Dementia and Delirium – Vocabulary Flashcards

A set of vocabulary flashcards covering essential terms, drugs and concepts related to delirium, dementia, Alzheimer’s disease and their pharmacological management.

Delirium

A major acute confusional state featuring loss of orientation, autonomic hyperactivity, hallucinations, agitation and fluctuating consciousness; a medical emergency.

Dementia

Progressive failure of many cerebral functions (memory, orientation, language, executive function) not due to impaired consciousness.

Alzheimer's disease

Most common cause (≈50–70 %) of dementia; marked by cortical shrinkage, neuronal/synapse loss, neurofibrillary tangles and senile plaques.

Confusion

Inability to think clearly or understand one’s situation, reflecting impaired cognitive function.

Disorientation

Loss of awareness of time, place or person.

Orientation

The ability to correctly identify time, place and person.

Reticular Activating System (RAS)

Upper brain-stem network projecting to cortex and limbic areas; its disruption contributes to delirium.

Neurofibrillary tangles

Abnormal intracellular twisted filaments of tau protein seen in neurons of Alzheimer’s patients.

Senile plaques

Extracellular deposits of β-amyloid and degenerating neurons characteristic of Alzheimer’s disease.

Antipsychotics

Drugs used to treat psychosis; typical agents (e.g., haloperidol) chiefly block dopamine receptors.

Antidepressants

Medications for clinical depression, including tricyclics, SSRIs and MAOIs.

Tricyclic Antidepressants (TCAs)

Older antidepressant class (e.g., doxepin) that blocks reuptake of serotonin and noradrenaline.

Selective Serotonin Reuptake Inhibitors (SSRIs)

Antidepressant class that increases synaptic serotonin by inhibiting its reuptake.

Monoamine Oxidase Inhibitors (MAOIs)

Antidepressants that inhibit the enzyme degrading monoamines, increasing serotonin, noradrenaline and dopamine levels.

Atypical antipsychotics

Newer antipsychotic agents with broader receptor profile and lower risk of motor side effects than typical drugs.

Haloperidol

Typical antipsychotic that blocks D2 receptors; used to manage delirium and acute psychosis.

Chlorpromazine

Phenothiazine antipsychotic used for agitation or behavioural disturbance in delirium/dementia.

Donepezil

Oral acetylcholinesterase inhibitor (brand: Aricept) for mild–severe Alzheimer’s disease.

Tardive dyskinesia

Late-onset involuntary movements (e.g., lip smacking) caused by long-term antipsychotic use.

Neuroleptic Malignant Syndrome

Life-threatening reaction to antipsychotics with hyperthermia, rigidity and autonomic instability.

Full Neurological Observations (FNO)

Comprehensive, frequent assessment of consciousness, pupils, motor and vital signs in at-risk patients.

Fluid Balance Chart (FBC)

Record of a patient’s fluid intake and output to monitor hydration and renal function.

Dopamine D2 Receptor Blockade

Primary pharmacological action of typical antipsychotics producing antipsychotic effects and motor side effects.

Acetylcholinesterase inhibitor

Drug that prevents acetylcholine breakdown, enhancing cholinergic transmission (e.g., donepezil).

Centrally acting anticholinesterases

Class of brain-penetrating acetylcholinesterase inhibitors used to slow cognitive decline in dementia.

Describe the pathophysiology of delirium.

an acute confusional state characterized by loss of orientation, autonomic hyperactivity, hallucinations, agitation, and fluctuating consciousness, indicating impaired cognitive function.

What key system, when disrupted, contributes to the development of delirium?

Disruption of the Reticular Activating System (RAS), an upper brain-stem network projecting to the cortex and limbic areas, is a central component in the aetiology of delirium.

What are the prominent signs and symptoms of delirium?

Key signs and symptoms include loss of orientation, autonomic hyperactivity, hallucinations, agitation, and fluctuating consciousness.

Outline the care management strategies for delirium.

Care management involves: - Pharmacological intervention: Use of antipsychotics like haloperidol (typical) or chlorpromazine for acute psychosis, agitation, or behavioural disturbance. - Monitoring: Comprehensive and frequent assessment through Full Neurological Observations (FNO) of consciousness, pupils, motor skills, and vital signs, along with Fluid Balance Chart (FBC) to monitor hydration.

Describe the pathophysiology of dementia, particularly in Alzheimer's disease.

Dementia involves the progressive failure of cerebral functions (memory, orientation, language, executive function). In Alzheimer's disease, this is marked by cortical shrinkage, neuronal/synapse loss, the formation of neurofibrillary tangles (abnormal intracellular twisted tau protein filaments), and senile plaques (extracellular deposits of \beta-amyloid and degenerating neurons).

What is the most common aetiology of dementia?

Alzheimer's disease is the most common cause of dementia, accounting for approximately 50–70% of cases.

What are the primary cognitive functions affected as signs and symptoms of dementia?

Dementia is characterized by the progressive failure of many cerebral functions, including memory, orientation, language, and executive function, without impaired consciousness.

How is dementia typically managed, focusing on pharmacological and symptomatic approaches?

Management includes: - Pharmacological intervention: Use of centrally acting anticholinesterases, such as donepezil (an acetylcholinesterase inhibitor), to prevent acetylcholine breakdown and enhance cholinergic transmission, aiming to slow cognitive decline. - Symptomatic management: Antipsychotics like chlorpromazine may be used for agitation or behavioural disturbance associated with dementia.