Quote from Mikai on October 4, 2025, 2:16 pm

Management of delirium

Mikai reply

 

 

**Identify and treat underlying causes:** - Correct electrolyte imbalances (e.g., hyponatremia, hypocalcemia). - Manage infections with appropriate antibiotics. - Discontinue or adjust medications contributing to delirium (e.g., anticholinergics, benzodiazepines). - **Rationale:** Delirium often resolves with treatment of the precipitating factor. -

 

**Non-pharmacologic interventions:** - Ensure a calm, well-lit environment with orientation cues (e.g., clocks, calendars). - Promote sleep-wake cycle regularity; minimize disruptions at night. - Encourage mobilization and engagement in familiar activities. - **Rationale:

 

** Reduces agitation and disorientation. -

 

**Pharmacologic management (if necessary):** -

**First-line:** Low-dose antipsychotics (e.g., haloperidol, quetiapine) for severe agitation or psychosis. - **Rationale:** Evidence supports their use for symptom control, though risks (e.g., extrapyramidal symptoms) must be weighed. - **Avoid:** Benzodiazepines unless for alcohol/benzodiazepine withdrawal (risk of worsening delirium). - **Rationale:** Benzodiazepines may exacerbate confusion. -

 

**Monitor and reassess:** - Reevaluate for new precipitants (e.g., pain, constipation, urinary retention). - Discontinue medications as delirium improves. - **Rationale:** Delirium is dynamic; ongoing assessment is critical.