Which medication is not listed as inappropriate for delirium?

• A. Anticholinergics
• B. Antipsychotics
• C. Corticosteroids
• D. Acetaminophen

Answer: (D)

Delirium in older adults is often worsened by drugs that cause anticholinergic effects or central nervous system depression, so the Beers Criteria flags those medications as inappropriate or to be used with great caution. Anticholinergic drugs are a classic trigger for delirium, and corticosteroids can provoke neuropsychiatric symptoms, especially at higher doses. Antipsychotics also carry notable risks in older patients, particularly those with dementia, and are approached with caution in delirium management.

Acetaminophen does not have anticholinergic effects and does not typically provoke delirium, so it is not listed as inappropriate for delirium. It is commonly chosen for pain relief in older adults when delirium risk is a concern, whereas other analgesics that depress the CNS or add anticholinergic burden are used more cautiously.