Medication Evaluation and Reducation
  • To be effective in elderly medication management, the clinician must practice the "three R’s" of prescribing: Reduction of dose, Replacment with safer medications and Removal of unnecessary medications.
  • Pre-operatively and peri-operatively review of medications with this in mind will reduce the incidence of delirium. Remember, any medication that can change neurotransmitters or sedate the patient is at risk to precipitate delirium.

High Risk Delirium Medications
 
Remember - "ACUTE CHANGES IN MS"
A ntiparkisonian
C orticosteroids
U rologic (antispasmodics e.g oxybutinin)
T heophylline
E mesis (antiemetics)
C ardiac (antiarrhythmics)
H 2 blockers (cimetidine)
A nticholinergics
N SAID’s
G eropsychotropic meds
E toh
I nsomnia meds
N arcotics
M uscle relaxants
S eizure meds