Delirium – Potentially deliriogenic medications
| Analgesics | NSAIDs, opioids (especially meperidine) |
| Antibiotics | Aminoglycosides, amphotericin B, antimalarials, cephalosporins, cycloserine, fluoroquinolones, isoniazid, interferon, linezolid |
| Antibiotics (cont) | Macrolides, metronidazole, nalidixic acid, penicillins, rifampin, sulfonamides |
| Antivirals | Acyclovir |
| Anticholinergics | Atropine, benztropine, diphenhydramine, scopolamine, trihexyphenidyl |
| Anticonvulsants | Carbamazepine, levetiracetam, phenytoin, valproate, vigabatrin |
| Antidepressants | Mirtazapine, SSRIs, tricyclic antidepressants |
| Cardiovascular | Antiarrhythmics, beta blockers, clonidine, digoxin, diuretics, methyldopa |
| Corticosteroids | All including prednisone, methylprednisone, dexamethasone, fludrocortisone |
| Dopamine agonists | Amantadine, bromocriptine, levodopa, pergolide, pramipexole, ropinirole |
| Gastrointestinal | Antiemetics, antispasmodics, H-2 blockers, loperamide |
| Herbal preparations | Atropa belladonna extract, henbane, mandrake, Jimson weed, St. John’s wort, valerian |
| Hypoglycemics | |
| Hypnotic/sedatives | Barbiturates, benzodiazepines |
| Muscle relaxants | Baclofen, cyclobenzaprine |
| Other CNS | Disulfiram, cholinesterase inhibitors (donepezil), interleukin-2, lithium, phenothiazines |
- Some drugs are directly deliriogenic (benzos, anticholinergics, dopamine agonists, etc.) while others are deliriogenic through adverse reactions (hypoglycemics causing hypoglycemia, NSAIDs causing AKI, antihypertensives causing hypotension, etc.)
- Consider all medications but also weigh their benefits as their treatment may be protective. For example, bone fracture pain treated with the judicious use of opioids or an underlying infection with an antimicrobial is strongly recommended!