I. Drugs shown to have delayed elimination or higher blood levels in elderly:
- Pyschiatric Drugs
- Tricyclics (desipramine has least anticholinergic and sedating effects)
- Benzos (Prolonged t-1/2, esp. in men. Flurazepam also more toxic. Oxazepam/lorazepam ok)
- Phenothiazines
- Lithium
- Cardiovascular Drugs
- Antihypertensives: Clonidine, Aldomet, Propanolol, Metoprolol
- Digoxin
- Anti-arrhythmics: Quinidine, Procainamide, Lidocaine
- Nitroprusside
- Antibiotics: penicillins (except nafcillin which isn't renally excreted), cephalosporins, aminoglycosides, tetracyclines
- Analgesics: acetaminophen, aspirin, narcotics, local and regional anesthesia
- Other: Thyroxine, Aminophylline, Cimetidine, Phenytoin
II. Increased effect/increased adverse f/x apart from diffs in blood levels: INH, Coumadin
III. Shown to cause confusion in elderly:
- Cimetidine
- Levodopa
- Diphenhydramine
- Lidocaine
- Tricyclic antidepressants