Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011206 (delirium)
 5,996 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From January 1974 to June 1983, the Paris Poison Control Centre collected 84 cases of overdosage with orphenadrine alone or in combination. Prior papers emphasized fatalities related to orphenadrine poisoning. This retrospective study suggests an underestimated incidence of anticholinergic drugs abuse in our country. The clinical picture of orphenadrine poisoning associates drowsiness, agitation, confusion, delirium and seizures. Anticholinergic symptoms are often noted: mydriasis, sinus tachycardia, dryness of the mouth and urinary retention. No severe cardiac disturbance was found in these patients.
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PMID:[Acute poisoning by orphenadrine]. 383 10

A 60-year-old man with psychotic depression became comatose following the administration of intravenous droperidol given for post-ECT delirious agitation. The differential diagnosis, which included neuroleptic malignant syndrome and the possibility that droperidol may have uniquely detrimental effects in the context of post-ECT delirium, are discussed. In light of recent publications advocating droperidol as the pharmacologic treatment of choice for severe agitation, this case illustrates a need for greater caution in its use for the treatment of post-ECT delirium.
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PMID:Coma following ECT and intravenous droperidol: case report. 394 73

Though recovery of consciousness after drug overdose may occur within a day or two, the drug itself may not finally leave the brain for another one to three weeks, and at this late time a withdrawal syndrome can occur, with insomnia, restlessness, raised paradoxical (R.E.M.) sleep, epileptic phenomena, and even delirium. It is proposed that a high degree of drug-tolerance and dependence can be rapidly acquired after overdose.Abnormal sleep features of 10 patients resolved only slowly over a period of up to two months after overdose. The data support the view that R.E.M. sleep is concerned with processes of brain repair.
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PMID:Late brain recovery processes after drug overdose. 431 51

Lorazepam 0.05 mg X kg-1 and diazepam 0.1 mg X kg-1 administered intravenously were compared as sedatives for 42 patients undergoing Caesarean Section under epidural anaesthesia. After receiving the drug, 15 per cent of the diazepam patients and 32 per cent of the lorazepam patients were still agitated. Ten per cent of the diazepam patients and 36 per cent of the lorazepam patients had severe symptoms of delirium. These included hallucinations, confusion, agitation, restlessness, inappropriate weeping and repetitive hand movements. Memory impairment was greater with lorazepam. Thirty-five per cent of the diazepam patients had pain at the injection site. None of the lorazepam patients had such pain. Respiratory rate, heart rate and mean blood pressure did not change significantly in either group. Half the patients who had been given lorazepam had side effects that were bothersome enough to cause them to complain the following day. Lorazepam and diazepam were both unsatisfactory as sedatives for patients having Caesarean Section.
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PMID:Lorazepam and diazepam as adjuncts to epidural anaesthesia for caesarean section. 612 34

Sultopride, a benzamide derivative, provides rapid sedation. This makes it one of the main drugs used in psychiatric emergencies. Our study includes 26 cases of psychomotor hyperactivity originating in manic-depressive psychosis of schizophrenia. The medication had no effect on wakefulness. It was always effective on agitation but not on delusion or hallucinations. Manic forms of primary delirious experiences are the best indication for sultopride. It is mainly effective on delirium as a state rather than on delirium as an idea (Wahn, Delusion) which is secondary from a pathogenetic standpoint.
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PMID:[Sultopride in acute manic psychoses (author's transl)]. 627 34

The effectiveness of sultopride in acute psychiatric syndromes with prominent agitation was tested in patients seen in the emergency department of a general hospital. Among 32 patients, 26 were given a single injection of 200 mg and 6 had two injections. Seven items were evaluated at ten minute intervals for one hour. Results showed excellent control of agitation and anxiety but little effect on delirium, hallucinations and depression. Furthermore, the patients' unwillingness to be cared for can be overcome by this agent and diagnosis, therapy and orientation can be established. These good results are partly achieved as early as 20 minutes after the injection. Psychomotor agitation thus appears to be the choice indication of sultopride.
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PMID:[Open trial of sultopride in psychiatric emergencies]. 630 77

Methyl bromide (MeBr) is used as an insecticide fumigant. Four deaths and three recent hospitalizations have resulted from exposures to MeBr in Dade County, FL. Six cases occurred during burglaries of tented houses over a nine-month period. In four lethal exposures, the symptoms of nausea, vomiting, and malaise preceded fulminant respiratory failure. Two of these also had seizures, delirium, and agitation. Serum or plasma bromide ion levels ranged from 40 to 583 mg/L. Pulmonary edema, hyaline membranes, and hemorrhagic alveolitis were present at autopsy along with varying degrees of cerebral edema. The nonlethal exposures resulted in symptoms of conjunctival irritation, headache, or nausea. Plasma bromide concentrations varied between 17.5 and 321 mg/L. Methyl bromide characteristics, use, morbidity, and mortality in Florida during the past 25 years are reviewed. Remedies for illegal entry are proposed.
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PMID:Death and injury caused by methyl bromide, an insecticide fumigant. 661 79

