Geriatric Medicine

Answer 5 Benzodiazepines have a large lipid volume of distribution and are therefore relatively safe to use in geriatric patients. Although the stores of lipid tend to become relatively larger with age, benzodiazepines accumulate in fat tissues and do not leave the body, resulting in cumulative effects. Chronic use of benzodiazepines in older patients is not safe and is associated with cognitive changes, daytime drowsiness, and increased body sway with falls. Chlorpropamide is best avoided, and meperidine and amantidine should be used with caution and require dose reduction. Use of metronidazole is generally safe in geriatric patients. SUGGESTED READINGS 1. Dharmarajan TS, Tota R. Appropriate prescribing of medications in older adults. Fam Pract Recert 2000;22:29-38. 2. Leipzig RM. Pharmacology and appropriate prescribing. In: Cobbs EL, Duthie EH, Murphy JB, editors. Geriatrics review syllabus, 4th ed. Dubuque (IA): Kendall/Hunt Publishing Co; 1999:30-5. 3. Schwartz JB. Clinical pharmacology. In: Hazzard WR, Blass JP, Ettinger WH, et al, editors. Principles of geriatric medicine and gerontology. 4th ed. New York: McGraw-Hill, Health Professions Division; 1999:303-31. Click here to return to the questions

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