Delirium – synonyms, diagnosis, prognosis

Synonyms: acute disorder of consciousness; acute psychotic syndrome; transient syndrome; exogenous reactive type

Definition of delirium: acute reversible disorder of attention, perception, thinking, consciousness with psychosomatic manifestations

Epidemiology of delirium. 15-30% of patients in somatic hospitals develop delirious syndromes, in 1/3 of which the occurrence is pharmacologically determined.

Etiopathogenesis of delirium

Cholinergic deficiency caused by:

  • ¬†Anticholinergic drugs
  • Intoxication
  • Cancellation (for example, alcohol), see Discontinuation Syndrome (withdrawal syndrome)
  • Metabolic disorders (diabetes, hepatic / renal failure)
  • Infectious diseases
  • Neurological disorders (Diseases)
  • Metabolic disorders (diabetes) .

Brain injury; addiction: alcohol, drug or drug; advanced age; severe or moderate severity of general health; previous episode of delirium in history; the postoperative period, accompanied by a water-electrolyte imbalance, taking painkillers, etc.

The development of drug-induced delirium, among other things, can be triggered by drugs with anticholinergic effects, such as tricyclic antidepressants and phenothiazines (neuroleptics), especially often in pre-treatment.

Medicinal / narcotic drugs that induce the development of delirium:

  • Alcohol (withdrawal)
  • Benzodiazepines (cancellation)
  • Barbiturates (cancellation)
  • Preparations with anticholinergic effects: for example, tricyclic antidepressants, phenothiazines, biperiden, atropine
  • Dopaminergic drugs, for example, to use systhemes, for example, tricyclic antidepressants, phenothiazines, biperiden, atropine. Anticonvulsant drugs: for example, phenytoin, valproaty
  • Antibiotics, antifungal, antiviral and anti-tuberculosis drugs: for example, gyrase inhibitors, nitrofurans, isoniazid, rifampicin, amphoteric The acyclovir
  • Others: for example, digitalis preparations, cimetidine, theophylline, lidocaine, corticosteroids main symptoms of delirium. Acute onset: disorientation, attention disorder, impaired consciousness.

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