Drug name Drug risks/ Recommendation Risk level Incidence rate (case)
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