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    Can overmedication lead to delirium in an elderly patient?

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Posted on Tue, 1 Aug 2017 in Hypertension and Heart Disease
Question: My father, 81 yrs old, had two valves replaced on XXXXXXX 14th in XXXXXXX at the Heart Institute. The Aortic Valve and the Mitral valve. He also has COPD and Emphysema from many years of smoking cigarettes. He was in a nursing home for rehab after leaving Mpls for a couple of weeks and then got pneumonia while in the nursing home. He is currently in the local hospital here in Calumet, MI being treated for the pneumonia. My concern is that he is taking too many medications that are reacting with each other. His eyes do not track properly and he is saying things that are not true. He is taking Bumex by IV, 2 mg, Cordarone 200mg daily, Norvsac 10 mg daily, Baby aspirin 81 mg daily, Lipitor 80 mg daily, Toprol - XL 50 mg daily, Kbdur.20mEq daily with breakfast, Zoloft 25 mg daily, Flomax .4 mg daily, Desyrel - 50 mg daily at bedtime, Vancomycin via IV (which is being closely monitored by blood draws and subject to change amounts, they are monitoring this closely),Rocephin by IV 1 gram every 24 hours. I think he is being overmedicated. Please advise. Thank you. XXXX
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Answered by Dr. Rishu Saxena 29 minutes later
Brief Answer:
most likely Delerium due to continuous medical admissions.

Detailed Answer:
Hi dear,
Thanks for query. I've gone through it in details,

Delirium is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of your environment. The start of delirium is usually rapid — within hours or a few days.

Delirium can often be traced to one or more contributing factors, such as a severe or chronic medical illness, changes in your metabolic balance (such as low sodium), medication, infection, surgery, or alcohol or drug withdrawal.

Signs and symptoms of delirium usually begin over a few hours or a few days. They often fluctuate throughout the day, and there may be periods of no symptoms. Symptoms tend to be worse during the night when it's dark and things look less familiar.

Antidepresssants (Fluoxetine, Citalopram), if depression is present.
Dopamine blockers (Haloperidol, Quetiapine, or Risperidone are most commonly used).

Sedatives (Clonazepam or Diazepam) in cases of delirium due to alcohol or sedative withdrawal are the main stay of treatment.

A psychiatrist should keep a strict watch on all his symptoms.

Please let me know if I can assist you further.

Thanks!

Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Dr. Rishu Saxena

Cardiologist

Practicing since :2012

Answered : 696 Questions

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