EXCITED DELIRIUM

Course overview

DELIRIUM IS UNDERSTOOD AS A COMPLEX NEUROPSYCHIATRIC SYNDROME THAT IS CHARACTERIZED BY DISTURBANCES IN CONSCIOUSNESS, ORIENTATION, MEMORY, THOUGHT, PERCEPTION AND BEHAVIOR DUE TO ONE OR MORE STRUCTURAL AND/OR PHYSIOLOGICAL ABNORMALITIES DIRECTLY OR INDIRECTLY AFFECTING THE BRAIN. IT IS QUITE PREVALENT IN MEDICAL AND SURGICAL SETTINGS AND IS ASSOCIATED WITH HIGH RATES OF DEATH AND HEALTHCARE COSTS. FIRST-LINE AGENTS FOR ACUTE AGITATION IN AN ADULT PATIENT INCLUDE AN ANTIPSYCHOTIC (HALOPERIDOL, RISPERIDONE, OR OLANZAPINE) PLUS A BENZODIAZEPINE (MIDAZOLAM OR LORAZEPAM). HALOPERIDOL AND DROPERIDOL CARRY A SIGNIFICANT RISK OF QT PROLONGATION AND ASSOCIATED CARDIAC EVENTS, ESPECIALLY IN PATIENTS ON PSYCHIATRIC MEDICATION OR WITH ELECTROLYTE ABNORMALITIES. THIS ACTIVITY DISCUSSES ITS ETIOLOGY, EPIDEMIOLOGY, PATHOPHYSIOLOGY, AND TREATMENT OPTIONS PERTINENT TO THE INTERPROFESSIONAL HEALTHCARE TEAM.