How long does it take for delirium to resolve? Even after resolution of the underlying cause of delirium and normalization of laboratory values it can take some time for the CNS to return to homeostasis. In many cases it can take weeks or months for delirium to resolve. In some vulnerable populations (e.g., patients with …
How is severely agitated patient treated in the acute setting? Here is the general approach to the severely agitated patient in the acute setting First, ensure caretaker safety. A quiet, low-stimulation, safe environment (i.e., free of movable objects and sharp edges) should be sought for the agitated patient. Evaluation should include consideration of potentially contributory …
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What abnormal cardiac rhythm is (rarely) associated with intravenous haloperidol? QTc prolongation and torsades de pointes. Telemetry and close monitoring of potassium and magnesium are recommended. Remember that all antipsychotics may prolong the QTc interval.
Pathophysiology of delirium What is the pathophysiology (neurotransmitter disturbance) of delirium and how does this generalization help guide empiric treatment while investigations are under way to uncover the underlying cause? In general, the delirious state is relatively hyperdopaminergic and hypocholinergic . Thus, dopamine-blocking antipsychotics (especially haloperidol, risperidone, olanzapine, and quetiapine), usually at low doses, are a well-established recommended intervention …
How is delirium distinguished from dementia depression, and other psychiatric disorders? In dementia there is typically a chronic, progressive decline in one or more cognitive domains, and attention and awareness are generally unaffected until late in the disease process. Likewise, in depression, concentration may be impaired but attention and awareness are not affected.
Cardinal features of delirium What is the cardinal feature of delirium and what are other core features? Impaired environmental awareness and ability to direct, sustain, and/or appropriately shift attention defines the delirium syndrome. This impairment is typically of acute onset and waxes and wanes in severity (usually worse at night [“sundowning”]) but there are chronic forms of …
What are the common neurotransmitter and CNS nuclei involved in the development of addiction to drugs of abuse? The mesolimbic reward system—involving mainly dopaminergic projections from the ventral tegmental area to the nucleus accumbens and other regions—is primarily disrupted by addictive substances. This results in disruption of networks mediating conditioned learning, mood regulation, and control …