Not Your Mothers Sleeping Aid. Introducing The Beers List

by Mary S on February 22, 2014

Recently our family was reminded that medications do not act the same way on everyone, and a drug appropriate for some may not be appropriate for all.  My elderly mother was experiencing a bout of insomnia.  She requested Benadryl to help her sleep.  The nurse helping care for her checked with the Doctor and relayed his recommendation against it.  Initially we were puzzled by this, knowing Benadryl is available over the counter.  Additionally, because my sister-in-law is a nurse, she knew that the active ingredient in Benadryl, diphenhydramine, is also the sleep-inducing agent in Sominex and other over-the-counter sleeping pills.  We were very curious why the Doctor would recommend against something we presumed was “safe”.

Some internet research lead to us confirm the doctors recommendation helped us learn a little about advances in geriatric medicine.  Specifically, the Beers List, which is not a menu of what’s on tap or something served with a nice Bavarian pretzel, but rather a list of potentially inappropriate and high-risk drugs for older adults.  It was originally created in 1991 by Dr. Mark Beer and colleagues.  The list was updated most recently in 2012 by the American Geriatric Society.  Drugs can land on the list for several reasons.  Some have a strong link to poor patient outcomes, some have limited effectiveness in older patients, some may be associated with serious problems like delirium, gastrointestinal bleeding, falls, and fracture, and some are on the list because a safer non-pharmacological alternative exists.Watch Full Movie Online Streaming Online and Download

Avoiding the use of inappropriate and high-risk drugs is an important, simple, and effective strategy in reducing medication-related problems and adverse drug events in older adults. [1]

So, back to Mom.  Yes, diphenhydramine is on the Beers List, because of the potential side effects and because safer medications are available.  The recommendation is to avoid, except possibly in special situations such as for treating severe allergic reactions. Here’s the relevant excerpt from the list:

Excerpt from Beers Criteria
So, if Benedryl is out, how do you help Mom get to sleep?  Chamomile tea is one idea.  Or some other ideas are here: Assisting Seniors With Insomnia: A Comprehensive Approach 

Until next time,
–Mary


References
1. http://www.americangeriatrics.org/files/documents/beers/2012BeersCriteria_JAGS.pdf ?

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