Use of Medications With Anticholinergic Effect Predicts Clinical Severity of Delirium Symptoms in Older Medical Inpatients

Abstract

Exposure to ACH medications is independently and specifically associated with a subsequent increase in delirium symptom severity in elderly medical inpatients with diagnosed delirium.

Parkinson's disease, visual hallucinations and apomorphine: A review of the available evidence

“…PD patients with VH were found to have impaired attention and higher cortical visuoperception, due to prefrontal cortex and parietooccipital cortex dysfunction respectively on functional imaging [16][17][18][19], and higher Lewy body density and alpha-synuclein aggregation was found in prefrontal, temporal and visuoperceptive areas in patients with coexistent PD and VH than age matched controls without VH [20][21][22][23].…”

“…Visual information from the inferior temporal cortex is dealt with in the lateral prefrontal cortex via the uncinate fascicle [15], and via cortico-thalamo-cortical loops [16][17][18]. The mediodorsal and reticular thalamic nuclei are essential in gating and filtering relevant visual information [19,20].…”

“…Low cholinergic activity following the use of anticholinergic drugs impairs attention [17,18] and visual processing [19], and can sometimes induce delirium with VH, even in individuals without clinical evidence of PD (Han et al, 2001) [20]. In contrast, use of cholinesterase inhibitors improves attention, thalamic function and visual processing in a dose-dependent manner [17,[21][22][23].…”

Opioid medications and longitudinal risk of delirium in hospitalized cancer patients

“…6,7 However, 2 pioneer studies on the course of delirium in association with exposure to psychoactive medications have been conducted in recent years. 8,9 Using the first approach, 1 study in patients with advanced cancer examined the relation between delirium reversibility and various risk factors, including psychoactive medications. 9 In multivariate analyses, psychoactive medications were associated significantly with reversibility.…”

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.…”