DEMENTIA OR DELIRIUM WHICH ONE IS IT ARTICLE AND DEMENTIA AND DELIRIUM AND PSYCHIATRIC MEDICINES AND 3 OTHER ARTICLES 6 PAGES NOV 2019 OPEN TO PUBLIC TO READ

DEMENTIA OR DELIRIUM WHICH ONE IS IT ARTICLE AND DEMENTIA AND DELIRIUM AND PSYCHIATRIC MEDICINES AND 3 OTHER ARTICLES 6 PAGES NOV 2019 OPEN TO PUBLIC TO READ
Is It Delirium or Dementia?
Both can be Scary - Know the Difference
Delirium and Dementia appear very similar on the surface. They are often confused. Even for medical professionals and caregivers, it can be easy to misinterpret the signals. It is possible for a person to have dementia and delirium, which further complicates the diagnosis.
Delirium can often be reversed.
Delirium causes confusion, disrupted behaviors, and disruptions in thinking; there can also be mood changes, perceptional changes, and changes in attention happens over days or weeks. There is disorganization in thinking patterns and the person may not be able to maintain focus. The person suffering from delirium may not be able to have a coherent conversation. They may be either "hyper-alert" or very lethargic. The symptoms can fluctuate throughout the day, and there may be times of the day that they are symptom-free. Some more obvious symptoms are alarming.
• Hallucinations
• Disorientation
• Nonsense speech
Difficulty understanding speech
Many causes of delirium can be treated or prevented. Unfortunately, delirium is missed half of the time. Knowing the potential causes can be the first step towards finding the solution.
• Illness-such as a urinary tract infection or influenza
• Brain injuries-such as a stroke or unrecognized head injury
• Withdrawal-from alcohol, nicotine, or stopping a medication
• Medication-adverse reaction, mixing medications or taking with alcohol
• Brain aging
. Dementia
• Electrolyte imbalance
• Multiple medications
• Dehydration
• Malnutrition
With the changes in memory and intellect happen gradually. Notable changes appear over months and even years. For a diagnosis of dementia, there needs to be a decline in memory and at least one other cognitive area. The causes of dementia are related specifically to the brain.
• Gradual dysfunction of the brain
• Loss of brain cells
Many of the risk factors associated with dementia are genetic. Dementia can also be influenced by general health and lifestyle choices. The connections are still not fully understood.
• Age - 30% risk if over 85 years, rare under 50 years
• Female — may be due to hormonal changes as women age
• Genetics - early or late chromosomal mutations
• Brain Damage - from Alzheimer's Disease, Parkinson's Disease, AID's, alcoholism and others
• Damage to blood vessels — heart disease, diabetes, stroke, high blood pressure
A person with dementia can be prone to bouts of delirium. A person with unresolved delirium can develop dementia.
If you notice sudden behavioral or cognitive changes that occur over a few days or weeks, it may be a good idea to investigate the some of the multiple causes of delirium. Investigate any recent changes in medication or an undiagnosed infection.
Knowing the differences between the two conditions can keep delirium from becoming dementia or improve the symptoms of the individual who shows signs of both. If you need help, reach out to a local behavioral health provider, a Memory Care Community, or your physician.
Delirium or Dementia? Know the Difference Delirium and dementia are both frightening to sufferers and caregivers alike, and often manifest themselves in similar ways. However, the two conditions are very different, and mistaking one for the other can have serious adverse consequences. Learning to recognize the distinctions between dementia and delirium can ensure that the patient receives the best care possible in a timely manner.
Causes and Symptoms of Delirium
Delirium is an acute condition. Symptoms often appear suddenly and cause dramatic behavior changes.
Symptoms of delirium include hallucinations, nonsense speech, disorientation and difficulty following normal conversation.
Delirium has a number of causes; finding the right cause is often the key to effective treatment.
Common causes of delirium are listed below: •
Acute illness such as influenza or infections • Brain injuries, including stroke and head trauma • Kidney or liver failure • Alcohol, narcotics or prescription drug withdrawal (the DTs or delirium tremens)
• Adverse reactions to medication or multiple medications •
Electrolyte imbalance • Malnutrition or dehydration The good news is that in many cases, delirium can be reversed with timely and effective treatment. The bad news is delirium is often misdiagnosed.
Even worse is that delirium can occur in combination with dementia —
and that untreated delirium can deteriorate into dementia
. Causes and Symptoms of Dementia Unlike delirium,
dementia occurs gradually, often going unnoticed until significant decline in cognitive function has occurred. Risk factors for dementia are listed below:
• Age — the risk increases to up to 30% for seniors over age 85 •
Gender — Females are more prone than men, perhaps due to menopause-related hormonal changes
• Genetic mutations that occur either early or late in life •
Brain damage from alcoholism, AIDS, Alzheimer’s Disease or Parkinson’s Disease
• Vascular damage from stroke, diabetes or high blood pressure
The most obvious symptoms of dementia involve memory loss. Except in rare cases, dementia is irreversible. Unfortunately, many dementia patients also develop delirium when they are hospitalized. Sincerely, Suzette Lindemuth Founder, Senior Living Systems To learn more about dealing with delirium and dementia, and the Senior Living Systems philosophy of ageless living, contact us today!
