Delirium is an acute, fluctuating disturbance of consciousness associated with changes in cognition or the development of perceptual disturbances. It can present as hyperactive, hypoactive, or mixed. Hyperactive delirium involves agitation and repetitive behaviors while hypoactive delirium involves withdrawal and is often missed. Causes include substance use, medical conditions like infection or metabolic disorders, and head injuries. Haloperidol is commonly used to treat delirium though it can cause extrapyramidal symptoms and other side effects. A thorough history including baseline cognition and current medications aids in diagnosis and distinguishing delirium from dementia.

1. DELIRIUM
Mr.Abdulaziz R. Alanzi
Medical Student, Al-Imam University
Riyadh – Saudi Arabia

2. Delirium is an acute, fluctuating disturbance of
consciousness, associated with a change in cognition
or the development of perceptual disturbances
Definition

3. Clinically delirium can be divided into the following three
categories:
i. Hyperactive Delirium (30%). Patients are agitated and hyper alert with
repetitive behaviours, wandering, hallucinations and aggression. Although
recognised earlier, there is association with increased use of benzodiazepines,
over sedation, use of
restraints and falls.
ii. Hypoactive Delirium (25%). Patients are quiet and withdrawn which is often
missed on a busy medical ward leading to increased length of stay, increased
and more severe complications.
iii. Mixed Delirium. Fluctuating pattern seen in 45% of cases.
Classification

4. Causes & RFs

5. Causes
Substance
induced conditions
General Medical
Conditions
Infection
Metabolic Disorders
hepatic or renal failure
seizure
Head injury
Drug intoxication
drug withdrawal

8. Pathophysiology

11. Clinical Features

13. Diagnosis Approach

14. History
• Information from a collateral source such as a spouse or
another family member.
• Most important things to ask :
1. the patient's baseline cognitive function.
2. the time course of the present illness.
3. current medications.

17. Deference between
dementia and delirium

20. Haloperidol

21. • Class: Antipsychotic and neuroleptic
• Haloperidol is a frequently used tranquilizer.
• MOA: Haloperidol is a major tranquilizer of the butyrophenone class that has proved
effective in management of acute psychotic episodes. It has pharmacological
properties similar to those of the phenothiazine class of drugs (e.g., Thorazine).
Haloperidol appears to block dopamine receptors in the brain associated with mood and
behavior. However, its precise mechanism of action Is not clearly understood.
Haloperidol has weak anticholinergic properties.
• Half-Life: 3-35 hours
• Indications: Haloperidol is used in acute psychotic episodes.
• Contraindications: Haloperidol should not be administered in cases in which other
drugs, especially sedatives, may be present. It should not be used in the management
of dysphoira caused by Talwin because it may promote sedation and anesthesia.
• SE: Extrapyramidal Symptoms (EPS), Insomnia, Restlessness, Drowsiness,
Tachycardia, Seizures, Respiratory Depression, Dry Mouth, Constipation, Hypotension

22. THANK YOU
d0pa@hotmail.com
@AbdulazizEnazi
http://imamu.academia.edu/AbdulazizAlanzi