delirium Flashcards
definition of delirium
change in attention or awareness that develops over a short period of time, represents a change from baseline and tends to fluctuate in severity throughout the course of the day
3 causes of pure hypoactive delirium
decreased perfusion
elevated ammonia
elevated urea
2 causes of pure hyperactive delirium
etoh and bzd w/d
stress-vulnerability model
explains why elderly are at higher risk for delirium- medical illness superimposed on a vulnerable brain
one of the biggest risk factors for developing delirium
pre-existing neurocognitive disorder (70%)
medications that can contribute to delirium
anticholinergic medications
temporal course of delirium
acute onset, fluctuating symptom severity
ACH in delirium
decreased cholinergic activity leads to deficits
DA in delirium
DA agonists may induce delirium
DA antagonists may be used to treat
what is the best clue to causality?
onset
MMSE score that indicates delirium
under 24
gold standard medication treatment for delirium
haloperidol
anticholinergic toxicity (5)
hot as a hare dry as a bone red as a beet blind as a bat mad as a hatter