitive impairment when exposed to ACs include: 1) total AC load (determined by number of AC drugs and dose of agents utilized), 2) baseline cognitive function, and 3) individual patient pharmacodynamic and pharmacokinetic features (e.g., renal/hepatic function).1 Evidence suggests that impairment of cholinergic transmission plays a key role in the development of Alzheimer’s dementia. Thus, the development of the cholinesterase inhibitors (CIs). When used appropriately, the CIs (donepezil [Aricept], rivastigmine [Exelon], and galantamine [Razadyne, Reminyl in Canada]) may slow the decline of cognitive and functional impairment in people with dementia. In order to achieve maximum therapeutic effect, they ideally should not be used in combination with ACs, agents known to have an opposing mechanism of action.1,2 Roe et al studied AC use in 836 elderly patients.1 Use of ACs was found to be greater in patients with probable dementia than healthy older adults (33% vs.
    [Show full text]
  • Thioridazine Induces Apoptosis of Multidrug-Resistant Mouse Lymphoma Cells Transfected with the Human ABCB1 and Inhibits the Expression of P-Glycoprotein
    ANTICANCER RESEARCH 31: 4201-4206 (2011) Thioridazine Induces Apoptosis of Multidrug-resistant Mouse Lymphoma Cells Transfected with the Human ABCB1 and Inhibits the Expression of P-Glycoprotein GABRIELLA SPENGLER1,3, JOSEPH MOLNAR1, MIGUEL VIVEIROS2,4 and LEONARD AMARAL2,3,4 1Institute of Medical Microbiology and Immunobiology, Faculty of Medicine, University of Szeged, Szeged, Hungary; 2Group of Mycobacteriology, Unit of Microbiology and 3Unit of Parasitology and Medical Microbiology (UPMM), Institute of Hygiene and Tropical Medicine, Universidade Nova de Lisboa, Lisboa, Portugal; 4Cost Action BM0701 (ATENS) of the European Commission, Brussels, Belgium Abstract. Aim: Chlorpromazine has activity against a large therapeutic aspects, and low availability of effective but also variety of cancer types. However, this phenothiazine produces costly forms of therapy (chemotherapy, radiotherapy). a plethora of serious side-effects. We have studied thioridazine Regardless of economic support, chemotherapy of cancer is (TZ), a phenothiazine neuroleptic that is much milder, for highly problematic, especially when therapy promotes the activity against multidrug-resistant (MDR) cancer cells, as development of multidrug resistance (MDR), hence cancer well as against the overexpressed ABCB1 transporter (P- becomes refractory not only to the initial chemotherapeutic glycoprotein) that is the cause for the MDR phenotype of these agent, but to many other anticancer drugs as well (1, 2). The cancer cells. Materials and Methods: MDR mouse T- development of an MDR phenotype of cancer cell has been lymphoma cells, transfected with the human gene ABCB1 that known for many decades to be due to the overexpression of codes for the transporter ABCB1, were incubated with TZ for transporters that extrude the anticancer agent before it various periods of time and examined for evidence of reaches its intended target (3).
    [Show full text]
  • FDA Approved Drugs with Broad Anti-Coronaviral Activity Inhibit SARS-Cov-2 in Vitro
    bioRxiv preprint doi: https://doi.org/10.1101/2020.03.25.008482; this version posted March 27, 2020. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity. It is made available under aCC-BY-NC-ND 4.0 International license. FDA approved drugs with broad anti-coronaviral activity inhibit SARS-CoV-2 in vitro Stuart Weston1, Rob Haupt1, James Logue1, Krystal Matthews1 and Matthew B. Frieman*1 1 - Department of Microbiology and Immunology, University of Maryland School of Medicine, 685 W. Baltimore St., Room 380, Baltimore, MD, 21201, USA *Corresponding author. Email: [email protected] Key words: SARS-CoV-2, nCoV-2019, COVID-19, drug repurposing, FDA approved drugs, antiviral therapeutics, pandemic, chloroquine, hydroxychloroquine AbstraCt SARS-CoV-2 emerged in China at the end of 2019 and has rapidly become a pandemic with over 400,000 recorded COVID-19 cases and greater than 19,000 recorded deaths by March 24th, 2020 (www.WHO.org) (1). There are no FDA approved antivirals or vaccines for any coronavirus, including SARS-CoV-2 (2). Current treatments for COVID-19 are limited to supportive therapies and off-label use of FDA approved drugs (3). Rapid development and human testing of potential antivirals is greatly needed. A potentially quicker way to test compounds with antiviral activity is through drug re-purposing (2, 4). Numerous drugs are already approved for use in humans and subsequently there is a good understanding of their safety profiles and potential side effects, making them easier to test in COVID-19 patients.
