รายการยาที่เสี่ยงต่อการหกล้ม | คณะแพทยศาสตร์โรงพยาบาลรามาธิบดี มหาวิทยาลัยมหิดล

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รายชื่อ ยาที่เสี่ยงต่อการหกล้มในผู้สูงอายุ แบ่งเป็น 3 กลุ่มหลักที่สำคัญ

เรียบเรียงโดย เภสัชกรหญิง กรองทอง พุฒิโภคิน

กลุ่มที่มีผลต่อระบบประสาท ได้แก่ antidepressants, antipsychotics, Benzodiazepines, non-benzodiazepine, hypnotics, antihistamine, anticonvulsants, muscle relaxants, narcotics, analgesics
กลุ่มที่มีผลต่อหัวใจและหลอดเลือด ได้แก่ antihypertensive, antiarrhythmic, digoxin, nitrates, diuretics
กลุ่มอื่นๆ ได้แก่ oral hypoglycemic, H2 blocker, proton pump inhibitors (PPI), NSAIDs, corticosteroid

ประเภทยา	ชื่อยา	ผลข้างเคียง
Central nervous system
1. Antidepressants	melitracen, clomipramine, doxepin, imipramine, amitriptyline, nortriptyline, mianserine, mirtazapine, trazodone, escitalopram, sertraline, paroxetine, fluoxetine, vortioxetine, desvenlafaxine, duloxetine, milnacipran, venlafaxine	Anticholinergic side effects include confusion, cognitive impairment, delirium, dry mouth, constipation, urinary retention, orthostatic hypotension, sedation, impair balance, slow reaction Hyponatremia, ataxia, impaired psychomotor function, and syncope
a.Antipsychotics	Risperidone, olanzapine, quetiapine, clozapine, aripiprazole, haloperidol	Sedation, dizziness, postural disturbances, altered gait and balance, impaired cognition
b.Benzodiazepines	Alprazolam, chlordiazepoxide, clobazam, clonazepam, dipotassium clorazepate, diazepam, flunitrazepam, lorazepam, midazolam, nitrazepam,	Sedation, dizziness, postural disturbances, altered gait and balance, impaired cognition
c.non-benzodiazepine	Zolpidem	cognitive impairment, unsteady gait, psychomotor impairment, accidents, delirium, and dependence
e.antihistamine	Chlorpheniramine, cyproheptadine, diphenhydramine, hydroxyzine	Anticholinergic effects can increase confusion, cognitive impairment, delirium, dry mouth, and constipation and cause urinary retention
f.anticonvulsants	Gabapentin, pregabalin, levetiracetam, phenytoin, sodium valproate	ataxia, impaired psychomotor function
g.muscle relaxants	Orphenadrine, tizanidine, baclofen	Anticholinergic effects can increase confusion, cognitive impairment, delirium, dry mouth, and constipation and cause urinary retention
h.narcotics	Morphine, fentanyl, oxycodone	sedation, dizziness, syncope, and central nervous system depression.
i.analgesics	Tramadol	sedation, dizziness, syncope, and central nervous system depression
2. Cardiovascular system
a.Antihypertensive	Doxazosin, prazosin, captopril, enalapril, imidapril, perindopril, quinapril, ramipril, losartan, valsartan, olmesartan, azilsartan, candesartan, irbesartan, telmisartan, amlodipine, felodipine, lercanidipine, manidipine, nifedipine, diltiazem, verapamil, atenolol, bisoprolol, metoprolol, nebivolol, propranolol, clonidine, hydralazine	Induced orthostasis, confusion, poor health status
b.antiarrhythmic	disopyramide
c.digoxin
d.nitrates	Isosorbide dinitrate, isosorbide mononitrate	nitrate-induced severe hypotension and bradycardia
e.diuretics	Acetazolamide, furosemide, amiloride,hydrochlorothiazide, spironolactone, indapamide, chlorthalidone	orthostatic hypotension, and hypotension risk is increased with dehydration. They also may cause weakness due to potassium loss as well as hyponatremia
3. others
a.oral hypoglycemic	glipizide, glimepiride, gliclazide	hypoglycemic
b.H2 blockers	famotidine	delirium
c.PPIs	Omeprazole, esomeprazole, pantoprazole, lansoprazole, rabeprazole, dexlansoprazole	increased risk of fracture (hip, spine, or wrist fracture)
d.NSAIDs	Ibuprofen, loxoprofen, naproxen, mefenamic acid , diclofenac, indomethacin , sulindac, meloxicam, piroxicam, celecoxib, etoricoxib	confusion, lightheadedness
e.corticosteroid	Dexamethasone, hydrocortisone, prednisolone	confusion, agitationdelirium

References

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