Delirium

Question 1

Describe delirium.

Answer 1

-Acute onset (typically hrs to days).

-Disturbances to attention, awareness, cognition.

-Fluctuating severity.

-Usually attributable to underlying cause (most commonly secondary to infection).

Question 2

What are some precipitating risk factors for developing delirium?

Answer 2

-Surgery / Trauma
-Pain
-Anemia
-Infection
-Chronic Illness
-Bedridden

Question 3

Corticosteroids at doses of > ____mg can occasionally precipitate delirium.

Answer 3

40mg

Question 4

What is an example of a psychoactive NSAID that can precipitate delirium?

Answer 4

Indomethacin

Question 5

Are THC or CBD-based Cannabis products associated with higher delirium rates?

Answer 5

THC

Question 6

What other less obvious drugs can precipitate delirium?

Answer 6

Amantadine
Dopamine Agonists
Digoxin

Question 7

What are the requirements for a delirium diagnosis using the CAM method?

Answer 7

-Acute mental status change (with fluctuations) & inattention

+ one of following

-Disorganized thinking
-Altered LOC

Question 8

What is the mean duration of a delirium episode?

Answer 8

16d

Question 9

Persistence of delirium beyond ___ mths leads to a diagnosis of dementia.

Answer 9

6mths

Question 10

What are some orientative strategies we can use to prevent delirium?

Answer 10

-Calendars / clocks
-Use of aid devices
-Regular sleep / wake cycles

Question 11

In what delirium cases would Benzo usage actually be recommended?

Answer 11

Alcohol Withdrawal Delirium

Terminal Delirium

Question 12

What makes Quetiapine the favored AP for treating delirium episodes in Parkinson’s / Lewy Body Dementia?

Answer 12

Least Dopaminergic blockade

Question 13

Although the risk of EPS side effects is reduced, what side effect increases with atypical antipsychotic usage?

Answer 13

Orthostatic Hypotension