|
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(> 0.125 mg/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(> 25 mg/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 < 30 ml/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
|
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
|