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Warning About Antipsychotics
People with LBD may have severe reactions to or side effects from antipsychotics, medications used to treat hallucinations, delusions, or agitation. These side effects include increased confusion, worsened parkinsonism, extreme sleepiness, and low blood pressure that can result in fainting (orthostatic hypotension). Caregivers should contact the doctor if these side effects continue after a few days.
Some antipsychotics, including olanzapine (Zyprexa®) and risperidone (Risperdal®), should be avoided, if possible, because they are more likely than others to cause serious side effects.
In rare cases, a potentially deadly condition called neuroleptic malignant syndrome can occur. Symptoms of this condition include high fever, muscle rigidity, and muscle tissue breakdown that can lead to kidney failure. Report these symptoms to your doctor immediately.
Antipsychotic medications increase the risk of death in all elderly people with dementia but can be particularly dangerous in those with LBD. Doctors, patients, and family members must weigh the risks of antipsychotic use against the risks of physical harm and distress that may occur as a result of untreated behavioral symptoms.
FROM KATRINE SACKETT32463WHITELADY
INFORMATION FOUND IN SENIOR CATOLOGS AND IN INTERENT ARTICLES AND MED BOOKS
NOV 2019
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How Medication Side Effects Can Masquerade as Dementia
Drug interactions and side effects often mimic the symptoms of age-related cognitive disorders. For instance, drugs that affect cognition and mobility, such as anti-anxiety meds, can make dementia symptoms worse — or even create a facade of dementia in people who don’t suffer from the disease, a condition known as pseudodementia.
For instance, many anti-anxiety drugs commonly prescribed to seniors such as Valium and Xanax, have side effects that are indistinguishable from Alzheimer’s or dementia, including:
• Short-term memory loss
• Disinhibition
• Hallucinations
Other medications can also cause pseudodementia, including cholesterol lowering statin drugs like Lipitor, which many seniors take. In fact, any medicine that can cause cognitive impairment could lead to a misdiagnosis of dementia. Classes of drugs including anti-histamines, antibiotics, corticosteroids, anticonvulsants, antiemetics, muscle relaxants and opioid pain killers all carry this risk.
Some structural brain disorders (eg, normal-pressure hydrocephalus, subdural hematoma), metabolic disorders (eg, hypothyroidism, vitamin B12 deficiency), and toxins (eg, lead) cause a slow deterioration of cognition that may resolve with treatment. This impairment is sometimes called reversible dementia, but some experts restrict the term dementia to irreversible cognitive deterioration.
Drugs
Eliminating or limiting drugs with CNS activity often improves function. Sedating and anticholinergic drugs, which tend to worsen dementia, should be avoided.
Drugs, particularly benzodiazepines and anticholinergics (eg, some tricyclic antidepressants, antihistamines, antipsychotics, benztropine), may temporarily cause or worsen symptoms of dementia, as may alcohol, even in moderate amounts. New or progressive kidney or liver failure may reduce drug clearance and cause drug toxicity after years of taking a stable drug dose (eg, of propranolol).
Ingestion of drugs or toxins Alcohol-associated dementia
Dementia due to exposure to heavy metals
Infections Fungal: Dementia due to cryptococcosis
Spirochetal: Dementia due to syphilis or Lyme disease
Viral:HIV-associated dementia, postencephalitis syndromes
The most common causes of delirium are the following:
• Drugs, particularly anticholinergics, psychoactive drugs, and opioids
• Dehydration
• Infection
Many other conditions can cause delirium (see Table: Causes of Delirium). In about 10 to 20% of patients, no cause is identified.
Vascular or circulatory disorders Anemia, cardiac arrhythmias, heart failure, hypoperfusion states, shock
Other causes Change of environment, fecal impaction, hypertensive encephalopathy, liver failure, long stays in an ICU, mental disorders, postoperative states, sensory deprivation, sleep deprivation, toxins that affect the CNS, urinary retention
• Treat the cause of delirium, and provide supportive care, including sedation when necessary.
