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Delirium in the Hospitalized Patient: A Primer for the Pharmacist Clinician

South Dakota State University College of Pharmacy, Avera McKennan Hospital and University Health Center, 800 E 21st St, PO Box 5045, Sioux Falls, SD 57117-5045, brad.laible{at}mckennan.org

Thomas Johnson, PharmD, BCPS

As appreciation grows for the negative impact delirium has on the clinical outcome of hospitalized patients, pharmacists are becoming more involved in the identification and treatment of this common problem. Delirium has been shown to have a significant impact on such factors as morbidity, mortality, and hospital length of stay. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) provides a simple assessment method for delirium that can be utilized by nonpsychiatrist personnel. While nonpharmacologic strategies are generally recommended to prevent and treat delirium, pharmacologic agents have also been investigated. This article will review causes of delirium, assessment with the CAM-ICU, and treatment options available to the pharmacist clinician.

Key Words: Delirium • haloperidol • risperidone • olanzapine • quetiapine • ziprazidone • torsade de pointes.

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