American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

American Geriatrics Society 2012 Beers Criteria Update Expert Panel

Disclosures

J Am Geriatr Soc. 2012;60(4):616-631. 

In This Article

Results

Fifty-three medications or medication classes encompass the final updated 2012 AGS Beers Criteria, which are divided into three categories (Table 2, Table 3 and Table 4). Tables were constructed and organized according to major therapeutic classes and organ systems.

Table 2 shows the 34 potentially inappropriate medications and classes to avoid in older adults. Notable new additions include megestrol, glyburide, and sliding-scale insulin.

Table 3 summarizes potentially inappropriate medications and classes to avoid in older adults with certain diseases and syndromes that the drugs listed can exacerbate. Notable new inclusions are thiazolidinediones or glitazones with heart failure, acetylcholinesterase inhibitors with history of syncope, and selective serotonin reuptake inhibitors with falls and fractures.

Table 4 lists medications to be used with caution in older adults. Fourteen medications and classes were categorized. Two of these involve recently marketed antithrombotics for which early evidence suggests caution for use in adults aged 75 and older.

Table 5 is a summary of medications that were moved to another category or modified since the last update, and Table 6 and Table 7 summarize medications that were removed or added since the last update. Nineteen medications and medication classes were dropped from the 2003 to the 2012 update of the criteria based on consensus of the panel and evidence or a rationale to justify their exclusion from the list. In several cases, medications were removed because they had been taken off the U.S. market since the 2003 update (e.g., propoxyphene) or because of insufficient or new evidence that was evaluated by the panel (e.g., ethacrynic acid). Table 8 includes a list of the antipsychotics included in the statements. Table 9 is the list of anticholinergic medications to be avoided in older adults compiled from drugs rated as having strong anticholinergic properties in the Anticholinergic Risk Scale,[26] Anticholinergic Drug Scale,[27] and Anticholinergic Burden Scale.[28]

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