Delirium may occur during therapy with opioid analgesia. This can cause significant problems for people caring for the patient.
Risk factors for delirium:
(1) advanced age
(2) renal insufficiency
(3) hepatic insufficiency
(4) alcohol and/or drug withdrawal
(5) high doses of the opioid
(6) drugs that interfere with opioid metabolism
(7) therapy with drugs that cause sedation
(8) dementia
(9) head injury or brain metastases
Management:
(1) Reduce the dose of the opioid.
(2) Select an opioid with a short half-life and inactive metabolites.
(3) Discontinue or reduce the dose of drugs that may cause sedation.
(4) Avoid drugs that interfere with opioid metabolism.
(5) Consider therapy with an antipsychotic agent.
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Specialty: Toxicology, Emergency Medicine, Critical Care
