Delirium is an acute cognitive disorder frequently encountered by inpatient providers, including neuropsychologists. The causes of delirium are broad but include electrolyte imbalances, vitamin deficiencies, polypharmacy, iatrogenic effects of medications (e.g., benzodiazepines, antipsychotics), drugs of abuse (e.g., alcohol, psychostimulants), and the sequelae of organ dysfunction and surgery. The present chapter reviews critical concepts in the management of patients with delirium and integrates practice guidance with specific discussion of interventions that may be less familiar to the reader (e.g., deprescribing). While these discussions are designed to be clinically helpful, readers with working knowledge of the pathophysiology of delirium and relevant medical knowledge will likely gain the most from this chapter. Familiarity with the Systems Integration Failure Hypothesis (Maldonado 2018) and other pathophysiological concepts is recommended as a broad overview of delirium which, along with its definitions, clinical features, and treatment approaches, is covered elsewhere.

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Delirium II—Common Etiologies

  • Ryan Van Patten,
  • Emily Hallowell,
  • Joel E. Kamper,
  • Kyle J. Jennette,
  • Robert Kanser

摘要

Delirium is an acute cognitive disorder frequently encountered by inpatient providers, including neuropsychologists. The causes of delirium are broad but include electrolyte imbalances, vitamin deficiencies, polypharmacy, iatrogenic effects of medications (e.g., benzodiazepines, antipsychotics), drugs of abuse (e.g., alcohol, psychostimulants), and the sequelae of organ dysfunction and surgery. The present chapter reviews critical concepts in the management of patients with delirium and integrates practice guidance with specific discussion of interventions that may be less familiar to the reader (e.g., deprescribing). While these discussions are designed to be clinically helpful, readers with working knowledge of the pathophysiology of delirium and relevant medical knowledge will likely gain the most from this chapter. Familiarity with the Systems Integration Failure Hypothesis (Maldonado 2018) and other pathophysiological concepts is recommended as a broad overview of delirium which, along with its definitions, clinical features, and treatment approaches, is covered elsewhere.