Drugs and toxins |
Prescription medications (eg, opioids, sedative-hypnotics, antipsychotics, lithium, skeletal muscle relaxers, polypharmacy) |
Nonprescription medications (eg, antihistamines) |
Drugs of abuse (eg, ethanol, heroin, hallucinogens, nonmedicinal use of prescription medications) |
Withdrawal states (eg, ethanol, benzodiazepines) |
Medication side effects (eg, hyperammonemia from valproic acid, confusion from quinolones, serotonin syndrome) |
Poisons: |
Atypical alcohols (ethylene glycol, methanol) |
Inhaled toxins (carbon monoxide, cyanide, hydrogen sulfide) |
Plant-derived (eg, Jimson weed, Salvia) |
Infections |
Sepsis |
Systemic infections; fever-related delirium |
Metabolic derangements |
Electrolyte disturbance (elevated or depressed): sodium, calcium, magnesium, phosphate |
Endocrine disturbance (depressed or increased): thyroid, parathyroid, pancreas, pituitary, adrenal |
Hypercarbia |
Hyperglycemia and hypoglycemia |
Hyperosmolar and hypoosmolar states |
Hypoxemia |
Inborn errors of metabolism: porphyria, Wilson disease, etc |
Nutritional: Wernicke encephalopathy, vitamin B12 deficiency, possibly folate and niacin deficiencies |
Brain disorders |
CNS infections: encephalitis, meningitis, brain or epidural abscess |
Epileptic seizures, especially nonconvulsive status epilepticus* |
Head injury* |
Hypertensive encephalopathy |
Psychiatric disorders* |
Systemic organ failure |
Cardiac failure |
Hematologic: thrombocytosis, hypereosinophilia, leukemic blast cell crisis, polycythemia |
Liver failure: acute, chronic |
Pulmonary disease, including hypercarbia and hypoxemia |
Renal failure: acute, chronic |
Physical disorders |
Burns |
Electrocution |
Hyperthermia |
Hypothermia |
Trauma: with systemic inflammatory response syndrome, head injury*, fat embolism |
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