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[Are benzodiazepines correctly used in the elderly?]
T Barberá1, J A Avellana, L Moreno
1Dirección General de Farmacia y Productos Sanitarios, Conselleria de Sanitat Generalitat Valenciana, Valencia, España.
Revista Clinica Espanola
|April 3, 2007
Summary
Elderly patients taking long half-life benzodiazepines face increased risks of falls and fractures due to sedation and drug interactions. Consider alternative medications metabolized differently to reduce these adverse events.
Area of Science:
- Geriatric Pharmacology
- Pharmacovigilance
- Drug Metabolism
Background:
- Benzodiazepines can cause drug dependence, sedation, and interactions.
- Elderly patients are particularly vulnerable to adverse effects like falls and fractures from benzodiazepine use.
- Dosage and metabolism pathways significantly influence risk in older adults.
Purpose of the Study:
- To analyze benzodiazepine prescription patterns in elderly patients.
- To evaluate the association between benzodiazepine elimination pathways and adverse events.
- To recommend safer prescribing practices for this demographic.
Main Methods:
- Retrospective analysis of official prescriptions from 2000-2003.
- Utilized daily dose defined per thousand patients/day (DDD/I) to measure drug consumption.
- Focused on benzodiazepines eliminated via oxidative vs. conjunctive metabolism.
Main Results:
- Long half-life benzodiazepines and inadequate dosing were linked to falls and fractures in the elderly.
- Benzodiazepines eliminated by oxidative metabolism were frequently prescribed.
- High drug consumption rates were observed during the study period.
Conclusions:
- Prescriptions for benzodiazepines eliminated by oxidative metabolism require re-evaluation in elderly patients.
- Switching to benzodiazepines metabolized by conjunctive pathways may decrease adverse reactions.
- This shift can reduce sedation, falls, and fractures in geriatric populations.
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