Which item is not typically on the Beers Criteria avoid list?

• A. Vitamin B12
• B. Nonselective peripheral alpha-1 blockers
• C. Anticholinergics
• D. Antipsychotics

Answer: (A)

The Beers Criteria highlight medications that pose higher risks for older adults and are often avoided because their harms outweigh benefits in this population. Vitamin B12 is not on that avoid list because it’s a vitamin that’s generally safe and beneficial when deficiencies are present or suspected in older adults. It does not carry the same risk profile (falls, delirium, cognitive impairment, mortality in dementia, or severe anticholinergic effects) that prompts avoidance of many drugs.

In contrast, nonselective peripheral alpha-1 blockers can cause orthostatic hypotension and falls; anticholinergic drugs contribute to confusion, dry mouth, constipation, urinary retention, and delirium; antipsychotics are associated with increased mortality in older adults with dementia and other adverse effects like extrapyramidal symptoms. Those risks are why they are commonly listed for avoidance, unlike Vitamin B12.