    [Show full text]
  • Nomination Background: Ketamine Hydrochloride (CASRN: 1867-66-9)
    KETAMINE Nomination TABLE OF CONTENTS Page 1.0 BASIS OF NOMINATION 1 2.0 BACKGROUND INFORMATION 1 3.0 CHEMICAL PROPERTIES 2 3.1 Chemical Identification 2 3.2 Physico-Chemical Properties 3 3.3 Purity and Commercial Availability 4 4.0 PRODUCTION PROCESSES AND ANALYSIS 6 5.0 PRODUCTION AND IMPORT VOLUMES 7 6.0 USES 7 7.0 ENVIRONMENTAL OCCURRENCE 7 8.0 HUMAN EXPOSURE 7 9.0 REGULATORY STATUS 7 10.0 CLINICAL PHARMACOLOGY 7 11.0 TOXICOLOGICAL DATA 13 11.1 General Toxicology 13 11.2 Neurotoxicology 14 12.0 CONCLUSIONS 15 APPENDIX A 17 APPENDIX B 23 APPENDIX C 27 1 KETAMINE 1.0 BASIS OF NOMINATION Ketamine, a noncompetitive NMDA receptor blocker, has been used extensively off - label as a pediatric anesthetic for surgical procedures in infants and toddlers. Recently, Olney and coworkers have demonstrated severe widespread apoptotic degeneration throughout the rapidly developing brain of the 7-day-old rat after ketamine administration. Recent research at FDA has confirmed and extended Olney’s observations. These findings are cause for concern with respect to ketamine use in children. The issue of whether the neurotoxicity found in this animal model (rat) has scientific and regulatory relevance for the pediatric use of ketamine relies heavily upon confirmation of these findings that may be obtained from the conduct of an appropriate study in non-human primates. 2.0 BACKGROUND INFORMATION The issue of potential ketamine neurotoxicity in children surfaced as a result of FDA’s reluctance to approve an NIH pediatric clinical trial using this compound because of its documented neurotoxic effects in young rats (published in several papers over the last ten years by Olney and co-workers).
    [Show full text]
  • A Drug Repositioning Approach Identifies Tricyclic Antidepressants As Inhibitors of Small Cell Lung Cancer and Other Neuroendocrine Tumors
    Published OnlineFirst September 26, 2013; DOI: 10.1158/2159-8290.CD-13-0183 RESEARCH ARTICLE A Drug Repositioning Approach Identifi es Tricyclic Antidepressants as Inhibitors of Small Cell Lung Cancer and Other Neuroendocrine Tumors Nadine S. Jahchan 1 , 2 , Joel T. Dudley 1 , Pawel K. Mazur 1 , 2 , Natasha Flores 1 , 2 , Dian Yang 1 , 2 , Alec Palmerton 1 , 2 , Anne-Flore Zmoos 1 , 2 , Dedeepya Vaka 1 , 2 , Kim Q.T. Tran 1 , 2 , Margaret Zhou 1 , 2 , Karolina Krasinska 3 , Jonathan W. Riess 4 , Joel W. Neal 5 , Purvesh Khatri 1 , 2 , Kwon S. Park 1 , 2 , Atul J. Butte 1 , 2 , and Julien Sage 1 , 2 Downloaded from cancerdiscovery.aacrjournals.org on September 29, 2021. © 2013 American Association for Cancer Research. Published OnlineFirst September 26, 2013; DOI: 10.1158/2159-8290.CD-13-0183 ABSTRACT Small cell lung cancer (SCLC) is an aggressive neuroendocrine subtype of lung cancer with high mortality. We used a systematic drug repositioning bioinformat- ics approach querying a large compendium of gene expression profi les to identify candidate U.S. Food and Drug Administration (FDA)–approved drugs to treat SCLC. We found that tricyclic antidepressants and related molecules potently induce apoptosis in both chemonaïve and chemoresistant SCLC cells in culture, in mouse and human SCLC tumors transplanted into immunocompromised mice, and in endog- enous tumors from a mouse model for human SCLC. The candidate drugs activate stress pathways and induce cell death in SCLC cells, at least in part by disrupting autocrine survival signals involving neurotransmitters and their G protein–coupled receptors. The candidate drugs inhibit the growth of other neuroendocrine tumors, including pancreatic neuroendocrine tumors and Merkel cell carcinoma.
