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Delirium: prescribing safety ⚠️ 🧠
Delirium: prescribing safety ⚠️ 🧠
Educational on-call framework — not a treatment protocol. New confusion is a clinical syndrome: look for treatable causes and non-drug interventions before reaching for sedation.
Investigate first
- Identify infection, hypoxia, glucose disturbance, pain, retention, constipation, dehydration, medication toxicity and withdrawal.
- Use a validated delirium assessment tool appropriate to the setting; ask family about baseline and acute change.
Non-pharmacological first
- Reorientation, sleep, glasses/hearing aids, mobilisation and consistent staff can reduce distress.
- For danger/distress, attempt verbal de-escalation and identify the particular behaviour being treated.
If considering medication
- haloperidol carries QT and neurological risks and is contraindicated in Parkinson disease and Lewy body dementia.
- Consider total anticholinergic burden (e.g., amitriptyline, cyclizine) and sedatives; involve senior/geriatric/psychiatry support.
- Document indication, intended effect, monitoring and review/stop time; do not use routine chemical restraint.
UK resources: NICE CG103 delirium · MHRA haloperidol warning
Editorial draft 4 November 2026; not formally clinically signed off. Use local policy and senior advice.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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