86b - Delirium Flashcards
1
Q
What is required to diagnose delirium?
A
- Disturbance in attention and awareness
- Develops over a short period of time and fluctuates
- Additional disturbance in cognition
- Memory, languaguage, visuospatial, or perception
- Evidence that the disrubance is caused by direct physiological consequences of another condition
- Medical, substance, toxin, etc
2
Q
How does delirium affect slee?
A
Disrupts architecture
No deep or REM sleep
3
Q
What is the cognitive trajectory after delirium?
A
Ongoing cognitive impairments
- Average is 1.5 SD below the population mean
- Equivalant to mild TBI
- 26% are 2.0 SD below the population mean
- Equivalent to mild Alzheimer’s Disease
4
Q
What 3 characteristics predispose a person to delirium?
A
- Increased age
- Cognitive impairment
- Frailty
5
Q
How will a patient with delirium present differently from a patient with dementia?
A
A delerious patient will have…
- Faster onset of symptoms
- Shorter duration of symptoms
- Fluctuating symtoms
- vs. dementia will be stable
- Reduced awareness and alertness
- vs. dementia will be unchanged
- More changes in speech
6
Q
How do you treat delirium?
A
Address underlying cause
Haloperidol can be used for psychosis (avoid in pts with long QT)
Supportive treatment for symptoms of delirium
- Fluids
- Sleep/wake intervention
- Orientation aids
- No restraints!!
- Ambulation and mobility
- Cognitive stimulation
7
Q
Which antipsychotic is used to treat delirium? In which patients should it be avoided?
A
Haloperidol
- Avoid in pts with long QT syndrome
8
Q
Which medications might be used for delirium prophylaxis?
A
Olanzapine and ramelteon
- But these are still being studied
