Pharmacologic Interventions
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When to consider pharmacologic interventions?
- May consider if:
- Nonpharmacologic interventions unsuccessful
- Patient is a danger to themselves or others
Which option to choose?
- Most recommendations are an extrapolation of outpatient data and expert consensus
- No “best” medication option
Therapeutic goal
Calm without inducing sleep
When using pharmacologic interventions for delirium:
-
Oral Regimen Preferred
-
Start Low and Go Slow
-
Allow time for therapeutic effect
IMPORTANT:
- No FDA-approved pharmacologic intervention
- Commonly used agents
- First-generation antipsychotics (FGAs)
- Second-generation antipsychotics (SGAs)
- Benzodiazepines
- Antipsychotics and benzodiazepines
potentially inappropriate by the Beer’s criteria
References
American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2015;63(11):2227–2246