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Table. 3.

Table. 3.

Most common medication classes/medications described as potentially inappropriate medications

Medication class Number of Tools (%) Medication Number of Tools (%) Rationale Quality of evidence Strength of Recommendation
Tricyclic antidepressants 16 73 Amitriptylline 12 55 Highly anticholinergic, sedating, and cause orthostatic hypotension High Strong
Clomipramine 11 50
Imipramine 10 45
Opioids 14 64 Meperidine (Pethidine) 11 50 Increased neurotoxicity, delirium risk, adverse CNS effects Moderate Strong
Benzodiazepine 15 68 Diazepam 10 45 Cognitive impairment, delirium, falls Moderate Strong
Alprazolam 9 41
Chlordiazepoxide 8 36
Clonazepam 8 36
Loprazolam 8 36
Antiplatelets 14 64 Ticlopidine 9 41 Risk of hematological toxicity, safer alternatives available Moderate Strong
First-generation 15 68 Chlorpheniramine 8 36 Highly anticholinergic toxicity Moderate Strong
anti-histamines Hydroxyzine 8 36
Barbiturates 8 36 Phenobarbital 8 36 High rate of physical dependence, tolerance to sleep benefits, greater risk of overdose at low dosages High Strong
Z-drugs 8 36 Zolpidem 8 36 Increased risk of cognitive impairment, confusion, falls Moderate Strong
NSAIDs 12 55 Indomethacin 8 36 Gastrointestinal bleeding, peptic ulcer, Acute kidney injury Moderate Strong
Ketoprofen 8 36
Piroxicam 8 36
Meloxicam 7 32
Antiarrhythmics 8 36 Amiodarone 7 32 Cardiotoxicities, risk of hypothyroidism High Strong
Antihypertensives 13 59 Methyldopa 7 32 Bradycardia, orthostatic hypotension Low Strong
Antiparkinson agents 10 45 Trihexyphenidyl 7 32 High anticholinergic effects that may lead to confusion, urinary retention, constipation Moderate Strong
α-1 blockers 9 41 Doxazosin 7 32 High risk of orthostatic hypotension and associated harms Moderate Strong

CNS, Central Nervous System; NSAIDs, Non-Steroidal Anti-inflammatory Drugs

Korean J Clin Pharm 2021;31:61-78 https://doi.org/10.24304/kjcp.2021.31.1.61
© 2021 Korean J Clin Pharm