Some Disorders and Symptoms That Can Be Worsened by Drugs in Older People
Disorder or Symptom |
Drugs |
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NSAIDs (such as ibuprofen and naproxen) |
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Chlorpromazine Corticosteroids Drugs with sedative effects (such as benzodiazepines, sedatives, and sleep aids) or anticholinergic effects* Histamine-2 blockers (cimetidine, famotidine, nizatidine, ranitidine) Meperidine |
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Fainting or orthostatic hypotension (sudden decrease in blood pressure when a person stands up) |
Chlorpromazine, donepezil, doxazosin, galantamine, olanzapine, prazosin, some older antidepressants (such as amitriptyline and imipramine), rivastigmine, terazosin, thioridazine Use of more than one antihypertensive drug (or too much of one antihypertensive) |
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Drugs with sedative effects (such as antiepileptic drugs, antipsychotics, benzodiazepines, eszopiclone, zaleplon, and zolpidem), antidepressants, some antihypertensive drugs when used at high doses, and opioids |
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Cilostazol, diltiazem, disopyramide, dronedarone (in patients with severe heart failure), NSAIDs and COX-2 inhibitors, pioglitazone, rosiglitazone, verapamil |
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Caffeine, oral decongestants (such as pseudoephedrine and phenylephrine), stimulants (such as armodafinil, amphetamine, methylphenidate, and modafinil), theophylline, selegiline |
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Certain antinausea drugs (metoclopramide, prochlorperazine, promethazine) and most antipsychotics except a few such as quetiapine and clozapine |
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Peptic ulcer disease or stomach bleeding |
Aspirin and most NSAIDs |
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Bupropion, chlorpromazine, clozapine, maprotiline, meperidine, olanzapine, thioridazine, thiothixene, tramadol |
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Urinary incontinence in women |
Doxazosin, estrogens taken by mouth or through the skin (not applied directly to the vagina), prazosin, terazosin |
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Urinary retention or urinary symptoms caused by an enlarged prostate (such as slow urinary flow, frequent urination of smaller amounts, and dribbling) |
Drugs with anticholinergic effects*, cold remedies containing decongestants, or a combination of antihistamines and decongestants |
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*Anticholinergic effects include confusion, blurred vision, constipation, dry mouth, light-headedness and loss of balance, and difficulty starting to urinate. COX-2 inhibitors = coxibs; NSAIDs = nonsteroidal anti-inflammatory drugs. |
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