Falls, confusion and drowsiness in older inpatients are often drug effects. Sedatives, opioids, anticholinergics, antihypertensives and sulfonylureas or insulin are the usual contributors, and new additions during an admission add up.
A structured medicine review takes a few minutes: list every drug, ask what each is for, note when it was started, stop what has no current indication, and check for postural hypotension and low glucose before settling on an age-related explanation.
- List every drug including those started in this admission and ones bought over the counter.
- Check lying and standing blood pressure and a glucose reading.
- Review sedatives, opioids, anticholinergics, antihypertensives and glucose-lowering drugs first.
- Stop or reduce a drug only with a clear plan for monitoring.
Why it matters
Falls on the ward are often a drug problem before they are an ageing problem.
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