Deliruim Flashcards
1
Q
Delirium Risk Factors
A
END ACUTE BRAIN FAILURE
2
Q
END
A
- Electrolyte
- Neurologic disorder & injury
- Deficiencies (nutritional)
3
Q
ACUTE
A
- Age & gender
- Cognition
- U-tox (intoxication & withdrawal)
- Trauma
- Endocrine disturbance
4
Q
BRAIN
A
- Behavioral, psychiatric
- RX & other toxins
- Anemia, anoxia, hypoxia, low perfusion
- Infections
- Noxious stimuli (pain)
5
Q
FAILURE
A
- Failure (organ)
- APACHE score (severity of illness)
- Isolation & immobility
- Light, sleep & circadian rhythm
- Uremia & other metabolic disorders
- Restraints
- Emergence delirium
6
Q
Hypoactive Delirium Rx Review
A
- Minimize use of agents w/ high anticholinergic potential
- Minimize use of CNS depressant agents
- Review QTc prolonging potential
7
Q
Hypoactive Delirium Avoid
A
Use of benzodiazepines
8
Q
Hypoactive Delirium Rx Treatment
A
- Melatonin 10 mg
- Dopamine Antagonists (low dose)
- Psychostimulant agents (low dose)
9
Q
Hypoactive - Dopamine Antagonists (low dose)
A
- Haloperidol IV (0.125 - 0.5 mg QHS)
- Aripiprazole (0.5 - 1 mg QAM)
10
Q
Hypoactive - Psychostimulant agents (low dose)
A
- Amantadine 25 - 100 mg TID (monitor CrCl; PO)
- Modafinil 25 - 200 mg QAM
11
Q
Hyperactive Delirium Rx Review
A
Minimize use of agents w/ high anticholinergic potential
- Review QTc prolonging potential
12
Q
Hyperactive Delirium Avoid
A
Benzodiazepine agents, if possible
13
Q
Hyperactive Delirium Rx
A
- Melatonin 10 mg
- Alpha-2 agents
- Dopamine Antagonists
- Antiglutamitergic Agents
14
Q
Hyperactive - Alpha-2 agents
A
- Use of dexmedetomidine (Precedex) indicated?
- If not, consider guanfacine
15
Q
Hyperactive - Dopamine Antagonists
A
Moderate - extreme agitation
- haloperidol IV
Mild agitation
- risperidone, lurasidone, quetiapine
