Clinical Therapeutics Flashcards
Define Delirium
An acute cognitive impairment syndrome that develops over a short period of time (hours to days)
What are the 3 subtypes of delirium?
Hyperactive –> Aroused, restlessness, agitation and aggression
Hypoactive –> Sleepiness, lack of interest in daily activities, quiet and withdrawn
Mixed –> Move between the above 2 subtypes
What are the 2 different things you can do to assess somebody for delirium/consiousness?
Abbreviated Mental Test Score (AMTS)
Confusion Assessment Method (CAM)
Name some pre-disposing factors for delerium
What can precipitate delirium?
What pharmacological treatments are there for delirium?
And when should these be used?
Antipsychotics for a short period of time (haloperiodol or olanzapine)
Benzodiazepines –> Usually avoid as can contribute to delerium…..can be useful for ‘regaining control’ of somebody
Should only be used when a person is a risk to themselves and verbal/non-verbal descalation techniques have been tried to no avail
What is vascular dementia (VD)?
Caused by an interuption of the brains blood supply…..leading to neuronal cell death
More common in those with hypertension, diabetes, those who smoke and males
Has a very sudden onset and step-wise progression
What is Lewy Body Dementia (LBD)?
And what are the 3 key features?
Circular aggregates of protein that form in brain cells that effect dopaminergic and acetylcholinergic transmission at synapses when present in large quantities
Fluctuations in attention and concentration
Spontaneous parkinsons-like motor symptoms
Recurring visual hallucinations
What are the 3 main points for frontotemporal dementia (FTP)?
Occurs earlier than other dementias
Large personality and behavioural changes
Language problems –> Due to damage of the frontal lobe
Name some cognitive testing instruments
What are the 4 types of drugs that can be used in dementia?
Cholinesterase Inhibitors (eg, donepezil/rivastigmine) –> Stimulate cholinergic pathways
NMDA Receptor Antagonists (eg, memantine) –> Decreases Ca2+ influx, and so reduces cell death
Monoclonal Antibodies –> Reduce amyloid plaque build up in the brain
Secretase Inhibitors
What is the aim of psychodynamic therapies?
Make unconsious feelings (that we have defences against) consious, so we can change them
Also a focus on relationships, pecifically those with the therapist and patients parents
What is the basis behind CBT?
What are the 3 components of a behavioural experiment?
And what is this type of treatment best for?
Prediction
Experiment
Observation
Best used in treating phobias
What are the 5 components of the Humanistic Pyramid?
And what is the goal of humanistic therapy?
Self-Actualisation
Esteem
Love/Belonging
Safety
Physiological
The goal is to facilitate the person in fullfilling their life potential
