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Treatment of Delirium in Older Persons: What We Should Not Do!
- Source :
- International Journal of Molecular Sciences, Vol 21, Iss 2397, p 2397 (2020), International Journal of Molecular Sciences
- Publication Year :
- 2020
- Publisher :
- MDPI AG, 2020.
-
Abstract
- The presentation of common acute diseases in older age is often referred to as “atypical”. Frequently, the symptoms are neither single nor tissue related. In most cases, the onset of symptoms and diseases is the expression of a diminished reserve with a failure of the body system and imbalance of brain function. Delirium is one of the main devastating and prevalent atypical symptoms and could be considered as a geriatric syndrome. It encompasses an array of neuropsychiatric symptoms and represents a disarrangement of the cerebral function in response to one or more stressors. The most recent definition, reported in the DSM-V, depicts delirium as a clear disturbance in attention and awareness. The deficit is to be developed in a relatively short time period (usually hours or days). The attention disorder must be associated with another cognitive impairment in memory, orientation, language, visual-spatial or perception abilities. For the treatment, it is imperative to remove the potential causes of delirium before prescribing drugs. Even a non-pharmacological approach to reducing the precipitating causes should be identified and planned. When we are forced to approach the pharmacological treatment of hyperactive delirium in older persons, we should select highly cost-effective drugs. High attention should be devoted to the correct balance between improvement of psychiatric symptoms and occurrence of side effects. Clinicians should be guided in the correct choice of drugs following cluster symptoms presentation, excluding drugs that could potentially produce complications rather than advantages. In this brief point-of-view, we propose a novel pharmacological flow-chart of treatment in relation to the basic clusters of diseases of an older patient acutely admitted to the hospital and, in particular, we emphasize “What We Should Not Do!”, with the intention of avoiding possible side effects of drugs used.
- Subjects :
- medicine.medical_specialty
media_common.quotation_subject
Review
Catalysis
Pharmacological treatment
Inorganic Chemistry
lcsh:Chemistry
03 medical and health sciences
0302 clinical medicine
delirium
pharmacological treatment
Orientation (mental)
Perception
Cerebral function
Medicine
Humans
Cognitive Dysfunction
030212 general & internal medicine
Physical and Theoretical Chemistry
Intensive care medicine
Molecular Biology
lcsh:QH301-705.5
Spectroscopy
Brain function
media_common
Balance (ability)
older person
Psychotropic Drugs
business.industry
Organic Chemistry
Stressor
General Medicine
Computer Science Applications
Hospitalization
neurogeriatric disorders
lcsh:Biology (General)
lcsh:QD1-999
Acute Disease
older persons
Delirium
neurogeriatric disorder
medicine.symptom
business
Cognition Disorders
030217 neurology & neurosurgery
Subjects
Details
- Language :
- English
- ISSN :
- 16616596 and 14220067
- Volume :
- 21
- Issue :
- 2397
- Database :
- OpenAIRE
- Journal :
- International Journal of Molecular Sciences
- Accession number :
- edsair.doi.dedup.....3c07431934e758bf8c581dd1cccd0810