Abstract :
Introduction: The use of sedatives in the elderly requires caution due to the increased risk of complications in this age group. Although there are no specific statistics from the Ministry of Health on complications resulting from the use of sedatives in the elderly, studies indicate that polypharmacy and the use of potentially inappropriate medications (PIMs) are common in this population, increasing the risk of drug interactions and adverse events. Objectives: To compare the side effects of the most commonly used sedatives and determine the drug with greater clinical safety and less functional impact. Methodology: This study is a systematic review of clinical trials and observational studies published between 2019 and 2024. Systematic literature review: Although sedatives are essential tools in the management of critically ill patients, their use requires careful monitoring due to the risk of significant adverse effects. The choice of agent should be based on the individual characteristics of the patient, and protocols should be implemented to reduce complications. In summary, according to the literature presented, the drug with the lowest incidence of falls was Ramelteone and zolpidem. Regarding residual drowsiness, Ramelteon presented the highest overall risk, and Benzodiazepines and promethazine. Conclusion: Elderly patients have pharmacokinetic changes, such as lower renal and hepatic clearance, which make them more vulnerable to adverse effects of sedatives. The results indicate that Ramelteon is the safest drug for mild to moderate sedation, especially in patients with a history of falls or cognitive impairment. The choice of sedative should be individualized, considering the patient's clinical condition and the risk of complications.
Keyword :
Elderly, geriatric, Sedation, sedative drugs, hypnotics, Adverse effects, side effects, safety profile.