Beers Criteria
The Beers Criteria (or Beers List) is a list of specific medications that are generally considered inappropriate when given to elderly people. For a wide variety of individual reasons, the medications listed tend to cause side effects in the elderly due to the physiologic changes of aging. The list was originally created by geriatrician Mark H. Beers.[1] The criteria were created through consensus of a panel of experts by using the Delphi method; they were originally published in the Archives of Internal Medicine in 1991[2] and were most recently updated in 2003.[3]
An alternative to Beers list has also been created, called the STOPP (Screening Tool for Older Persons of potentially inappropriate Prescriptions) criteria. The STOPP Criteria criticizes the Beers List because, when used as a simple checklist, the Beers List neglects the patient's medical diagnosis, psychosocial status, and ADLs (activities of daily living), drug availability (e.g., European Agency approved or FDA approved), and causality. This is documented in the Archives of Internal Medicine June, 2011.[4]
Revised list
The 2003 revised list is as follows:[3]
- alprazolam (Xanax)
- amiodarone (Cordarone)
- amitriptyline (Elavil)
- amphetamines
- anorexic agents
- barbiturates
- belladonna alkaloids (Donnatal)
- bisacodyl (Dulcolax)
- carisoprodol (Soma)
- cascara sagrada
- chlordiazepoxide (Librium, Mitran)
- chlordiazepoxide-amitriptyline (Limbitrol)
- chlorpheniramine (Chlor-Trimeton)
- chlorpropamide (Diabinese)
- chlorzoxazone (Paraflex)
- cimetidine (Tagamet)
- clidinium-chlordiazepoxide (Librax)
- clonidine (Catapres)
- clorazepate (Tranxene)
- cyclandelate (Cyclospasmol)
- cyclobenzaprine (Flexeril)
- cyproheptadine (Periactin)
- desiccated thyroid
- dexchlorpheniramine (Polaramine)
- diazepam (Valium)
- dicyclomine (Bentyl)
- digoxin (Lanoxin)
- diphenhydramine (Benadryl)
- dipyridamole (Persantine)
- disopyramide (Norpace, Norpace CR)
- doxazosin (Cardura)
- doxepin (Sinequan)
- ergot mesyloids (Hydergine)
- estrogens
- ethacrynic acid (Edecrin)
- ferrous sulfate (iron)
- fluoxetine (Prozac)
- flurazepam (Dalmane)
- guanadrel (Hylorel)
- guanethidine (Ismelin)
- halazepam (Paxipam)
- hydroxyzine (Vistaril, Atarax)
- hyoscyamine (Levsin, Levsinex)
- indomethacin (Indocin, Indocin SR)
- isoxsuprine (Vasodilan)
- ketorolac (Toradol)
- lorazepam (Ativan)
- meperidine (Demerol)
- meprobamate (Miltown, Equanil)
- mesoridazine (Serintil)
- metaxalone (Skelaxin)
- methocarbamol (Robaxin)
- methyldopa (Aldomet)
- methyldopa-hydrochlorothiazide (Aldoril)
- methyltestosterone (Android, Testred, Virilon)
- mineral oil
- naproxen (Naprosyn, Avaprox, Aleve)
- Neoloid
- nifedipine (Procardia, Adalat)
- nitrofurantoin (Microdantin)
- orphenadrine (Norflex)
- oxaprozin (Daypro)
- oxazepam (Serax)
- oxybutynin (Ditropan)
- pentazocine (Talwin)
- perphenazine-amitriptyline (Triavil)
- piroxicam (Feldene)
- promethazine (Phenergan)
- propantheline (Pro-Banthine)
- propoxyphene (Darvon) and combination products (Off the market)
- quazepam (Doral)
- reserpine (Serpalan, Serpasil)
- temazepam (Restoril)
- thioridazine (Mellaril)
- ticlopidine (Ticlid)
- triazolam (Halcion)
- trimethobenzamide (Tigan)
- tripelennamine
References
- ^ Pearce, Jeremy (March 9, 2009. Accessed March 10, 2009.). "Mark H. Beers, 54, Expert on Drugs Given to Elderly, Dies". The New York Times. http://www.nytimes.com/2009/03/10/health/10beers.html.
- ^ Beers MH (July 28, 1997). "Explicit criteria for determining potentially inappropriate medication use by the elderly". Archives of Internal Medicine 157 (14): 1531–1536. doi:10.1001/archinte.1997.00440350031003. PMID 9236554. http://archinte.ama-assn.org/cgi/content/abstract/157/14/1531?ijkey=ca348beb593ee0fa8eabfbca759f515a83291837&keytype2=tf_ipsecsha.
- ^ a b Fick DM, Cooper JW, Wade WE, Waller JL, Maclean JR, Beers MH (December 8, 2003). "Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts". Archives of Internal Medicine 163 (22): 2716–2724. doi:10.1001/archinte.163.22.2716. PMID 14662625. http://archinte.ama-assn.org/cgi/content/full/163/22/2716.
- ^ Hilary Hamilton, MB, MRCPI; Paul Gallagher, PhD, MRCPI; Cristin Ryan, PhD, MPSI; Stephen Byrne, PhD, MPSI; Denis O’Mahony, MD, FRCPI. Potentially Inappropriate Medications Defined by STOPP Criteria and the Risk of Adverse Drug Events in Older Hospitalized Patients. Arch Intern Med. 2011;171(11):1013-1019. doi:10.1001/archinternmed.2011.215
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