Delirium Flashcards
What is the most common mental health problem in those hospitalised >65yrs?
delirium
How does delirium present?
impairment of conciousness
disturbance in cognition
pyschomotor disturbance - agitation, confusion
disturbance of sleep cycle - insomnia, nightmares
emotional disturbance - fear predominantly
What are the general features of delirium?
rapid onset
transient and fluctuating course
lasts days -> months
What is the mean duration of a delirium episode?
1-4 weeks
What generally can cause delirium?
ANYTHING drugs withdrawal metabolic epilepsy cancer vascular disorders
What screening tools for dementia should be used in a delirious patient?
4AT
MoCA
MMSE
Addenbrooks
What is the best way to manage a patient with delirium?
move them to a bright side room
reduce noise
remove unsafe objects
make sure that they have hearing aids/glasses
What can you prescribe is a delirium patient is distressed?
Haloperidol 0.5-5mg orally then IM - up to 10mg in 24hours
Lorazepam 0.5-2mg up to 2s in 24hours = for lewy body dementia, narcoleptic sensitivity and Parkinson’s
use 1 drug at a time, start at a low dose
What do you need to prescribe in an alcohol/sedative withdrawal?
benzodiazepine
What is hyperactive delirium?
fine during the day, overactive in the evening and then awake and distruptive over night with hallucinations/delusions
What is a hypoactive delirium?
become suddenly withdrawn, quiet and sleepy
doesnt care about eating and drinking
What is mixed delirium?
varies widely from hypo to hyper over a 24hr period
What is anterograde amnesia?
difficulty aquiring new material and remembering events SINCE the onset of injury or illness
What is retrograde amnesia?
difficulty in remembering information PRIOR to the event of illness or injury
