What is one of the major concerns when using antiemetic agents in the elderly?

The use of antiemetic agents in the elderly presents several unique challenges, with the risk of sedation and falls standing out as a major concern. Older adults often have age-related changes in pharmacokinetics, such as slower metabolism and excretion of drugs, along with an increased sensitivity to central nervous system effects. Many antiemetics, especially those with sedative properties like first-generation antihistamines, can lead to drowsiness, dizziness, and impaired coordination.

These side effects significantly increase the risk of falls, which can lead to serious injuries, including fractures and head trauma. The elderly population is particularly susceptible to these risks due to existing frailty, balance issues, and potential polypharmacy, where multiple medications may exacerbate sedation or dizziness. As a result, careful consideration must be taken when prescribing antiemetics to older patients, prioritizing medications with minimal central nervous system effects and closely monitoring their response to treatment.