Delirium Flashcards
Define delirium
Acute change in cognition over short period - flucuating
What are the types of delirium?
Hyperactive
Hypoactive
Mixed
List some of the main predisposing risk factors for delirium
Polypharmacy Age Dementia Malnutrition Immobility
Those are only the main ones
Name some drugs that may precipitate delirium
Digoxin Anticholinergic Diuretic Opiate CCS Cimetidine Sedative AED Alcohol Benzo (withdrawal)
Delirium presents [insidiously/rapidly] and is worse in the [night/day]
Rapidly
Night
(Called sundowning)
Are visual or auditory hallucinations more strongly associated with delirium?
Visual
What should you do first when if you suspect delirium?
Review drugs U+Es FBC CRP BG
If you suspect a PTx has delirium, what drug class should you stop?
Benzos
What are the 2 assessments used specifically for delirium?
4AT score
CAM
What is the CAM assessment?
Delirium = Acute fluctuating \+ Inattention \+ Disorganised thinking OR altered consciousness
How do you measure a 4AT score - what are the 4 categories?
Alertness 0-4
Age, DOB, place, current year 0-2
Attention (months of year backwards) 0-2
Acute fluctuating 0-4
Score >4 = possible delirium
What is the 1st line non-drug Mx of delirium?
Orientate PTx in calm well lit environment
What are the drug options in delirium Mx?
1st IM/PO sedative haloperidol 2nd benzo (>SE)
What drug class is haloperidol in?
Anticholinergic antipsychotic
When is haloperidol contraindicated in delirium? What should be used instead?
Parkinsons / LBD
Quetiapine
