title: Medications in long-term care: when less is more.
abstract: Attention has been drawn to the potential risks of several medications in the long-term care setting. Most of these medications deemed as inappropriate affect the central nervous system and are indicated only for select populations with specific conditions. Many of these drugs are prescribed without clear indications and continued indefinitely without critical decision-making about the potentially salutary effects of discontinuing medications. This article describes the increasing awareness of potentially inappropriate prescribing in the long-term care setting and reviews the rationale for why various types of medications are deemed inappropriate, with a focus on agents that affect central nervous system functioning.
authors.affiliation: Department of Psychiatry, Division of Geriatric Psychiatry, University of California, La Jolla, San Diego, CA 92093, USA. tmeeks@ucsd.edu
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Meeks
authors.forename: John W
authors.initials: JW
authors.lastname: Culberson
authors.forename: Monica S
authors.initials: MS
authors.lastname: Horton
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002490:Central Nervous System / Q000187:drug effects; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005853:Geriatrics; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D057970:Inappropriate Prescribing / Q000639:trends*; D008134:Long-Term Care; D008297:Male; D008508:Medication Errors; D001523:Mental Disorders / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D019338:Polypharmacy; D010818:Practice Patterns, Physicians'; D011619:Psychotropic Drugs / Q000627:therapeutic use*; D014481:United States / Q000453:epidemiology
chemical_list: D006993:Hypnotics and Sedatives; D011619:Psychotropic Drugs