https://idwiki.org/index.php?action=history&feed=atom&title=Delirium_at_the_end_of_life 2026-04-29T12:08:32Z Revision history for this page on the wiki MediaWiki 1.43.8 https://idwiki.org/index.php?title=Delirium_at_the_end_of_life&diff=4166&oldid=prev 2020-07-04T01:17:30Z

<p>Imported from text file</p> <p><b>New page</b></p><div>== Management ==<br /> <br /> * Treat underlying causes<br /> ** Opioid neurotoxicity:<br /> *** Switch opioid<br /> *** Dose reduction<br /> *** Hydration<br /> ** Medications<br /> *** Stop medication<br /> ** Dehydration<br /> *** IV<br /> *** Hypodermoclesis (fluid given subcutaneously)<br /> ** Hypercalcemia<br /> *** IV bisphosphonate (zoledronate/pamidronate)<br /> ** Infection<br /> *** Antibiotics<br /> ** Hepatic encepalopathy<br /> *** Lactulose<br /> ** Brain metastases<br /> *** Corticosteroids<br /> * Non-pharmacologic<br /> ** Reduce stimulation<br /> ** Low ambient light<br /> ** Low noise<br /> ** Correct sensory deficits (glasses, hearing aids)<br /> ** Gentle, repeated reassurances (but labour intensive)<br /> ** Do not use physical restraints<br /> * Pharmacologic<br /> ** Mild<br /> *** Haloperidol 0.5-1mg po or subcut daily or BID + haloperidol 0.5-1mg po/SC q1h prn<br /> ** Moderate<br /> *** Haloperidol 2-2.5mg po/sc bid or tid + haloperidol 2mg po/sc q1h prn<br /> *** Or methotrimeprazine 5-12.5mg po/sc bid or tid + prn<br /> ** Severe<br /> *** Midazolam 2.5-5mg sc stat once + haloperidol 5mg sc stat<br /> *** Or methotrimeprazine 25mg sc stat then po/sc<br /> *** Follow with haloperidol 2.5-5mg sc q30min prn (max 10-15mg/day)<br /> ** Sundowning<br /> *** Methotrimeprazine qhs<br /> ** Alternatives<br /> *** Quetiapine<br /> *** Respiradone<br /> *** Olanzapine<br /> <br /> [[Category:Palliative care]]</div>

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