MEDI2022 Lecture Notes - Benzatropine, Entrust, Cerebrovascular Disease
6 Nov 2013
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Delirium: acute or subacute brain failure in which impairment of attention is accompanied by abnormalities of perception and mood. Thought and speech incoherent, memory impaired and misperceptions occur. Episodic visual hallucinations and persecutory delusions may occur. Patient may be frightened, suspicious, restless and uncooperative. Newly commenced especially in last 4-8 weeks. Multiple drugs may have small effects which when added are toxic (potential polypharmacy) A acute metabolic disorder hepatic failure, renal failure, dehydration, electrolyte imbalance. Hypothyroidism, cushing"s, diabetes, parathyroid shock, vasculitis, hypertensive encephalopathy. Substance use, withdrawal, sedatives, opioids, anesthetics, anticholinergics, anticonvulsants, dopaminergic agenets, steroids, insulin, glyburide, antibiotics, nsaids arsenic, lead, mercury. Constipation, pain, frequent moves in severe dementia, postoperative state. Acute change and fluctuation of mental state. Visual hallucinations and delusions usually related to these. Anxiety, fear, depression, irritability, anger, euphoria, apathy. Disturbances of emotion, cognition or behavior in older people that produce significant disability or risk are commonly due to:
