Which medication places an older adult at the highest risk for injury after a fall?

Warfarin (Coumadin) is an anticoagulant medication that significantly increases the risk of bleeding, particularly in older adults who experience a fall. Falls can easily result in trauma, and if a person is on anticoagulation therapy, even minor trauma can lead to major complications such as internal bleeding or hematoma formation.

In older adults, the effects of warfarin can be compounded by age-related changes in pharmacokinetics and pharmacodynamics, as well as the presence of comorbidities that could affect coagulation status. The risk of injury is particularly heightened in those who are also at greater risk for falls due to factors like decreased mobility, vision impairment, or existing musculoskeletal issues.

Other medications listed may also pose risks to older adults, but none carry the same level of concern for immediate injury post-fall as warfarin does. For instance, acetaminophen/hydrocodone may cause dizziness and sedation, which can increase fall risk, but its primary concern is with dependence and liver toxicity rather than immediate injury from a fall. Alendronate, while used for osteoporosis, does not directly affect fall risk or injury severity, and loratadine is an antihistamine with minimal sedative properties and