Delirium/confusion caused

Geriatric Considerations - Summary Alkaloids from the belladonna plant contain 3 potent anticholinergics and offer no advantage over other available drugs. Belladonna alkaloids possess potent anticholinergic effects and can cause dry mouth, blurred vision, delirium, confusion, psychosis, and increased risk of falls. This compound has no role in treating the older adult. 

The histamine-2 receptor blockers (H-2 blockers) are used to treat hyperacidity in the stomach, and the most commonly used medications are available over the counter (without prescription). The first one was cimetidine (brand name Tagamet), which is a very common cause of delirium, confusion, psychosis, and aggression in the elderly—especially at night. The other H-2 blockers, such as ranitidine (brand name Zantac) and famotidine (brand name Pepcid), can also cause these symptoms, which are quite rare with these two drugs. Cimetidine should be avoided in the elderly and those with a serious illness. The H-2 blockers can also cause depression, mania, and nightmares. Therapists will see many patients who are taking H-2 blockers, and the patients may not... 

Therapeutic doses of scopolamine produce CNS depression, characterized by drowsiness, amnesia, and dreamless sleep (Brown and Taylor 1996). It reduces arousal and increases the effort required to awaken (Parrott 1987). Higher therapeutic doses of atropine cause central excitation, characterized by restlessness, irritability, confusion, disorientation, hallucinations, and delirium. Larger doses produce central depression, paralysis, coma, and death by respiratory failure and cardiovascular collapse. 

Although many physicians routinely use benzodiazepines to treat combative, delirious patients, this is not recommended. First, benzodiazepines can cloud consciousness and actually worsen the confusion of delirium. Second, benzodiazepines can worsen the breathing problems of patients with pneumonia or emphysema, two common causes of delirium. The lone exception is a delirium that is caused by alcohol or benzodiazepine withdrawal. A benzodiazepine MUST be used for alcohol... 

Uses Prevention Rx influenza A (including 2009 Novel HlNl ) B, Action -1- Viral neuraminida.se Dose AduUs. Tx 75 mg PO bid X 5 d Prophylaxis 75 mg PO daily X 10 d Peds >1 yr. (Authorized 2009 by FDA for emergency use in <1 y) PO bid dosing <15 kg 30 mg 15-23 kg 45 mg 24-40 kg 60 mg >40 kg Adult dose -1- w/ renal impair Caution [C, /—] Contra Component allergy Disp Caps SE NA, insomnia, rqjorts of neuropsychiatric events in children (self-injury, confusion, delirium) caution urged in children as SEs are often more severe that the HlNl influenza Interaction T Effects W/ probenecid EMS Beware acute neuropsychiatric effects esp in children OD May cause NA symptomatic and supportive... 

Long half-life BZDs may increase the risk of daytime sedation, lethargy, cognitive impairment, and delirium, as well as falls and hip fractures ( 309, 310 and 311). Long-term use of flurazepam (30 mg per day) has been associated with an increased incidence of ataxia and hallucinations ( 312). However, short half-life BZDs also may cause serious adverse effects. Ataxia, depression, confusion, amnestic syndromes, and oversedation have been reported in elderly lorazepam users, and there is some evidence that short-acting BZDs may also increase the risk of falls (313, 314, 315, 316 and 317). 

Often, toxic organic states that may be complicated by psychotic symptoms develop in terminally ill patients. Acute confusion has been reported in up to 85% of terminal cancer patients, with restlessness and agitation occurring in up to 42%. Unfortunately, the cause of delirium is determined in only 21% of these patients ( 373, 374). Common sources can include the following ... 

If phlegm obstructs the Heart, blocks the blood circulation and disturbs the mind, it causes palpitations, chest pain, restlessness, insomnia, depression, mental confusion, delirium and mania. 

Abusers initially feel happy, giddy, excited, and uninhibited. After these immediate effects wear off, they may feel lightheaded, dizzy, drowsy, or agitated. They may hallucinate, have delusions, and/or experience a loss of sensation or of feeling no pain. Concentrated doses can cause confusion and delirium. 

Inhalation of vapor may cause dizziness, drowsiness, mental confusion, muscular twitching, and delirium. The vapor and liquid irritate the eyes and distort the vision. The liquid irritates the skin and may cause blistering. The liquid must be assumed to be an irritant and poisonous if taken by mouth. Avoid breathing vapor. Prevent contact with skin and eyes.4 An experimental neoplastic.5 TLV-TWA 2 ppm (12 mg/m3) (skin).6... 

Effects Leaves similar to D. inoxia. Seeds cause mental confusion, delirium followed by fitful sleep with colorful hallucinations. 

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