The increased sensitivity of older people to benzodiazepines is due to age-related alterations in the central nervous system receptors. It is likely that benzodiazepine receptors in the brain become more sensitive, causing increased sedation, unsteadiness, memory loss, and disinhibition.
Why are older adults more prone to medication toxicity?
Increased Sensitivity to Many Drugs: The problems of decreased body size, altered body composition (more fat, less water), and decreased liver and kidney function cause many drugs to accumulate in older people’s bodies at dangerously higher levels and for longer times than in younger people.
Why are elderly more sensitive to drugs?
The pharmacokinetic, pharmacodynamic and homeostatic changes that occur with age combine with the effects of chronic disease to make the elderly person particularly sensitive to both the desired and adverse effects of many drugs. This is compounded by an increase in both the incidence and degree of polypharmacy.
Which benzodiazepine is preferred for elderly patients?
On the basis of their shorter half-lives and lack of (or rapid disappearance of) active metabolites produced by their mode of metabolism, oxazepam and lorazepam (and perhaps alprazolam) are the benzodiazepines of choice for elderly patients.
How does Diazepam affect the elderly?
However, elderly patients are more likely to have unwanted effects (eg, severe drowsiness, dizziness, confusion, clumsiness, or unsteadiness) and age-related kidney problems, which may require caution and an adjustment in the dose for patients receiving diazepam.
What is the most common medication problem in the elderly?
Warfarin is one of the most common causes of medication-related hospitalizations in older adults. To reduce the risk of serious problems, one may need to apply extra care in monitoring warfarin effect (via the prothrombin blood test) and extra care in checking for interactions when a new drug is prescribed.
Why is taking multiple medications a problem for the elderly?
Elderly people are at a greater risk for adverse drug reactions (ADRs) because of the metabolic changes and reduced drug clearance associated with ageing; this risk is furthermore exacerbated by increasing the number of drugs used. Potential of drug-drug interactions is further increased by use of multiple drugs.
Why are older adults at increased risk for toxicity when on antidepressants?
Old people are at greater risk of developing adverse events while taking any medication—including antidepressants—because of concurrent illness, consumption of other prescribed and over the counter drugs, dose miscalculation because of forgetfulness, and altered drug kinetics.
Why do elderly need lower doses of medication?
Changes in the Body Changes that decrease your body’s ability to break down or remove certain medications from your system may mean that medications can stay in your body longer. So, you may need a lower dose of the medication or a different medication that is safer.
Why are benzodiazepines not recommended for the elderly?
Adverse effects The use of benzodiazepines among elderly patients has been associated with intellectual and cognitive impairment (13). Cognitive impairment is characterized by anterograde amnesia, diminished short-term recall, and increased forgetfulness.
What benzodiazepines should elderly avoid?
Long half-life benzodiazepines usually are not preferred for older patients because of cumulative toxicity. Among the short half-life drugs, high-potency compounds (e.g., lorazepam, alprazolam) may be more toxic than low-potency compounds (e.g., oxazepam).
What is the risk to the elderly of taking benzodiazepines?
Benzodiazepines can impair cognition, mobility, and driving skills in older people, as well as increase the risk of falls. A recent study also found an association between benzodiazepine use in older people and increased risk of Alzheimer’s disease.
Which benzodiazepine should be avoided?
– Ultra-short acting BZ such as Triazolam (Halcion) should be avoided because of side effects of memory impairment, withdrawal psychosis, and confusion. effects that may cause drowsiness, risks of fall, and cognitive impairment especially in elderly patients. Alprazolam (Xanax) has high abuse risk.
What is the best anti-anxiety medication for elderly?
Buspirone is an anti-anxiety drug that has been shown to be effective for older adults. Benzodiazepines, another anti-anxiety drug, are effective but should be prescribed carefully to older adults because of risk of memory impairment, unsteadiness, and falls.
Is clonazepam bad for seniors?
However, elderly patients are more likely to have confusion and severe drowsiness, or age-related heart, liver, or kidney problems, which may require caution and an adjustment in the dose for patients receiving clonazepam.