Anti-emetics
- Metoclopramide and promethazine have anticholinergic effects.
- Prochlorperazine can affect balance whereas metoclopramide is associated with gait abnormalities; avoid when possible
- Consider switching to domperidone or 5HT3 antagonists.1,2
- Ondansetron appears as the preferred choice for nausea in patients at risk of falls.3
- Promethazine, diphenhydramine, and other first-generation antihistamines are not recommended due to highly anticholinergic side effects.2,3 These effects are increased in the elderly.2
- Haloperidol should be avoided as an anti-emetic due to significant side effects unless used short-term as an anti-emetic during chemotherapy.2
References
Browne Claire. Falls risk medication review tool. 2012 February.
The American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc [Internet]. 2015 [cited 2017 Aug 10]; 63(11):2227-46. Available from: http://onlinelibrary.wiley.com/doi/10.1111/jgs.13702/epdf
Van Leuven K. Psychotropic Medications and Falls in Older Adults. J Psychosoc Nurs 2010; 48(9):35-43.