|
Drugs of A-class caution |
Drugs of A-class caution |
Drugs of A-class
caution |
Nervous system medication |
|
|
|
Esmolol alprazolam |
( 1 ) Nervous system adverse reactions (prolonged
sedation time, lethargy); ( 2 ) risk of falls |
low |
5 |
Nigeria ergot Lin |
( 1 ) The curative effect is inaccurate; ( 2 ) The
risk of medication is greater than the benefit; ( 3 ) Orthostatic
hypotension; ( 4 ) risk of falls |
low |
17 |
Psychotropic drugs |
|
|
|
Risperidone |
( 1 ) Avoid the treatment of abnormal behavior in patients
with dementia, and only apply when non-drug treatment fails or the
patient poses a threat to themselves and others; ( 2 ) Increase the risk
of cerebrovascular accidents and death in patients with dementia |
low |
1 |
Olanzapine |
(1) Nervous system adverse reactions (prolonged sedation
time, cognitive dysfunction); (2) Extravertebral system and
anticholinergic adverse reactions (Parkinson’s disease, hypotonia); (3)
Falls; (4) Increasing the mortality rate of patients with mental illness |
low |
2 |
Cardiovascular system medication |
|
|
|
Digoxin(>0.125mg/d) |
(1) Severe arrhythmia (prolonged QT interval
and torsade de pointes arrhythmia) |
low |
25 |
Amiodarone |
(1) Severe arrhythmia (prolonged QT interval and torsade de
pointes arrhythmia) |
low |
5 |
Endocrine system medication |
|
|
|
insulin |
Risk of hypoglycemia (increase dose carefully) |
low |
45 |
Blood system medication |
|
|
|
Warfarin |
(1) Individual differences are large, protein binding rate is
high, overdose is likely to cause hemorrhage; (2) Old adults take more
drugs, and their physiological state changes, possible interactions and
risk of adverse reactions caused by single drugs are increased; (3)
Routine monitoring of Coagulation index |
low |
7 |
Clopidogrel |
(1) Hematological adverse reactions (thrombocytopenia,
neutropenia, gastrointestinal bleeding, purpura, epistaxis, eye
bleeding, hematuria, intracranial hemorrhage); (2) Nervous system
adverse reactions (headache, dizziness,
confusion
of consciousness, hallucinations) |
low |
45 |
Urinary system medication |
|
|
|
Spironolactone(>25mg/d) |
(1) Patients with heart failure have an
increased risk of hyperkalemia, especially when the dose
>25 mg/d, combined with non-steroidal drugs, angiotensin
converting enzyme inhibitors, angiotensin receptor antagonists or
potassium supplements; (2) Avoid use in patients with heart failure or
endogenous creatinine clearance <30ml/min |
low |
61 |
Respiratory system medication |
|
|
|
Theophylline |
(1) Cardiac adverse reactions (atrial fibrosis, atrial
flutter and tachycardia, etc.); (2) Nervous system adverse reactions
(epilepsy, insomnia, irritability); (3) Nausea and diarrhea (dose
correlation) |
low |
6 |
|
Class B warning drugs |
Class B warning drugs |
Class B warning
drugs |
Nervous system medication |
|
|
|
Barbiturates (except phenobarbital) |
(1) It is easier to cause drug
dependence dependence, tolerance and withdrawal reactions than most
sedative hypnotics; (2) Nervous system adverse reactions
(unconsciousness); (3) Falls and fractures |
high |
14 |
Phenobarbital |
(1) Nervous system adverse reactions (prolonged
sedation, reversal excitability, drowsiness, memory loss, abnormal
reactions, agitation); (2) dyskinesia, ataxia; (3) respiratory
depression |
high |
29 |
Diazepam |
(1) Prolonged half-life in old adults; (2) Nervous system
adverse reactions (prolonged sedation, lethargy, forgetfulness, ataxia,
cognitive dysfunction, agitation, restlessness, hallucinations,
confusion, depression); (3) Falls and fractures; (4) hypotension; (5)
respiratory depression |
high |
2 |
Psychotropic drugs |
|
|
|
Chlorpromazine |
(1) Orthostatic hypotension, palpitations or changes in
electrocardiogram; (2) Extravertebral system adverse reactions (tremor,
stiffness, salivation, bradykinesia, akathisia, acute dystonia),
long-term large amounts of medication can causetardive dyskinesia; (3)
secondary drugs |
high |
1 |
Antipyretic, analgesic, anti-inflammatory and antirheumatic drugs |
|
|
|
≥Combination of 2 non-steroidal anti-inflammatory drugs |
No improvement
in therapeutic effect, but increased risk of adverse reactions |
high |
15 |
Cardiovascular system medication |
|
|
|
Nifedipine |
(1)Increased risk of myocardial infarction or
stroke;(2)Hypotension;(3)Constipation |
low |
13 |
Anti-infective drugs |
|
|
|
Aminoglycoside antibiotics |
(1) Kidney damage; (2) Ototoxicity |
low |
14 |
Clindamycin |
(1) Allergic reactions (anaphylactic shock, high fever,
chills, throat edema, dyspnea); (2) Urinary system adverse reactions
(hematuria, acute kidney injury) |
low |
2 |
Anti-allergic drugs |
|
|
|
Promethazine |
(1) Anticholinergic adverse reactions (dry mouth, blurred
vision, gastrointestinal reactions); (2) Nervous system adverse
reactions (sedation, lethargy, disturbance of consciousness); (3)
Non-anticholinergic antihistamines are preferred for allergic reactions
in old adults |
low |
16 |
Endocrine system medication |
|
|
|
Megestrol |
(1) Increase the risk of thrombosis; (2) Increase the risk
of death in old adult patients |
low |
1 |
Digestive system medication |
|
|
|
Hyoscyamines |
(1) The curative effect is dubious; (2) Strong
anticholinergic effect; (3) Avoid use (especially long-term use) |
high |
15 |
Belladonna alkaloids |
(1) The curative effect is dubious; (2) Strong
anticholinergic effect; (3) Avoid use (especially long-term use) |
high |
16 |
Cimetidine |
(1) Nervous system adverse reactions (disorders of
consciousness, delirium); (2) More interactions than other H2-receptor
blockers |
low |
31 |
Anesthetics and anesthesia auxiliary medication |
|
|
|
Pethidine |
(1) Nervous system adverse reactions (unconsciousness,
delirium, seizures, sedation); (2) respiratory depression; (3) falls |
high |
1 |
Morphine, morphine sustained-release tablets |
(1) Excessive use is
prone to respiratory depression; (2) Once respiratory depression occurs,
the duration is long |
low |
3 |
Tramadol |
(1) Nervous system adverse reactions (seizures, delirium,
dizziness); (2) Vomiting; (3) Constipation |
low |
9 |