Do medications cause confusion at times and if so which ones are able to do so?
Answer
As therapists, we need to start looking at the medications and their side effects to see if they are possibly having confusion side effects. This may be the problem the patient is having all along. Antidepressants cause confusion. Opioid analgesics cause confusion. Drugs with anticholinergic effects also cause confusion. Certain medications become toxic in the blood. They have a very long half-life and they have to be monitored with blood work to make sure that the medicine is not going to a toxic level. Two medications in particular that cause problems related to toxicity are lithium and digoxin. This is one reason why you see these medicines being prescribed less often than they used to be. As far as lithium goes, they have other antipsychotic medications that do not have the same toxicity. Digoxin is a heart pill and it is prescribed less than it used to be, because we are catching heart failure at an earlier stage and therefore is able to be treated with diuretics. Worsening of confusion for people with mild cognitive impairment can also occur with specific medications. Be aware of this as you are treating your patients. See what they are taking, and if you are not sure if what they are taking is causing this, I recommend downloading a free app called WebMD to put on your iPhone or android device. With this app, you can look up any medication and it will tell you the indications for use, all the side effects, and it will have pictures of the medications inorder to determine generic pills over name brands.
Kenneth L. Miller, PT, DPT, GCS, CEEAA
Dr. Kenneth L. Miller is a board-certified geriatric clinical specialist, advanced credentialed exercise expert for aging adults, and credentialed clinical instructor from the APTA. He has over 26 years of clinical experience with the older adult population. Dr. Miller is an assistant professor at the University of North Texas Science Center with dual appointments in the Department of Physical Therapy in the School of Health Professions and in the Department of Internal Medicine and Geriatrics in the Texas College of Osteopathic Medicine.
His clinical focus is on best practices for use with the older adult population. He has spoken nationally and internationally on topics of gerontology including primary prevention, fragility, outcome measures, and pharmacology.
He serves on editorial boards related to geriatric care and physical therapy education including Topics in Geriatric Rehabilitation where he was guest editor for a thematic issue dedicated to pharmacology and nutrition. He also serves the physical therapy profession as director of practice for the Academy of Geriatric Physical Therapy and on several Academy Task Forces. Most recently, he has helped to develop the best practice guidelines for the Academy that describe best practices for the care of older adults. Dr. Miller is also a co-editor of the Ciccone's Pharmacology in Rehabilitation 5th edition textbook update.
Related Courses
1https://www.physicaltherapy.com/pt-ceus/course/wound-management-in-the-home-2862Wound Management in the HomeThis course will enhance the participants' knowledge base regarding treatment plans for wound management In the home. This course is directly related to the practice of physical therapy and therefore appropriate for the PT and PTA.auditory, textual, visual
This course will enhance the participants' knowledge base regarding treatment plans for wound management In the home. This course is directly related to the practice of physical therapy and therefore appropriate for the PT and PTA.
2https://www.physicaltherapy.com/pt-ceus/course/maintenance-therapy-in-home-health-3136Maintenance Therapy in Home Health: RevisitedThe Medicare Benefit for Home Health under Part A includes both restorative care and maintenance therapy. The Benefit Manual clearly states that coverage determination for maintenance service provided is not dependent on any "improvement standard" but, rather on whether there is a need for skilled care. The purpose of this course is to provide the CMS regulations regarding maintenance therapy in home health define rehabilitation and maintenance level care and provide examples of appropriate maintenance episodes.auditory, textual, visual
The Medicare Benefit for Home Health under Part A includes both restorative care and maintenance therapy. The Benefit Manual clearly states that coverage determination for maintenance service provided is not dependent on any "improvement standard" but, rather on whether there is a need for skilled care. The purpose of this course is to provide the CMS regulations regarding maintenance therapy in home health define rehabilitation and maintenance level care and provide examples of appropriate maintenance episodes.
3https://www.physicaltherapy.com/pt-ceus/course/learning-to-lead-4426Learning to LeadThis course will provide the participant with a roadmap for developing or refining leadership skills in whatever role they serve as clinician, academician, or administrator. The roles of manager and leader will be explained in terms of motivation, productivity, and engagement.auditory, textual, visual
This course will provide the participant with a roadmap for developing or refining leadership skills in whatever role they serve as clinician, academician, or administrator. The roles of manager and leader will be explained in terms of motivation, productivity, and engagement.
4https://www.physicaltherapy.com/pt-ceus/course/balance-training-with-smart-phone-3298Balance Training with Smart Phone Apps and Household ItemsThis course will provide the participant with a framework for treating balance impairments in the home using items available in the home and technology. Use of household items and inexpensive smartphone applications offers clinicians the opportunity to provide effective and progressive home programs without cost-prohibitive barriers that purchasing "treatment" equipment poses. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.auditory, textual, visual
This course will provide the participant with a framework for treating balance impairments in the home using items available in the home and technology. Use of household items and inexpensive smartphone applications offers clinicians the opportunity to provide effective and progressive home programs without cost-prohibitive barriers that purchasing "treatment" equipment poses. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.
5https://www.physicaltherapy.com/pt-ceus/course/put-down-drugs-evidence-based-3072Put Down the Drugs: Evidence-Based Interventions to Reduce Unwanted Behaviors with DementiaPTs can apply evidence-based interventions to improve dementia care. This session reviews the etiology of common behaviors. Cognitive-emotion, multi-sensory, animal-assisted, and exercise interventions to reduce agitation are discussed as well as specific strategies for improving task-related engagement. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.auditory, textual, visual
'Very comprehensive, from the etiology of behavioral disorders/and sxs to interventions (cognitive, multi-sensory, animal-assisted, exercise), and targeting specific behaviors with interventions (agitation, wandering)'Read Reviews
PTs can apply evidence-based interventions to improve dementia care. This session reviews the etiology of common behaviors. Cognitive-emotion, multi-sensory, animal-assisted, and exercise interventions to reduce agitation are discussed as well as specific strategies for improving task-related engagement. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.
