What are the treatment options used incase non-medical treatment fails for managing delirium?
Delirium is a state of mental confusion or a syndrome characterised by fluctuating or decreasing cognitive impairment along with behavioural abnormalities. It may includes the following features: Global cognitive deficit, Varying conscious level, Memory impairment, Strange behaviour, Disordered thinking, Disturbed perception, Mood swings Treatment options of delirium are as follows: NON-PHARMACOLOGICAL TREATMENT 1. Identifying and finding out the triggering factors or aggravating factors. -The main causative agents can vary according to the environment and examination. -Controlling and improving the already existing condition. 2. Giving patients supportive measures -Patient and family education -Making the surrounding safe -Optimization of environment by frequent mobilization, adequate hydration and adequate sleep. 3. Avoiding unnecessary sedation. Sedation is commonly done in severely agitated patients. PHARMACOLOGICAL TREATMENT This treatment is used when the non-medical interventions fails. Treatment includes giving a single drug at a low dose initially. Dose is then titrated to effects. Reassess the patient in 2-4 hours of giving the drug. Medications used: Oral haloperidol (0.5-1 mg) with max dose of 6 gm, Lorazepam (0.5-1 mg) with max dose of 4 gm, Oral risperidone (1-4 mg) with max dose of 6 gm daily