Table 3.

Medications associated with brain dysfunction in the ICU

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
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)

CNS central nervous system.