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Medication-induced delirium — DGM MCQ

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ModerateDeliriumMedication-induced deliriumDGM

An 84-year-old woman develops acute confusion after starting treatment for urinary urgency. She is seeing insects on the wall and cannot sustain attention. Urine culture is negative and observations are normal. Current medicines include oxybutynin, bisoprolol and levothyroxine. Which medication should be reviewed?

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Correct answer: D — Oxybutynin

Oxybutynin has anticholinergic effects and can precipitate delirium in older adults. Bisoprolol and levothyroxine may cause adverse effects but are less likely to cause anticholinergic hallucinations; paracetamol and emollients are unlikely causes. Anticholinergic burden is a key part of delirium assessment.

Reference: NICE CG103; BNF