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Delirium - Coggle Diagram

- - - - Antipsychotics are treatment of chocie for agitation
      - Benzodiapines treatment of choice for alcohol withdrawal or Benzo withdrawal
      - Trazadone may be used to help restore sleep and to calm patient
      - Haloperidol: Best studied in delirium lowest dosage and wean quickly
      - Newer "atypical" antipsychotics
      - Benzodiazepines:
        
        Avoid in combination with antipsychotics (Signle drug)
        
        May cause disinhibition/increased agitation
        
        Best reserved fro Delirium 2 degrees to alcohol
        
        Relatively contraindicated in delirium
      - Antipsychotics
        
        Black box warning (Increase risk of death/CVAEs in pts with dementia)
        
        Increased risk of death/CVAEs
- - - - Disturbance in attention
      - Disturbance develops over a short period of time
      - A change in additional cognitive domain
      - Disturbances in No 1 and 3 must not occur
    - - History of Acute Onset of Change in patient's normal mental status AND Lack of Attention AND (Disorganized Thinking OR Altered Level of Consciousness)
    - - MMSE (Serial 7s, WORLD), Digit Span (5 forwards, 4 backwards), Day of weeks, Months of the year backwards
    - - Hyperactive, Hypoactive, Mixed Delirium
    - - 5 Final Precipitating Factors were
        
        Use of Physical restraints, Malnutrition, More than 3 medications, use of an indwelling bladder catheter, any iatrogenic