90 CHAPTER 2.2 Table SI1.1. Continued. STOPP Action Clarity rating Condition Clarity rating Explanation Clarity rating J6 Androgens (male sex hormones) 67% in the absence of primary or secondary hypogonadism 58% (risk of androgen toxicity; no proven benefit outside of hypogonadism indication). 92% K K1 Benzodiazepines 67% [falls] 0% (sedative, may cause reduced sensorium, impair balance). 58% K2 Neuroleptic drugs 17% [falls] 0% (may cause gait dyspraxia, Parkinsonism). 58% K3 Vasodilator drugs (e.g. alpha-1 receptor blockers, calcium channel blockers, long-acting nitrates, ACE inhibitors, angiotensin I receptor blockers, ) 33% with persistent postural hypotension i.e. recurrent drop in systolic blood pressure ≥ 20mmHg 83% (risk of syncope, falls). 75% K4 Hypnotic Z-drugs e.g. zopiclone, zolpidem, zaleplon 50% [falls] 0% (may cause protracted daytime sedation, ataxia). 58% L L1 Use of oral or transdermal strong opioids (morphine, oxycodone, fentanyl, buprenorphine, diamorphine, methadone, tramadol, pethidine, pentazocine) 42% as first line therapy for mild pain 50% (WHO analgesic ladder not observed). 33% L2 Use of regular (as distinct from PRN) opioids 67% without concomitant laxative 17% (risk of severe constipation). 83% L3 Long-acting opioids 17% without short-acting opioids for break-through pain 17% (risk of non-control of severe pain) 67%
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