H2 Blocker Delirium

Picotte-Prillmayer, Dawn; Dimaggio, Joseph R.; Baile, Walter F.

doi:10.1016/s0033-3182(95)71712-1

Cited by 18 publications

(8 citation statements)

References 7 publications

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“…Although rare, there are reports of histamine-2 blockers, such as famotidine, ranitidine, and cimetidine, causing delirium. 138, 139 These should be avoided in delirious patients if at all possible.…”

Section: Pharmacologic Management Of Deliriummentioning

confidence: 99%

Delirium in the Older Emergency Department Patient: A Quiet Epidemic

Han

Wilson

Ely

2010

Emergency Medicine Clinics of North America

104

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Synopsis Delirium is defined as an acute change in cognition that cannot be better accounted for by a preexisting or evolving dementia. This form of organ dysfunction commonly occurs in older emergency department (ED) patients and is associated with a multitude of adverse patient outcomes. Consequently, delirium should be routinely screened for in older ED patients. Once delirium is diagnosed, the ED evaluation should focus on searching for the underlying etiology. Infection is one of the most common precipitants of delirium, but multiple etiologies may exist concurrently.

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Section: Pharmacologic Management Of Deliriummentioning

confidence: 99%

Delirium in the Older Emergency Department Patient: A Quiet Epidemic

Han

Wilson

Ely

2010

Emergency Medicine Clinics of North America

104

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“…There have been case reports of older people treated with ranitidine and cimetidine developing hallucinations, confusion, and delirium. [40][41][42][43][44] The results from the present study show that older age is associated with a higher risk of reporting NPAEs with cimetidine. Schentag et al 45 reported that cerebrospinal fluid concentrations that are higher for cimetidine in critically ill older patients with compromised renal function and mental confusion may be due to the blockade of histamine H2 receptors in the CNS.…”

Section: Discussionmentioning

confidence: 47%

Anticholinergic Activity of Commonly Prescribed Medications and Neuropsychiatric Adverse Events in Older People

Nishtala

Fois

McLachlan

et al. 2009

The Journal of Clinical Pharma

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This study sought to determine whether the presence of in vitro anticholinergic activity (AA) among different drugs is associated with reporting of neuropsychiatric adverse events (NPAEs) and whether age affects this relationship. Retrospective case/noncase analyses using Australia's spontaneous Adverse Drug Reaction System (ADRS) database containing 150 475 reports determined crude and adjusted reporting odds ratios (RORs) for NPAEs for 23 drugs with various reported in vitro AA. Covariates were age (treated as a dichotomous variable [> or =65 years]), gender, and concomitant use of antipsychotics, benzodiazepines, tricyclic antidepressants, and drugs with recognized inherent anticholinergic properties (anticholinergic drugs). The interaction effect between these covariates and each drug exposure category was examined. Age (> or =65 years) has a significant association with greater odds relative to younger age for reporting NPAEs. Drugs with reported significant AA in vitro were not always associated with RORs greater than 1 for reporting NPAEs, highlighting a dissonance between the in vitro AA index and ADRS observations. Significant interactions were observed between age (> or =65 years) and exposure to cimetidine, anticholinergic drugs, antipsychotics, and tricyclic antidepressants in modifying odds for reporting NPAEs, reinforcing the need for cautious use and monitoring of drugs with AA in older people.

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“…Consistency is reinforced by similar reports in adults. 7 Specificity is observed (the supposed causal factor…”

Section: Discussionmentioning

confidence: 99%

“…However, ranitidine is an anticholinergic drug 4-6 that has been linked to anticholinergic toxidrome and delirium in adults. 7 We report the case of a child with asthma admitted to the PICU for bronchospasm, who presented delirium possibly caused by anticholinergic toxidrome secondary to ranitidine, resolving after its discontinuation. To the best of our knowledge, this is the first case reported in children.…”

Section: Introductionmentioning

confidence: 99%

Ranitidine-Induced Delirium in a 7-Year-Old Girl: A Case Report

et al. 2019

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Ranitidine is a histamine-2 blocker commonly prescribed in PICUs for the prophylaxis of gastrointestinal bleeding and stress ulcers. However, it can be associated to central nervous system side effects, such as delirium, in adults. We present the first case of a child presenting delirium possibly caused by anticholinergic toxidrome secondary to the use of ranitidine, resolving after drug discontinuation. With this case report, we reinforce that a wide variety of clinical conditions can trigger delirium and that the best therapeutic approach is to minimize risk factors.

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H2 Blocker Delirium

Cited by 18 publications

References 7 publications

Delirium in the Older Emergency Department Patient: A Quiet Epidemic

Delirium in the Older Emergency Department Patient: A Quiet Epidemic

Anticholinergic Activity of Commonly Prescribed Medications and Neuropsychiatric Adverse Events in Older People

Ranitidine-Induced Delirium in a 7-Year-Old Girl: A Case Report

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