Medication and Falls

What is a Fall?[edit | edit source]

What is Polypharmacy?[edit | edit source]

Medications Associated with Increased Risk of Falls[edit | edit source]

Psychotropic Drugs and Falls Risk[1]
Medication Group Overall Risk Category Commonly Used Medications Effects on Risk
Sedatives

HIGH RISK

Can cause falls alone

Lorazepam, Temazepam, Nitrazepam

similar -epamsuffix

Drowsiness, slows reactions, impaired balance.
Sedating Antidepressants

HIGH RISK

Can cause falls alone

Amitriptyline, Nortriptyline Orthostatic hypotension, drowsiness, slow reactions. DOUBLE THE RATE OF FALLS
Monoamine Oxidase Inhibitors

HIGH RISK

Can cause falls alone

Phenelzine, Moclobemide Severe orthostatic hypotension
For Psychosis Agitation

HIGH RISK

Can cause falls alone

Haloperidol, Chlorpromazine, Olanzapine Orthostatic hypotension, slow reflexes, loss of balance
Selective Serotonin Reuptake Inhibitors (SSRI) and Serotonin and Noradrenaline Reuptake Inhibitor )SNRI)

MODERATE RISK

Can cause falls in combination

Fluoxetine, Sertaline, Paroxetine, Venlafaxine, Duloetine Increased risk of falls with fractures, orthostatic hypotension, bradycardia, impaired sleep quality
Opiate Analegsics

HIGH RISK

Can cause falls alone

Codeine, Morphine, Tramadol Sedates, slows reactions, impairs balance, delirium
Anti Epileptics HIGH RISK Phenytoin, Carbamazepine, Phenobarbitone Cerebellar damage, ataxia, slowed reactions
MODERATE RISK Sodium Valporate, Gabapentin Some association with falls risk
Parkinson's Disease - Dopamine Agonists HIGH RISK Roprinerole, Pramipexole Delirium, orthostatic hypotension
Parkinson's Disease - MAOI-B Inhibitors HIGH RISK Selegiline Orthostatic hypotension (Difficult to assess due to high falls risk in PD as the disease process)
Muscle Relaxant MODERATE RISK Baclofen Reduced muscle tone, sedative
Vestibular Sedative POSSIBLE CAUSES Prochlorperazine, Cinnarazine, Betahistine Prochlor... - Dopamine agonist which may cause movement disorder in long term, sedating
Anticholinergics acting on Bladder POSSIBLE CAUSES Oxybutinin, Solifenacin, Tolterodine, Solifenacin Known CNS effects.

 














 

 

 

 

 










 

 





Drugs Acting on the heart and Circulation[1]
Medication Group Overall Risk Category Commonly Used Medications Effect of Risk
Alpha Receptor blockers HIGH RISK Doxasozin, Tamsulosin, Indoramin Severe orthostatic hypotension, urinary retention
Centreally Acting Alpha-2-Receptor Agonsits HIGH RISK Clonidine, Moxonidine Severe orthostatic hypotension, sedating
Thiazide Diuretics HIGH RISK Bendroflumethiazide, Metolazone Weakness due to low potassium, hyponatraemia, orthostatic hypotension
Loop Diuretic MODERATE RISK Furosemide, Bumetanide Dehydration, hypotension, low potassium and sodium
Angiotensin Converting Enzyme Inhibitors (ACEIs) HIGH RISK Lisinopril, Ramipril -opril Rely upon kidney elimination and accumulate can cause failure, dehydration.
Angiotensin Receptor Blockers (ARBs) MODERATE RISK Losartan or similar -tan Hypotension
Beta Blockers HIGH RISK Atenolol, Propranolol, Sotalol Bradycardia, hypotension, carotid sinus hypersensitivity, vasovagal syndrome
Antianginals HIGH RISK Glyceryl Trinitrate (GTN), Isosorbide Mononitrate, Nicornadil Sudden hypotension
Calcium Channel Blockers MODERATE RISK Amlodipine, Felodipine, Diltiazem, Verapamil Hypotension, bradycardia
Other Antidysrhythmics MODERATE RISK Digoxin, Flecainide, Amiodarone Bradycardia, arrythmias
Acetylcholinersterase Inhibitors (For Dementia) POSSIBLE CAUSES Rivastigmine, Donepezil, galantamine Bradycardia and syncope

Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]

  1. 1.0 1.1 Darowski A. Dwight J. Reynolds J. Medicines and Falls in Hospital: Guidance Sheet [ONLINE] available from https://www.rcplondon.ac.uk/sites/default/files/documents/medicines-and-falls2.pdf date accessed 14/01/2015