    [Show full text]
  • The Anticholinergic Toxidrome
    Poison HOTLINE Partnership between Iowa Health System and University of Iowa Hospitals and Clinics July 2011 The Anticholinergic Toxidrome A toxidrome is a group of symptoms associated with poisoning by a particular class of agents. One example is the opiate toxidrome, the triad of CNS depression, respiratory depression, and pinpoint pupils, and which usually responds to naloxone. The anticholinergic toxidrome is most frequently associated with overdoses of diphenhydramine, a very common OTC medication. However, many drugs and plants can produce the anticholinergic toxidrome. A partial list includes: tricyclic antidepressants (amitriptyline), older antihistamines (chlorpheniramine), Did you know …… phenothiazines (promethazine) and plants containing the anticholinergic alkaloids atropine, hyoscyamine and scopolamine (Jimson Weed). Each summer, the ISPCC receives approximately 10-20 The mnemonic used to help remember the symptoms and signs of this snake bite calls, some being toxidrome are derived from the Alice in Wonderland story: from poisonous snakes (both Blind as a Bat (mydriasis and inability to focus on near objects) local and exotic). Red as a Beet (flushed skin color) Four poisonous snakes can be Hot as Hades (elevated temperature) found in Iowa: the prairie These patients can sometimes die of agitation-induced hyperthermia. rattlesnake, the massasauga, Dry as a Bone (dry mouth and dry skin) the copperhead, and the Mad as a Hatter (hallucinations and delirium) timber rattlesnake. Each Bowel and bladder lose their tone (urinary retention and constipation) snake has specific territories Heart races on alone (tachycardia) within the state. ISPCC A patient who has ingested only an anticholinergic substance and is not specialists have access to tachycardic argues against a serious anticholinergic overdose.
    [Show full text]
  • 3 Drugs That May Cause Delirium Or Problem Behaviors CARD 03 19 12 JUSTIFIED.Pub
    Drugs that May Cause Delirium or Problem Behaviors Drugs that May Cause Delirium or Problem Behaviors This reference card lists common and especially problemac drugs that may Ancholinergics—all drugs on this side of the card. May impair cognion cause delirium or contribute to problem behaviors in people with demena. and cause psychosis. Drugs available over‐the‐counter marked with * This does not always mean the drugs should not be used, and not all such drugs are listed. If a paent develops delirium or has new problem Tricyclic Andepressants Bladder Anspasmodics behaviors, a careful review of all medicaons is recommended. Amitriptyline – Elavil Darifenacin – Enablex Be especially mindful of new medicaons. Clomipramine – Anafranil Flavoxate – Urispas Desipramine – Norpramin Anconvulsants Psychiatric Oxybutynin – Ditropan Doxepin – Sinequan Solifenacin – VESIcare All can cause delirium, e.g. All psychiatric medicaons should be Imipramine – Tofranil Tolterodine – Detrol Carbamazepine – Tegretol reviewed as possible causes, as Nortriptyline – Aventyl, Pamelor Gabapenn – Neuronn effects are unpredictable. Trospium – Sanctura Anhistamines / Allergy / Leveracetam – Keppra Notable offenders include: Insomnia / Sleep Valproic acid – Depakote Benzodiazepines e.g. Cough & Cold Medicines *Diphenhydramine – Sominex, ‐Alprazolam – Xanax *Azelasne – Astepro Pain Tylenol‐PM, others ‐Clonazepam – Klonopin *Brompheniramine – Bromax, All opiates can cause delirium if dose *Doxylamine – Unisom, Medi‐Sleep ‐Lorazepam – Avan Bromfed, Lodrane is too high or
    [Show full text]