3.3.2 Delirium Flashcards
What must be ruled out when thinking about the possibility of delirium?
Preexisting or developing neurocognitive disorder or lessened state of arousal
How are attention and awareness affected in delirium?
Attention: reduced ability to direct, focus, sustain and shift attention
Awareness: reduced orientation to environment
What differentiates delirium from dementia?
Time of onset.
Delirium develops over a short period of time (hrs to days) whereas dementia takes a long time to develop.
What are the ways in which haloperidol can be administered?
Oral, shot, or IV (only dopamine antagonist on the market that can be given through IV)
What are some other cognitive disturbances seen with delirium?
memory deficit, disorientation, language, visiospacial ability, or perception
How does the DSM-5 Diagnostic Criteria define delirium?
What are some of the etiologies associated with delirium?
Postoperative delirium is common in the elderly
Describe the progression of severity of delirium throughout the course of a day.
The severity of delirium tends to flucuate
Should these psychopharmacologics be used to treat delirium?
What is the most selective scheduled dopamine antagonist?
Haloperidol (Vitamin H)
What is the etiopathogenesis of delirium? What are some of the resultant ion/channel disturbances?
Anoxia
Failure of ATPase pumps
ATPase-dependent transporters fail -> Decreased NT reuptake
Na++ and Ca++ flood cells
Ca++ influx increases activity of TH increasing dopamine prod
Ca++ influx stimulates NT release
K++ flows out of cells
Dopamine-beta-hydroxylase activity decrease -> no conversion of DA -> NE
DA metabolized shifts to toxic metabolic pathways generating cytotoxic quinones
