title: Delirium in palliative care patients: focus on pharmacotherapy.
abstract: Patients receiving palliative care often possess multiple risk factors and predisposing conditions for delirium. The impact of delirium on patient care in this population may also be far-reaching: affecting not only quality of remaining life but the dying process experienced by patients, caregivers, and the medical team as well. As palliative care focuses on comfort and symptom management, the approach to assessment and subsequent treatment of delirium in palliative care patients may prove difficult for providers to navigate. This article summarizes the multifactorial nature, numerous predisposing medical risk factors, neuropsychiatric adverse effects of palliative medications, pharmacokinetic changes, and challenges complicating delirium assessment and provides a systematic framework for assessment. The benefits, risks, and patient-specific considerations for treatment selection are also discussed.
authors: Department of Pharmacy and Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA. Zimmerman.Kristin@gmail.com
authors: Kristin
authors: K
authors: Zimmerman
authors: James
authors: J
authors: Rudolph
authors: Marci
authors: M
authors: Salow
authors: L Michal
authors: LM
authors: Skarf
mesh_terms: D000701:Analgesics, Opioid / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000493:pharmacokinetics / Q000627:therapeutic use; D018680:Cholinergic Antagonists / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D003693:Delirium / Q000139:chemically induced / Q000188:drug therapy* / Q000453:epidemiology; D005938:Glucocorticoids / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D006801:Humans; D010166:Palliative Care / Q000379:methods*; D012307:Risk Factors
chemical_list: D000701:Analgesics, Opioid; D000970:Antineoplastic Agents; D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists; D005938:Glucocorticoids; D001569:Benzodiazepines