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Dr. Andrew Rynne

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Exp 50 years

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What causes delirium while treating high blood pressure?

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Dr. Indranil Ghosh

Oncologist

Practicing since :2004

Answered : 1480 Questions

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Posted on Fri, 6 Nov 2015 in Cancer
Question: For high blood pressure, hydralazine (100mg) 4 x day); hydralade zinc (10 mg) 4 x day and isosorbide dinitrate 3x day with carvedilol now 3.25 from 12.5. Hospital for 2 weeks without a diagnoses. I think they were treating dementia. Now my husband is diagnosed with delirium. He has not been out of bed since being admitted for high blood pressure.
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Answered by Dr. Indranil Ghosh 1 hour later
Brief Answer:
need to investigate fully

Detailed Answer:
Hi
Thanks for your query.

It appears that his hypertension is not getting controlled and now it has affected his sensorium.

First of all, we need to find out the cause for this hypertension, specifically ruling out kidney or cardiac diseases and if any hormonal excess is there in blood which is causing this. Then we can treat it better.

Also we need to find out the cause of his delirium. Brain CT or MRI and comprehensive, metabolic panel in blood can rule out common causes of this.

May be you can discuss these points with his docs.
I will be available for follow-up as required.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Indranil Ghosh 30 hours later
He has had 4 CT's, MRI and blood work. The doctor made the remark that he was healthier than he. He is also taking Depakote (125 mg) (down from 3/day); Transadone; Finasteride 5 mg; Trospium 60 mg. They have discontinued Zyprex;Zofran;Compazine/Haldol and at times still use Valium.
doctor
Answered by Dr. Indranil Ghosh 6 hours later
Brief Answer:
sensorium may improve

Detailed Answer:
Ok. You have not mentioned the reports of CT and MRI. I assume that they don't show anything significant. In that case, after withdrawing these meds and gradual control of blood pressure, sensorium should improve.

If it doesn't then we are left with the diagnosis of dementia.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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