Reversal of Lorazepam Delirium by Physostigmine

Abstract

Two adult patients suffered postoperative delirium following administration of lorazepam, a new benzodiazepine sedative. Physostigmine was found effective in reversing all untoward central nervous system effects.

Delirium in elderly adults: diagnosis, prevention and treatment

“…Anticholinergic drugs can induce delirium and often contribute substantially to the delirium seen in hospitalized patients 16. Increasing acetylcholine levels by use of cholinesterase inhibitors such as physostigmine has been shown to reverse delirium associated with anticholinergic drugs 17–19. Serum anticholinergic activity, which reflects anticholinergic influences of both endogenous and exogenous drugs and their metabolites, has been shown in some studies to be increased in patients with delirium and to decline with the resolution of delirium 20–22.…”

Pethidine‐associated seizure in a healthy adolescent receiving pethidine for postoperative pain control

“…During the first 23 h postsurgical he used a total of 1110 mg were not warranted. Although (9,22). Throughout this period the nursing observations indicated that the patient two days later.…”

“…(1). Although (9,22). Hepatic N-demethylation enzyme-inducing the blood concentrations of both norpethidine and agents such as loperamide (a piperidine derivative pethidine contribute to the variation in the intensity and congener of pethidine) and carbamazepine may of CNS excitation, the norpethidine concentration increase the formation of norpethidine (2,10,23).…”

Post stroke delirium

“…Наиболее часто причиной делирия считают наруше-ние функционирования холинергической системы [29], и это обосновывается целым рядом факторов [35][36][37][38][39][40][41]. Есть также упоминание [42] о нарушении функционирования дофаминергической системы, а также о дисбалансе дофаминовой и холинергиче-ской систем.…”