OBJECTIVE: To describe a case of @entity933 associated with use of @entity1406 and to analyse 24 such cases including 22 cases reported to Australian @entity137 and one case previously published (S. Ahmad, Am Fam Physician, 1991;44:1142, 1144). CASE SUMMARY: An 89 year old caucasian @entity1 with an @entity1187 who had no @entity146 history and no infections, @entity1545 , @entity64 , metabolic nor @entity5 developed @entity933 after two small doses of @entity1406 (25 mg). The @entity933 disappeared within 20 hours after @entity1406 was ceased, despite continuing all other medications. THE COMBINED SERIES: Of 24 @entity1 (12 @entity1 , mean age 71.8 years), 83% were older than 60 years. The duration of therapy before onset of @entity933 in 14 (58%) subjects was within one week; 23 of 24 @entity1 were receiving therapeutic amounts of the drug (25-200 mg/day). Clinical features included @entity911 /disorientation in all subjects, @entity2146 in 13, @entity146 in 6, @entity1833 in 7, @entity2167 in 1, @entity10963 in 3, vivid dreams in 2 and language disturbances in 3 @entity1 . @entity1168 was reported in 4 cases, @entity551 in 2, @entity1295 /tiredness in 3, @entity1910 in 1 @entity1 . DISCUSSION: The mechanism of @entity1406 -induced @entity933 is unclear. It could be due to @entity409 (especially in the ageing liver) and complex neurotransmitter-related effects on brain beta-adrenoceptors and @entity750 ( @entity750 ) receptors. CONCLUSIONS: Physicians should be aware that @entity1406 , a widely used beta-blocker, may rarely cause @entity933 , especially in the elderly population.

Acute XXXX induced by @entity1406 .

@entity1 :: ('9606', 'Species') :: ['patient', 'man', 'persons', 'women', 'patients'] @entity1187 :: ('MESH:D054058', 'Disease') :: ['acute coronary syndrome'] @entity1545 :: ('MESH:D020214', 'Disease') :: ['brain injury'] @entity137 :: ('MESH:D064420', 'Disease') :: ['Adverse Drug Reaction Advisory Committee'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity2167 :: ('MESH:D006311', 'Disease') :: ['auditory hallucinations'] @entity146 :: ('MESH:D001523', 'Disease') :: ['psychiatric', 'aggression'] @entity5 :: ('MESH:D009369', 'Disease') :: ['neoplastic disease'] @entity1910 :: ('MESH:D005076', 'Disease') :: ["Raynaud's phenomenon in 1 and skin rash"] @entity409 :: ('MESH:D008107', 'Disease') :: ['impairment of hepatic metabolism'] @entity1295 :: ('MESH:D005221', 'Disease') :: ['fatigue'] @entity1833 :: ('MESH:D006212', 'Disease') :: ['visual hallucinations'] @entity1406 :: ('MESH:D008790', 'Chemical') :: ['metoprolol'] @entity911 :: ('MESH:D003221', 'Disease') :: ['confusion'] @entity2146 :: ('MESH:D011595', 'Disease') :: ['agitation'] @entity750 :: ('MESH:D012701', 'Chemical') :: ['serotonin', '5-HT'] @entity933 :: ('MESH:D003693', 'Disease') :: ['delirium'] @entity10963 :: ('MESH:D010259', 'Disease') :: ['paranoid delusions'] @entity551 :: ('MESH:D007022', 'Disease') :: ['hypotension'] @entity1168 :: ('MESH:D001919', 'Disease') :: ['Bradycardia']
@entity933 :: (MESH:D003693,Disease) :: ['delirium']