Intramuscular chlordiazepoxide (CDX) is commonly administered to alcoholic liver disease (ALD) patients requiring prompt management of alcohol agitation, anxiety, and delirium tremors. Sedative action is associated with plasma levels of approximately 2.0 mcg/ml, however, intramuscular CDX has been shown to produce peak concentrations consistently below 2.0 mcg/ml in normal subjects. The present study was designed to define the absorption characteristics of intramuscular 25 mg CDX in males with ALD. Five normal males had mean CDX absorption half-lives of 3.0 h and peaked at 0.8 mcg/ml in 7.2 h, while 11 males with ALD had mean absorption half-lives of 9.0 h, and peaked at 0.7 mcg/ml in 19.1 h when they received the drug dissolved in normal saline. Four other males with ALD who received CDX dissolved in the manufacturer's diluent had significantly slower mean absorption half-lives of 16.1 h which peaked at 0.3 mcg/ml in 35.2 h. Significant linear correlations were found with age (r = 0.60, p less than 0.01), body weight (r = 0.55, p less than 0.01), and serum albumin (r = 0.60, p less than 0.01). Because of the extremely slow intramuscular absorption of CDX dissolved in normal saline or the manufacturer's diluent in males with ALD, we do not recommend this route of administration in this population.
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PMID:The absorption of intramuscular chlordiazepoxide (Librium) in patients with severe alcoholic liver disease. 662 48

General anesthesia offers greater comfort for both the abortion patient and the operator. The combination of diazepam and ketamine which is rapidly reversible and offers a moderately deep anesthesia was used in 127 voluntary abortions and 3 therapeutic abortions. Patients ranged in age from 14-40 years and averaged 26, with 58% under 26. Patient weights ranged from 40-82 kg and averaged 56 kg. 43% were primaparas and average parity was 2.5. The average duration of the prenancy was 8.1 weeks. 10 patients were obese, 1 was asthmatic, 1 was a controlled hypertensive, 3 had cardiopathies, and 4 each had hepatitis and meningitis. 1 had treated epilepsy and 2 had serious depressive syndromes. 3 women had previously had voluntary abortions, 9 had had miscarriages, and 1 had had an extrauterine pregnancy. 17% had no fear or anxiety before the procedure, 56% had moderate levels, 28% had significant levels, and 19% had very high levels. 94% of the procedures were done by aspiration and in most cases a preliminary insertion of laminaria was done. The average duration of the procedure was 5 minutes, with extremes of 2 and 25 minutes. Patients were premedicated 1 hour before the procedure with intramuscular injections of 10 mg diazepam and 1/4 mg of atropine. For the induction, a butterfly needle with an antireturn system was used to inject 10 mg of diazepam and 1/4 mg of atropine diluted in 20 ml of distilled water. The patient was placed in the gynecological position and, if necessary, 5 mg of diazepam were added. Between .5-1 mg/kg of ketamine were injected in 10-15 seconds. The same dose was reinjected if the anesthesia was insufficient or the procedure was prolonged. A mixture of 40% oxygen and 60% nitrous oxide was administered if necessary. Patients remained in bed for 6 hours after awakening. 85% of patients received total doses of ketamine of .70mg/kg or less. Average duration of anesthesia was 9.2 minutes, with durations of less than 15 minutes in 94% of cases. On awakening 5% of patients had nausea and vomiting. 16% had minor psychic disturbances or disorientation, 8% had moderate problems with vocalization, and 2% had hallucinatory delirium with agitation. Overall, 20% of patients experienced headaches, 11% nausea, and 9% dizziness. It was concluded that the combination of diazepam .2 mg/kg and ketamine .5-.7 mg/kg provides well tolerated light anesthesia utilizable for outpatient abortions.
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PMID:[Diazepam and ketamine for voluntary interruptions of pregnancy]. 692 72

Agitation in elderly patients is often caused by acute cerebral failure, more commonly called acute brain syndrome, delirium, or acute confusional state. Defects in cognition, sleep-waking cycles, and psychomotor behavior result. Careful history taking, physical examination, and laboratory testing may reveal a specific, reversible organic factor related to the acute brain syndrome. This article outlines the clues to recognizing agitation due to a cerebral failure and gives guidelines for workup and management.
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PMID:Agitation in the elderly: an often-treatable manifestation of acute brain syndrome. 714 88


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