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Table 3 Medications associated with brain dysfunction in the ICU

From: Understanding brain dysfunction in sepsis

Agent Mechanism of action
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
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)  
  1. CNS central nervous system.