II. Background
- Medications are responsible for 23% of persistent Dizziness in elderly patients
- Polypharmacy with more than 5 medications increases the Dizziness risk
III. Causes: Cardiovascular Agents
- Class Ia Antiarrhythmics (e.g. Quinidine, Imipramine, Amiodarone, Disopyramide)
- Antihypertensives (esp. Beta Blockers)
- Diuretics (e.g. Lasix)
- Digoxin
- Nitroglycerin
- Dipyridamole
IV. Causes: Endocrine Agents
- Antithyroid Drug (Bone Marrow suppression)
- Injectable and Oral Hypoglycemic Agents (esp. SGLT2 Inhibitors such as Invokana)
V. Causes: Hematologic Agents
- Salicylates or Aspirin (Ototoxicity)
- Dipyridamole (e.g. Aggrenox)
VI. Causes: Infectious Disease Agents
- Amantadine
- Aminoglycosides (Ototoxicity)
- Quinolones (e.g. Ciprofloxacin)
VII. Causes: Neurologic Agents
- Antidementia agents (e.g. Namenda)
- Antiparkinsonism Medications (esp. Anticholinergics such as Benztropine, Trihexyphenidyl)
- Anticonvulsants (typically at toxic levels)
VIII. Causes: Psychiatric agents
IX. Causes: Miscellaneous
- See Ototoxic Drug
- Alcohol
- Hydroxychloroquine (Ototoxicity)
- Phosphodiesterase Inhibitors (e.g. Viagra, Cialis, Levitra)
- Opioids
- Toxin Exposure (e.g. Carbon Monoxide)
-
Anticholinergic Agents
- See Anticholinergic Agent
- Antihistamines (esp. First Generation Antihistamines, Diphenyhydramine)
- Skeletal Muscle Relaxants (e.g. Flexeril)
- Urinary Antispasmodics (e.g. Ditropan)