Table 3 Medications associated with brain dysfunction in the ICU

Benzodiazepines

CNS sedation, neuronal inhibition by membrane hyperpolarization (GABA-agonist)

(long- and short-acting)

Opioids

Anticholinergic toxicity, CNS sedation, fecal impaction

Antibiotics

Inhibition of GABA-A receptors

Penicillins, cephalosporins, carbapenems, Quinolones

Antiarrhythmics

Strong anticholinergic effects, sodium channel blockage, unknown

Flecaïne, Amiodarone, Digoxin

Beta-blockers

Not yet described, association with delirium

Diuretics

Dehydration and electrolyte disturbances

Steroids

Anticholinergic toxicity, Increase of catecholamine activity, GABA-agonist, altered serotonin activity

Inhaled anesthetics

Beta-amyloïd protein generation, cytotoxicity of beta-amyloïd potentiating, apoptosis-inducing

Ketamine

NMDA-antagonism

Histamine-2 blocking agents

Anticholinergic toxicity

Cimetidine

Nonsteroidal anti-inflammatory drugs

Blood–brain-barrier permeability

Anticholinergics

Anticholinergic toxicity

oxybutynin, bladder antispasmodics

Anticonvulsants

CNS Sedation

phenobarbital, phenytoin

Antiparkinsonian agents

Dopaminergic toxicity

L-Dopa, dopamine agonists, amantadine

Antidepressants

Anticholinergic toxicity

(amitriptyline, imipramine, doxepin)