MEDI7212 Lecture Notes - Lecture 79: Citalopram, Duloxetine, Tacrine
Document Summary
Delirium: delirium is an acute or subacute alteration in mental status (consciousness, attention) fluctuating over days-weeks; it is a symptom, not a disease. Inability to sustain attention to external and internal stimuli. Fragmented or disorder stream of thought: psychomotor disturbance (eg restless, pick at bed clothes, sluggishness, drowsiness, emotional disturbances (eg anxiety, fear, irritability, anger, apathy, absence of neurological signs (except asterixis) Sub-types: active psychomotor (30%, hypo-active psychomotor (25%, mixed (45%, classic presentation, older patient 65+yo, severe illness, inattention and confusion. It can complicate medical or surgical hospitalizations: risk factors, age 80+yo, male, preexisting dementia, depression, alcohol, pain, 3+ medications, use neuroleptics and narcotics, use restraints, bladder. Stroke factors - htn, previous stroke, tias, cardiac arrhythmias of birth, day, date, month, year, place, prime minister. Alcohol withdrawal: classic presentation, agitation, hypertension, tachycardia (first 2 days post-admission) Seizures with delusions and delirium (first 3-5 days post-admission)