Drugs Mentioned In This Article
Drug Name Select Trade
diphenhydramine No US trade name
haloperidol HALDOL
risperidone RISPERDAL
olanzapine ZYPREXA
cimetidine TAGAMET
quetiapine SEROQUEL
lorazepam ATIVAN
dopamine No US brand name
Drugs
Drugs, typically low-dose haloperidol (0.5 to 1.0 mg po, IV, or IM once, then repeated q 1 to 2 h as needed), may lessen agitation or psychotic symptoms; occasionally, much higher doses are necessary. However, drugs do not correct the underlying problem and may prolong or exacerbate delirium
Correcting the cause (eg, treating infection, giving fluids and electrolytes for dehydration) and removing aggravating factors (eg, stopping drugs) may result in resolution of delirium
Delirium due to certain conditions (eg, hypoglycemia, drug or alcohol intoxication, infection, iatrogenic factors, drug toxicity, electrolyte imbalance) typically resolves rapidly with treatment. However, recovery may be slow (days to even weeks or months), especially in the elderly, resulting in longer hospital stays, increased risk and severity of complications, increased costs, and long-term disability. Some patients never fully recover from delirium. For up to 2 yr after delirium occurs, risk of cognitive and functional decline, institutionalization, and death is increased.
Causes of Delirium
Drugs (numerous) Anticholinergics, antiemetics, antihistamines (eg, diphenhydramine), antihypertensives, some antimicrobials, antipsychotics, antispasmodics, benzodiazepines, cardiovascular drugs (often beta-blockers), cimetidine, corticosteroids, digoxin, dopamine agonists, hypnotics, muscle relaxants, NSAIDs, opioids, recreational drugs, sedatives, tricyclic antidepressants
Delirium is sometimes called acute confusional state or toxic or metabolic encephalopathy.
Delirium and dementia are separate disorders but are sometimes difficult to distinguish. In both, cognition is disordered; however, the following helps distinguish them:
• Delirium affects mainly attention, is typically caused by acute illness or drug toxicity (sometimes life threatening), and is often reversible.
• Dementia affects mainly memory, is typically caused by anatomic changes in the brain, has slower onset, and is generally irreversible.
FROM KATRINESACKETT32463WHITELADY
INFORMATION FROM SENIOR CATOLOG AND ARTICLES AND BOOK
normothermia (redirected from normothermic) Also found in: Dictionary, Thesaurus, Encyclopedia. normothermia [nor″mo-ther´me-ah] a normal state of temperature. adj., adj normother´mic. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. nor·mo·ther·mi·a (nōr'mō-ther'mē-ă), Environmental temperature that does not cause increased or depressed activity of body cells. [normo- + G. thermē, heat] Farlex Partner Medical Dictionary © Farlex 2012 normothermia (nôr′mō-thûr′mē-ə) n. A condition of normal body temperature. ________________________________________ nor′mo·ther′mic adj. The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved. nor·mo·ther·mi·a (nōr'mō-thĕr'mē-ă) Environmental temperature that does not cause increased or depressed activity of body cells. [normo- + G. thermē, heat] Medical Dictionary for the Health Professions and Nursing © Farlex 2012 normothermia A body temperature within normal limits. The term is used mainly in contexts in which hypothermia is a possibility or a risk. Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005 Normal human body temperature, also known as normothermia or euthermia, is the typical temperature range found in humans. The normal human body temperature range is typically stated as 36.5–37.5 °C (97.7–99.5 °F).[8] Individual body temperature depends upon the age, exertion, infection, sex, and reproductive status of the subject, the time of day, the place in the body at which the measurement is made, and the subject's state of consciousness (waking, sleeping or sedated), activity level, and emotional state. It is typically maintained within this range by thermoregulation.
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Submitted by Unregistered User on Sun, 11/24/2019 - 21:28
normothermia (redirected from normothermic) Also found in: Dictionary, Thesaurus, Encyclopedia. normothermia [nor″mo-ther´me-ah] a normal state of temperature. adj., adj normother´mic. Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc. All rights reserved. nor·mo·ther·mi·a (nōr'mō-ther'mē-ă), Environmental temperature that does not cause increased or depressed activity of body cells. [normo- + G. thermē, heat] Farlex Partner Medical Dictionary © Farlex 2012 normothermia (nôr′mō-thûr′mē-ə) n. A condition of normal body temperature. ________________________________________ nor′mo·ther′mic adj. The American Heritage® Medical Dictionary Copyright © 2007, 2004 by Houghton Mifflin Company. Published by Houghton Mifflin Company. All rights reserved. nor·mo·ther·mi·a (nōr'mō-thĕr'mē-ă) Environmental temperature that does not cause increased or depressed activity of body cells. [normo- + G. thermē, heat] Medical Dictionary for the Health Professions and Nursing © Farlex 2012 normothermia A body temperature within normal limits. The term is used mainly in contexts in which hypothermia is a possibility or a risk. Collins Dictionary of Medicine © Robert M. Youngson 2004, 2005 Normal human body temperature, also known as normothermia or euthermia, is the typical temperature range found in humans. The normal human body temperature range is typically stated as 36.5–37.5 °C (97.7–99.5 °F).