Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

What Medications Contribute to Delirium in Older Adults?
Mnemonic: Drug Category Examples of Drugs
A Antiparkinsonian drugs Trihexyphenidyl, Benzatropine, Bromocriptine, Levadopa, Selegiline (deprenyl)
C Corticosteroids Prednisolone: Decadron, Prednisone
U Urinary incontinence drugs Oxybutinin (Ditropan), Flavoxate (Urispas), Tolterodine (Detrol)
T Theophylline Theophylline
E Emptying drugs (motility drugs) Metoclopramide (Reglan)
C Cardiovascular drugs (including anti-hypertensives) Digoxin, Quinidine, Methyldopa, Reserpine, Beta Blockers (Propranolol - to a lesser extent), Diuretics, Ace inhibitors (Captopril & Enalapril), Calcium Channel antagonists (Nifedipine, Verapamil & Diltiazem)
H H2 blockers Cimetidine (uncommon on its own but   risk with renal impairment), Ranitidine
A Antimicrobials Cephalosporins, Penicillin, Quinolones
N NSAIDS Indomethacin, Ibuprofen, Naproxen, High dose ASA
G Geropsychiatry drugs
  1. Tricyclic antidepressants (e.g., Amitriptyline, Desipramine - to a lesser extent Imipramine, Nortriptyline)
  2. SSRIs- safer but watch if hyponatremia present.
  3. Benzodiazepines (e.g., diazepam, lorazepam)
  4. Antipsychotics (e.g., Haloperidol, Chlorpromazine, Risperidone, Olanzepine)
E ENT drugs Antihistamines/decongestants/cough syrups in over-the-counter preparations
I Insomnia Nitrazepam, Flurazepam, Diazepam, Temazepam
N Narcotics Meperdine, morphine, codeine
M Muscle relaxants Cyclobenzaprine (Flexeril), Methocarbamol (Robaxin)
S Seizure drugs Phenytoin, Primidone

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* This is a table noting some examples of possible medications that can contribute to delirium. It is the physiological status of the older adult and the combination of medications, among other factors that increase risk. Therefore: "Watch and Beware".

Reprinted from Clinics in Geriatric Medicine, 14(1), Flaherty, J.H., Commonly prescribed and over-the counter medications: Causes of confussion, pp. 101-125, copyright (1998), with permission from Elsevier.

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