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KMID : 0869620160330010008
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Journal of Korean Society of Hospital Pharmacists
2016 Volume.33 No. 1 p.8 ~ p.19
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Pharmacotherapy for Delirium in the Intensive Care Units
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이민정:Lee Min-Jeong
송예슬:Song Yae-Seul/김현아:Kim Hyun-Ah
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Abstract
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Delirium is defined as an acute disturbance of consciousness with inattention difficulties, changes in cognition or perceptual disturbance, which can develop over hours to days. Delirium is common in the medical and surgical intensive care units (ICU) and associated with many negative outcomes such as increased mortality, ICU and hospital length of stay, and cognitive impairment. A large number of studies have been conducted on various nonpharmacologic and pharmacologic strategies for prevention or treatment of delirium. The purpose of this article was to review the nonpharmacologic and pharmacologic agents used for delirium and review current studies on each strategy. Nonpharmacologic delirium managements using early mobilization and spontaneous awakening trials/spontaneous breathing trials have been demonstrated to reduce the incidence or duration of delirium in ICU patients. Pharmacologic medications such as haloperidol, atypical antipsychotics (e.g., risperidone, olanzapine, quetiapine, ziprasidone), and dexmedetomidine can be used to treat delirium in the ICU, although there are limited data on when to treat and which agents to use. Haloperidol and atypical antipsychotics have the potential to cause QT prolongation and should be used cautiously in ICU patients.
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KEYWORD
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Delirium, Haloperidol, Antipsychotic Agents, Dexmedetomidine
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