I. Drugs shown to have delayed elimination or higher blood levels in elderly:

  1. Pyschiatric Drugs
  1. Tricyclics (desipramine has least anticholinergic and sedating effects)
  2. Benzos (Prolonged t-1/2, esp. in men. Flurazepam also more toxic. Oxazepam/lorazepam ok)
  3. Phenothiazines
  4. Lithium
  1. Cardiovascular Drugs
  1. Antihypertensives: Clonidine, Aldomet, Propanolol, Metoprolol
  2. Digoxin
  3. Anti-arrhythmics: Quinidine, Procainamide, Lidocaine
  4. Nitroprusside
  1. Antibiotics: penicillins (except nafcillin which isn't renally excreted), cephalosporins, aminoglycosides, tetracyclines
  2. Analgesics: acetaminophen, aspirin, narcotics, local and regional anesthesia
  3. Other: Thyroxine, Aminophylline, Cimetidine, Phenytoin

II. Increased effect/increased adverse f/x apart from diffs in blood levels: INH, Coumadin

III. Shown to cause confusion in elderly:

  1. Cimetidine
  2. Levodopa
  3. Diphenhydramine
  4. Lidocaine
  5. Tricyclic antidepressants