Changes in the Dose of Benzodiazepines and Falls in Elderly Inpatients in an Acute-care Hospital

Hyponatremia and hypokalemia as risk factors for falls

“…15 Among these agents, anticancer agents 16 and benzodiazepine are especially associated with greater fall risks, 2 with increased dosages reportedly doubling the risk of falls. 17 Defined as a serum sodium concentration of o135 mEq/l, 18,19 hyponatremia is the most common electrolyte imbalance in hospitalized patients, 20 and the incidence has been reported to increase with advancing age. 21 Hyponatremia is more commonly observed in individuals residing in nursing homes than in the general population, 22 and has been reported to occur in 15-22% of hospitalized patients.…”

Development of an evidence‐based fall risk assessment tool and evaluation of interrater reliability and nurses’ perceptions of the tool's clarity and usability

“…The Edmonson Psychiatric Fall Risk Assessment tool includes the use of psychotropic medication and assigns a higher score when the dose of medication has been increased or is administered as needed within a 24 h period. A number of studies has reported an increased fall risk when psychotropic medications are newly prescribed or within 2–3 days of a dose increase (Echt, Samelson, Hannan, Dufour, & Berry, ; Lamis, Kramer, Hale, Zackula, & Berg, ; Neutel, Perry, & Maxwell, ; Sorock et al , ; Takahashi et al , ). Therefore, in the evidence‐based fall risk assessment tool, the use of hypnotics and/or psychotropic medication was scored depending on whether the drug was newly prescribed or the dose had been increased within 2 days of assessment.…”

Analysis of potential cost reductions related to falls in hospitalized elderly patients by correcting high-dose prescriptions of sedative

“…Known side effects of sedative hypnotics include disorientation, listlessness, headache, fatigue, amnesia, and muscle relaxation [24]. Many reports have indicated that sedative hypnotics are related to fall rates [8,12,18]. The use of high-dose sedative hypnotics in the elderly seems to be associated with an increased fall risk due to a carry-over effect caused by the increased half-life of the drug associated with the patients' poor hepatic and renal function.…”

“…Among these drugs, sedative hypnotics greatly affect the risk of falling [15,16] since they cause depressed levels of consciousness, cognitive impairment, and muscle relaxation [17]. High dosages of sedative hypnotics have been shown to be associated with falls in the elderly [18].…”