Beers Criteria includes which of the following in its medication lists?

• A. First generation antihistamines
• B. Beta blockers
• C. Proton pump inhibitors
• D. Corticosteroids

Answer: (A)

The main idea here is that Beers Criteria identifies medications that pose higher risks for older adults, often due to stronger anticholinergic effects or other age-related sensitivities. First-generation antihistamines (such as diphenhydramine) have potent anticholinergic properties. They cross into the brain easily, which can lead to confusion, delirium, sedation, dry mouth, constipation, and urinary retention. In older adults, who are more vulnerable to cognitive changes and falls, these effects are especially problematic, so these drugs are prominently listed as ones to avoid in most seniors.

The other options don’t carry the same universal "avoid" signal in Beers Criteria. Beta blockers are commonly used with careful consideration of the individual’s cardiovascular status. Proton pump inhibitors can be appropriate for certain conditions, though long-term use is reviewed in the criteria for other risks. Corticosteroids carry their own risks with chronic use, but they aren’t singled out in the Beers list for all older patients in the same way as the strong anticholinergic burden from first-generation antihistamines.