Anileridine-induced delirium

Abstract

Delirium is a common complication in hospitalized patients and is often associated with significant morbidity. It is important to recognize this syndrome early so that potential causes can be identified and properly managed. Although the etiology of delirium in critically or terminally ill patients is often multifactorial, opioid analgesics are often implicated as a potential underlying cause. Certain opioids, such as meperidine, have been identified as having a greater potential for causing delirium than others. There have been no published reports of anileridine-induced delirium and an illustrative case is presented.

Palliative therapy in the terminal stage of neurological disease

“…Causes may include CNS involvement by the underlying pathology, terminal multiorgan failure, hyperhydration, hypercalcemia or drug side effect [21, 54,69]. Symptoms may worsen during the evening and night, or with sedating medication.…”

Opioid use in cancer pain. Is a more liberal approach enhancing toxicity?

“…Hallucinations have been previously described in patients requiring opioid analgesia (53)(54)(55)(56)(57)(58)(59)(60). Most of the reports have described visual hallucinations.…”

“…If the parent opioid or its active metabolites are suspected of being responsible for OIN, a rotation of the opioid may be instrumental in alleviating its effects. Several papers (summarized in Table 3) have shown this to be a safe and reliable method to decrease neurotoxicity but retain analgesia (58,60,76,79,81,(96)(97)(98)(99)(100)(101)(102)(103). Although the studies were uncontrolled and the total number of patients was small, all patients in these studies had evidence of OIN and all were observed to have significant improvement following the rotation of the opioid.…”