July 9, 2008
Researchers at the UNC Eshelman School of Pharmacy have created a list of prescription drugs that increase the risk of falling for patients aged sixty-five and older who take four or more medications on a regular basis.
“Falls are the leading cause of both fatal and nonfatal injuries for adults sixty-five and older, and research suggests that those taking four or more medications are at an even greater risk than those who don’t—perhaps two to three times greater,” says Susan Blalock, PhD, principal investigator of the study and an associate professor at the School.
“What we’ve done as part of our study is to identify specific prescription drugs that are most likely to contribute to the falls,” she says.
The drugs on the list cover a wide range of common prescription antidepressants, seizure medications, painkillers, and more. The common denominator among them is that they all work to depress the central nervous system, which can make patients less alert and slower to react.
The researchers compiled the list as part of an ongoing study of a falls-prevention program they developed for pharmacists to implement. Both the list and the study’s methodology were recently published in the June issue of the American Journal of Geriatric Pharmacotherapy, volume six, number two. The article with its list of drugs is available online.
Stefanie Ferreri, Pharm.D., lead author of the paper and a clinical assistant professor in the pharmacy school, warns that patients need to be wary of more than just prescription medications, as many over-the-counter medications can also contribute to falls.
“Some allergy medications, sleep aids and some cold and cough remedies can have the same effects as prescription drugs,” Ferreri said. “Always let your doctor know what over-the-counter medications you are taking and be sure to read the labels. Anything that can cause drowsiness can put you at increased risk of falling.”
The researchers offered the following advice to patients and practitioners:
For Patients
If patients see a drug they are taking on the list, they should not stop taking it. Next time they see their doctor, talk about the risk of falling and possible alternative medications.
For Doctors
Physicians should look for medications that have been proven safe and effective in older adults and look for medicines that have less of a sedating effect. Physicians should be especially wary of anticholinergics, a class of drugs that affect nerve cells and used to treat a wide range of conditions.
For Pharmacists
Pharmacists should be alert for patients sixty-five and older who are taking four or more drugs and be sure the patients know about the additional risk of falling created by their medications.
The authors of the study are Ferreri, Blalock and assistant professor Mary Roth McClurg, PharmD, of the UNC Eshelman School of Pharmacy; Karen Demby, PhD, social research specialist with the UNC Injury Prevention Research Center; and Carri Casteel, PhD, a research assistant professor with the UNC Injury Prevention Research Center and the UNC School of Public Health department of epidemiology.
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