Which anticholinergic is commonly associated with delirium in older adults?

Which anticholinergic is commonly associated with delirium in older adults?

• A. Diphenhydramine
• B. Lorazepam
• C. Dextromethorphan
• D. Acetaminophen

Answer: (A)

In older adults, drugs with anticholinergic effects can provoke delirium by blocking acetylcholine activity in the brain, which is important for attention and cognition. Diphenhydramine has strong central anticholinergic properties and crosses the blood-brain barrier easily, making it a common culprit for delirium in the elderly. While lorazepam can contribute to delirium through sedation and cognitive slowing, it does not exert its effects via anticholinergic receptor blockade. Dextromethorphan mainly affects NMDA and other neurotransmitter systems and is not classically anticholinergic. Acetaminophen has no meaningful anticholinergic activity and is not typically linked to delirium through that mechanism.

In older adults, drugs with anticholinergic effects can provoke delirium by blocking acetylcholine activity in the brain, which is important for attention and cognition. Diphenhydramine has strong central anticholinergic properties and crosses the blood-brain barrier easily, making it a common culprit for delirium in the elderly. While lorazepam can contribute to delirium through sedation and cognitive slowing, it does not exert its effects via anticholinergic receptor blockade. Dextromethorphan mainly affects NMDA and other neurotransmitter systems and is not classically anticholinergic. Acetaminophen has no meaningful anticholinergic activity and is not typically linked to delirium through that mechanism.