Medicine For The Elderly

Question 1

Types of delirium

Answer 1

Hyperactive = agitated, aggressive, wandering
Hypoactive = withdrawn, apathetic, sleepy, coma

Question 2

Describe screening tool for delirium

Answer 2

4AT Score

Alertness = 0 or 4

AMT e.g. age, DOB, place, year = 0, 1 for 1 mistake, 2 for 2 or more mistakes

Attention e.g. backwards months = 0 for 7 or more correct, 1 for some, 2 can’t test

Acute change? = 0 or 4

More than 4 needs investigating

Question 3

Pharmacological treatment for delirium

Answer 3

Only use if non-pharmacological methods haven’t worked

1st line = Haloperidol 500micrograms orally or IM
NOT FOR PARKINSONS OR LEWY BODY DEMENTIA
Use lorazepam 500 micrograms - 1mg orally

Question 4

In what timeframe should the delirium time bundle TIM be started?

Answer 4

Within 2 hours