Medication

Effects on older adults

Benzodiazepines

Due to increased sensitivity to the central nervous system effect of psychotropic drugs such as benzodiazepines, older adults experience an increased risk of sedation, delirium, falls, and fractures

Opioids

Older patients are more sensitive to opioids and generally require lower doses. In addition, they may also experience greater sedation, cognitive impairment, and other adverse effects of the medication. Accumulation of drug metabolites in patients with renal impairment may also have adverse effects requiring dose adjustment or switching to an alternative opioid

Antihypertensives (eg, calcium channel blockers, beta-blockers)

Baroreflex sensitivity declines with age, creating a fall in systolic blood pressure and pulse pressure when standing. If blood pressure is reduced or heart rate is suppressed with medications, compensatory mechanisms may be inadequate and orthostatic and postprandial hypotension problems may occur

Anticholinergic medications (eg, amitriptyline, oxybutynin, dimenhydrinate)

Due to a reduced number of cholinergic neurons in the brain, older adults are more sensitive to medications with anticholinergic effects. This leads to an increased risk of confusion, constipation, urinary retention, blurred vision, orthostatic hypotension, and dry mouth