Risk of Injury Associated with Skeletal Muscle Relaxant Use in Older Adults
@article{Spence2013RiskOI, title={Risk of Injury Associated with Skeletal Muscle Relaxant Use in Older Adults}, author={Michele M. Spence and Patrick J Shin and Eric Anthony Lee and Nancy E. Gibbs}, journal={Annals of Pharmacotherapy}, year={2013}, volume={47}, pages={993 - 998} }
BACKGROUND The use of skeletal muscle relaxants (SMRs) among older adults is associated with sedation and confusion, which may lead to an increased risk of falls and injuries. SMRs continue to be used among older adults, although they are on the Beers list as drugs to avoid in the elderly. OBJECTIVE To investigate the relationship between SMR use and subsequent risk of injury. METHODS This was a retrospective case-control study of members aged 65 years or older enrolled in an integrated health…
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References
SHOWING 1-10 OF 14 REFERENCES
Injury in an Elderly Population Before and After Initiating a Skeletal Muscle Relaxant
- MedicineThe Annals of pharmacotherapy
- 2011
Cautionary use of these medications in the elderly continues to be advisable, but their use in selected patients 65 years and older could be considered if the expected benefits outweigh the small increased risk of injury.
Risk for Fractures with Centrally Acting Muscle Relaxants: An Analysis of a National Medicare Advantage Claims Database
- MedicineThe Annals of pharmacotherapy
- 2010
Evidence of an association between the risk of fractures and the use of centrally acting muscle relaxants in older adults is provided, which supports current recommendations advising extreme caution in prescribing muscle Relaxants to older adults.
Risk factors for falls with severe fracture in elderly people living in a middle-income country: a case control study
- MedicineBMC geriatrics
- 2008
The decision to prescribe muscle relaxants for elderly people should take into account the risk of severe fracture associated with these drugs, although the association between benzodiazepines and fractures due to fall has been consistently demonstrated for old people, this has not been the case for muscle relaxant drugs.
Skeletal Muscle Relaxant Use in the United States: Data From the Third National Health and Nutrition Examination Survey (NHANES III)
- MedicineSpine
- 2004
Muscle relaxant use in the elderly, among older persons with ambulatory impairments, and in chronic obstructive pulmonary disease appeared undiminished compared with general population use.
Quality Indicators for Medication Use in Vulnerable Elders
- MedicineJournal of the American Geriatrics Society
- 2007
This updated set of QIs reevaluates QIs to assess pharmacological care provided to community-dwelling VEs and finds substantial underuse of appropriate medications and shortfalls were seen in medication monitoring and education.
Muscle relaxants for non-specific low back pain.
- MedicineThe Cochrane database of systematic reviews
- 2003
There is strong evidence that any of these muscle relaxants are more effective than placebo for patients with acute LBP on short-term pain relief, but the adverse effects require that they be used with caution.
American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults
- Medicine
- 2012
This update has much strength, including the use of an evidence-based approach using the Institute of Medicine standards and the development of a partnership to regularly update the Criteria.
Choosing a skeletal muscle relaxant.
- MedicineAmerican family physician
- 2008
Systematic reviews and meta-analyses support using skeletal muscle relaxants for short-term relief of acute low back pain when nonsteroidal anti-inflammatory drugs or acetaminophen are not effective or tolerated.
Risk of osteoporotic fracture in elderly patients taking warfarin: results from the National Registry of Atrial Fibrillation 2.
- MedicineArchives of internal medicine
- 2006
Long-term use of warfarin was associated with osteoporotic fractures, at least in men with atrial fibrillation, and beta-adrenergic antagonists may protect against osteopootic fractures.
Using medical services claims to assess injuries in the elderly: sensitivity of diagnostic and procedure codes for injury ascertainment.
- MedicineJournal of clinical epidemiology
- 2000