The Annals of pharmacotherapy
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Review Comparative Study
Systematic review of antipsychotics for the treatment of hospital-associated delirium in medically or surgically ill patients.
To determine which antipsychotic is associated with the greatest efficacy and safety when used for the pharmacotherapeutic management of delirium in medically or surgically ill patients. ⋯ The comparative studies evaluated here suggest that antipsychotic drugs are efficacious, when compared with baseline, and safe for the treatment of delirium. Haloperidol remains the most studied agent. Recommendation of one antipsychotic over another as a first-line pharmacologic intervention in the treatment of hospital-associated delirium is limited by the quality and quantity of data available. Better designed and larger studies evaluating the addition of antipsychotic agents to nonpharmacologic treatments are needed to measure the true effect of pharmacologic treatment.
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To report a case of myoclonus associated with the use of a low dose of the opioid analgesic hydromorphone. ⋯ Neuroexcitatory effects of hydromorphone may occur at relatively low doses in patients without renal dysfunction. Early recognition and intervention are required to achieve resolution of these symptoms and prevent further sequelae to the patient.