A 76-year-old woman with stage IV lung adenocarcinoma has been in the ICU for pneumonia. She has advanced directives making clear that she would not want to be intubated and mechanically ventilated. Her condition steadily declines and her family agrees that a focus on comfort is the primary goal of care. The patient develops agitated delirium and pharmacologic therapy is required after non-pharmacologic measures are taken.
What is the medication of choice for agitated delirium in the patient at the end of life?
Haloperidol
Morphine
Propofol
midazolam
Lorazepam
The correct answer is:
Haloperidol
The drug of choice for agitated delirium at the end of life is haloperidol or a similar neuroleptic. Nonpharmacologic measures such as removing restraints, reducing noise, verbal soothing, and reducing light should all be employed as well.
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