[8] Individual body temperature depends upon the age, exertion, infection, sex, and reproductive status of the subject, the time of day, the place in the body at which the measurement is made, and the subject's state of consciousness (waking, sleeping or sedated), activity level, and emotional state. It is typically maintained within this range by thermoregulation. Taking a person's temperature is an initial part of a full clinical examination. There are various types of medical thermometers, as well as sites used for measurement, including: • In the rectum (rectal temperature) • In the mouth (oral temperature) • Under the arm (axillary temperature) • In the ear (tympanic temperature) • On the skin of the forehead over the temporal artery • Temperature control (thermoregulation) is part of a homeostatic mechanism that keeps the organism at optimum operating temperature, as the temperature affects the rate of chemical reactions. In humans, the average internal temperature is 37.0 °C (98.6 °F), though it varies among individuals. However, no person always has exactly the same temperature at every moment of the day. Temperatures cycle regularly up and down through the day, as controlled by the person's circadian rhythm. The lowest temperature occurs about two hours before the person normally wakes up. Additionally, temperatures change according to activities and external factors.[9][unreliable medical source?] • In addition to varying throughout the day, normal body temperature may also differ as much as 0.5 °C (0.9 °F) from one day to the next, so that the highest or lowest temperatures on one day will not always exactly match the highest or lowest temperatures on the next day. • Normal human body temperature varies slightly from person to person and by the time of day. Consequently, each type of measurement has a range of normal temperatures. The range for normal human body temperatures, taken orally, is 36.8±0.5 °C (98.2±0.9 °F).[10] This means that any oral temperature between 36.3 and 37.3 °C (97.3 and 99.1 °F) is likely to be normal. Introduction Differences between necrosis and apoptosis 1.2 Differences between necrosis and apoptosis There are many observable morphological (Figure 1, Table 1) and biochemical differences (Table 1) between necrosis and apoptosis2. Necrosis occurs when cells are exposed to extreme variance from physiological conditions (e.g., hypothermia, hypoxia) which may result in damage to the plasma membrane. Under physiological conditions direct damage to the plasma membrane is evoked by agents like complement and lytic viruses. Necrosis begins with an impairment of the cell’s ability to maintain homeostasis, leading to an influx of water and extracellular ions. Intracellular organelles, most notably the mitochondria, and the entire cell swell and rupture (cell lysis). Due to the ultimate breakdown of the plasma membrane, the cytoplasmic contents including lysosomal enzymes are released into the extracellular fluid. Therefore, in vivo, necrotic cell death is often associated with extensive tissue damage resulting in an intense inflammatory response5. Apoptosis, in contrast, is a mode of cell death that occurs under normal physiological conditions and the cell is an active participant in its own demise (“cellular suicide”). It is most often found during normal cell turnover and tissue homeostasis, embryogenesis, induction and maintenance of immune tolerance, development of the nervous system and endocrine-dependent tissue atrophy. Cells undergoing apoptosis show characteristic morphological and biochemical features6. These features include chromatin aggregation, nuclear and cytoplasmic condensation, partition of cytoplasm and nucleus into membrane bound-vesicles (apoptotic bodies) which contain ribosomes, morphologically intact mitochondria and nuclear material. In vivo, these apoptotic bodies are rapidly recognized and phagocytized by either macrophages or adjacent epithelial cells7. Due to this efficient mechanism for the removal of apoptotic cells in vivo no inflammatory response is elicited. In vitro, the apoptotic bodies as well as the remaining cell fragments ultimately swell and finally lyse. This terminal phase of in vitro cell death has been termed “secondary necrosis” (Figure 1). Core temperature[edit] Core temperature, also called core body temperature, is the operating temperature of an organism, specifically in deep structures of the body such as the liver, in comparison to temperatures of peripheral tissues. Core temperature is normally maintained within a narrow range so that essential enzymatic reactions can occur. Significant core temperature elevation (hyperthermia) or depression (hypothermia) over more than a brief period of time is incompatible with human life.
Submitted by Unregistered User on Mon, 11/25/2019 - 20:32
The order is affirmed. McGuiness, P. J., and Siggins, J., concurred. Appellant's petition for review by the Supreme Court was denied November 20, 2012, S205518. Footnotes 1 All statutory references are to the Penal Code unless otherwise noted. 2 Dr. Brar testified that “Thorazine and Haldol can cause [a] variety of different side effects ranging from sedation to drowsiness. They can, there [are] cardiac effects which range from palpitations to sudden death. There are possible, there are some studies that [find] Thorazine may cause cataracts in Beagle dogs. They can also cause weight gain, metabolic syndrome, hypercholestremia. They can cause constipation as well. There [is a] prudentially failed [sic] side effect which is neurological malignant syndrome which is potentially life threatening. Patient presents with fever, breakdown of muscle tissue that can cause kidney failure.” Defendant apparently was receiving generic versions of thorazine and haldol which presumably have the same side effects.

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