Q What medications commonly used in the intensive care unit (ICU) would predispose the patients to delirium? Are there any drug interactions that we should be paying attention to?

A Earnest Alexander, PharmD, replies:

Delirium is a clinical syndrome characterized by a disturbance in consciousness, attention, cognition, and perception. It may develop over a period of hours to days and is the most common clinical neuropsychiatric condition, occurring in 26% to 44% of hospital admissions. An alarmingly high incidence of up to 80% has been reported in critically ill patients. Delirium is associated with prolonged mechanical ventilation, self-extubations, and the need for reintubation, which have led to increased hospital stay, mechanical ventilator days, and mortality risk.1 This negative impact on outcomes and potential reversibility of the condition in up to 50% of cases, makes understanding risk factors for ICU delirium extremely important.

Delirium, especially in older patients, is usually...

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