Gallagher et al used the STOPP (Screening Tool of Older Person's Prescriptions) to help guide therapy in older adults. An important category are those used for patients with gastrointestinal or genitourinary disorders. The authors are from Cork University in Ireland.
Patient selection: age >= 65 years
|
GI Drug |
Comorbid |
Other |
Adverse Effect |
|
antidiarrheal drug |
diarrhea of unknown origin |
|
delayed diagnosis, worsening of diarrhea, toxic megacolon in IBD, delay recovery if infectious |
|
antidiarrheal drug |
severe infective gastroenteritis |
|
worsening or protraction of infection |
|
prochlorperazine |
parkinsonism |
|
worsening of parkinsonism |
|
metoclopramide |
parkinsonism |
|
worsening of parkinsonism |
|
proton pump inhibitor at full dose > 8 weeks |
peptic ulcer disease |
|
discontinue or reduce dose |
|
anticholinergic antispasmodic |
chronic constipation |
|
worsening of constipation |
|
GU Drug |
Comorbid |
Other |
Adverse Effect |
|
antimuscarinic drug |
dementia |
|
increased confusion, agitation |
|
anitmuscarinic drug |
glaucoma |
|
worsening of glaucoma |
|
antimuscarinic drug |
constipation |
|
worsening of constipation |
|
antimuscarinic acid |
BPH |
|
increased urinary retention |
|
alpha blockers |
male with frequent incontinence |
|
worsening of incontinence |
|
alpha blockers |
|
long-term indwelling urinary catheter |
drug not indicated |
where:
• Antidiarrheal drug = dephenoxylate, loperamide, or codeine phosphate
• IBD = inflammatory bowel disease
• BPH = benign prostatic hypertrophy.
Specialty: Pharmacology, clinical
