Which of the following can cause delirium ?
**Core Concept**
Delirium is a neuropsychiatric syndrome characterized by a disturbance in attention, awareness, and cognition, often accompanied by a fluctuating course and a reduced level of consciousness. It is a medical emergency that requires prompt recognition and management to prevent complications and improve outcomes.
**Why the Correct Answer is Right**
Delirium can be caused by a variety of factors, including medications, medical conditions, and environmental factors. One of the most common causes of delirium is the use of benzodiazepines, such as lorazepam, which can lead to sedation, confusion, and impaired cognitive function. This is due to the action of benzodiazepines on the GABA receptors in the brain, leading to an increase in inhibitory neurotransmission and a decrease in excitatory neurotransmission.
**Why Each Wrong Option is Incorrect**
* **Option A:** Although antipsychotics can cause sedation and cognitive impairment, they are not a common cause of delirium. This is because antipsychotics often have a more predictable pharmacological profile and are used to treat psychiatric conditions, where delirium is not a typical side effect.
* **Option B:** While opioids can cause sedation and respiratory depression, they are not typically associated with delirium. Opioids work by binding to opioid receptors in the brain, leading to analgesia and respiratory depression, but they do not typically cause the cognitive impairment and fluctuating course that is characteristic of delirium.
* **Option C:** This option is not provided.
**Clinical Pearl / High-Yield Fact**
The CAM-ICU (Confusion Assessment Method for the Intensive Care Unit) is a validated tool for diagnosing delirium in critically ill patients. It requires the presence of four features: acute onset or fluctuating course, inattention, disorganized thinking, and altered level of consciousness.
**Correct Answer:** C. Lorazepam