II. Risk factors: Medication induced Altered Level of Consciousness

  1. Age over 60 years old

III. Medications: Neuro-Psychopharmacologic Agents

  1. Anticholinergics (e.g. Atropine)
    1. See Anticholinergic Medications
    2. See Anticholinergic Toxicity
  2. Anticonvulsants
    1. Delirium or Confusion
    2. Cognitive Impairment
    3. Amnesia
  3. Barbiturates
    1. Delirium or Confusion
    2. Incoordination
    3. Barbiturate withdrawal related signs
  4. Benzodiazepines (esp. high dose longer acting agents)
    1. Cognitive Impairment
    2. Amnesia
    3. Sedation
    4. Pseudo-Dementia
    5. Incoordination
    6. Benzodiazepine Withdrawal (e.g. Delirium)
      1. Higher risk with shorter acting Benzodiazepines
  5. Tricyclic Antidepressants (e.g. Elavil, Doxepin)
    1. Delirium
    2. Confusion
    3. Impaired Memory
  6. Selective Serotonin Reuptake Inhibitors (SSRIs)
    1. Decreased concentration
    2. Confusion associated with SIADH
  7. Antipsychotics
    1. Effects
      1. Delirium or confusion
      2. Cognitive Impairment
      3. Amnesia
    2. High risk
      1. Chlorpromazine
      2. Thioridazine
      3. Clozapine
    3. Low risk
      1. Risperidone
  8. Lithium
    1. Organic brain syndrome
  9. Zolpidem (Ambien)
    1. Memory Impairment
    2. Hallucinations

IV. Medications: Analgesics

V. Medications: Drugs of Abuse and Toxins

VI. Medications: CardioPulmonary agents

  1. Beta Blockers
    1. Confusion
    2. Cognitive Impairment
  2. Calcium Channel Blockers
    1. Cognitive decline
  3. Acetazolamide (Diamox)
    1. Confusion
  4. Digoxin
    1. Confusion or Delirium
  5. Disopyramide (Norpace)
    1. Psychosis (Anticholinergic related)
  6. Ethacrynic Acid
    1. Confusion
  7. Nitroprusside
    1. Confusion or Delirium
  8. Procainamide
    1. Delirium
  9. Quinidine
    1. Confusion
    2. Psychosis
  10. Theophylline
    1. Psychosis

VII. Medications: Infectious Disease Agents

  1. Beta lactam antibiotics
    1. Confusion
  2. Fluoroquinolones
    1. Neurologic stimulation
    2. Confusion
  3. Acyclovir
    1. Confusion
  4. Mefloquine
    1. Confusion
    2. Psychosis
  5. Trimethoprim-Sulfamethoxazole (Bactrim, Septra)
    1. Delirium
    2. Psychosis

VIII. Medications: Antihistamines

  1. See Anticholinergic Medications
  2. See Anticholinergic Toxicity
  3. H1 blocker
    1. Effects
      1. Decreased attention
      2. Decreased Concentration
    2. High risk: Sedating Antihistamine
    3. Low risk: Fexofenadine, Loratadine
  4. H2 Blocker (esp. Cimetidine)
    1. Delirium or confusion

IX. Medications: Miscellaneous

  1. Corticosteroids (Prednisone at doses above 60 mg)
    1. Confusion of Delirium
    2. Memory Impairment
  2. Baclofen
    1. Psychosis
  3. Cyclobenzaprine (Flexeril)
    1. Delirium or confusion
  4. Cyclosporine
    1. Confusion
  5. Fenfluramine
    1. Confusion
  6. Interferon alpha
    1. Confusion
    2. Memory Impairment
  7. Omeprazole (Prilosec)
    1. Confusion
    2. Agitation
    3. Memory Impairment

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