A 75-year-old female patient shows signs of delirium after surgery. She received which two medications preoperatively and intraoperatively that relate to her symptoms?

The correct answer highlights the role of high dose cholinergics and Physostigmine in relation to the patient's symptoms of delirium after surgery. Cholinergics are known to influence the parasympathetic nervous system and can lead to increased levels of acetylcholine in the brain. In the context of a patient, especially an older adult, high doses of cholinergic medications can cause confusion, agitation, and delirium, which may explain the patient’s postoperative changes in mental status.

Physostigmine is a reversible inhibitor of acetylcholinesterase, which prolongs the action of acetylcholine at synapses by inhibiting its breakdown. This aspect makes it relevant when considering the potential for delirium, as increased acetylcholine activity in certain contexts can contribute to confusion and delirium.

The selected combination reflects a specific physiological interaction that can adversely affect cognition in susceptible patients, such as the elderly, after surgical procedures. Therefore, understanding the mechanisms by which these medications exert their effects illuminates the connection between their use and the development of delirium symptoms in this patient.