Mineral oil is inappropriate for older adults because of aspiration risk. Which option correctly lists a safer alternative?

• A. Lactulose
• B. Polyethylene glycol
• C. Senna
• D. Mineral oil

Answer: (D)

The main idea is that mineral oil carries a risk of aspiration and lipid pneumonitis in older adults, so the Beers Criteria favors safer laxatives that don’t pose this risk. Among common laxatives, polyethylene glycol stands out as a safer choice for constipation in older adults. It’s an osmotic laxative that stays in the gut to hold water and soften stool, with minimal systemic absorption and a lower risk of respiratory complications if an event like aspiration were to occur. This makes it preferable to mineral oil in the older population.

Lactulose can be effective but often causes gas and bloating and may be less tolerable for some patients. Senna is a stimulant laxative and, with long-term use, can lead to cramps, electrolyte disturbances, or interactions with other medications. While all three of these non-mineral-oil options can be used, polyethylene glycol has the best overall safety profile for older adults in terms of aspiration risk and tolerability.