Mental confusion

The Class I agents have many similar side effects and toxicities. The anticholinergic side effects include dry mouth, constipation, and urinary hesitancy and retention. Common gastrointestinal (GI) side effects include nausea, vomiting, diarrhea, and anorexia. Cardiovascular adverse effects are hypotension, tachycardia, arrhythmias, and myocardial depression, especially in patients with congestive heart failure. Common central nervous system (CNS) side effects are headache, dizziness, mental confusion, hallucinations, CNS stimulation, paraesthesias, and convulsions. 

What has become an even greater concern in recent years is the phenomenon known as multiple chemical sensitivity disorder triggered by exposures to many chemicals in the environment. Synthetic chemicals are all around us. They are in the products we use, in the clothes we wear, in the food we eat, in the air we breathe at work. Because chemicals are everywhere in the environment, it is not possible to escape exposure. For this reason many people have become sensitized to the chemicals around them. In fact, it is estimated that 15% of the population has become sensitized to common household and commercial products. For some people the sensitization is not too serious a problem. They may have what appears to be a minor allergy to one or more chemicals. Other people are much more seriously affected. They may feel tired all the time, and suffer from mental confusion, breathing problems, sore muscles, and a weakened immune system. Such people suffer from a condition known as Multiple Chemical Sensitivity (MCS). 

Antagonists of muscarinic acetylcholine receptors had widely been used since 1860 for the treatment of Parkinson s disease, prior to the discovery of l-DOPA. They block receptors that mediate the response to striatal cholinergic interneurons. The antiparkinsonian effects of drugs like benzatropine, trihexyphenidyl and biper-iden are moderate the resting tremor may sometimes respond in a favorable manner. The adverse effects, e.g., constipation, urinary retention, and mental confusion, may be troublesome, especially in the elderly. 

ACYCLOVIR When given IV, acyclovir can cause crystal-luria (presence of crystals in the urine) and mental confusion. The nurse helps the patient maintain adequate hydration to prevent crystalluria by encouraging the patient to drink 2000 to 3000 mL of fluid each day (if the disease condition permits). In addition, the nurse should give careful attention to assessing the mental status of the patient. 

Levels greater than 150 mcg mL may result in symptoms of mild salicylism, namely tinnitus (ringing sound in the ear), difficulty in hearing, dizziness, nausea, vomiting, diarrhea, mental confusion, central nervous system depression, headache, sweating, and hyperventilation (rapid, deep breathing). 

Central nervous system-euphoria, drowsiness, apathy, mental confusion, alterations in mood, reduction in body temperature, feelings of relaxation, dysphoria (depression accompanied by anxiety), nausea, and vomiting are caused by direct stimulation of the emetic chemoreceptors located in the medulla. The degree to which these occur usually depends on the drug and the dose. 

The nurse observesthe elderly patient receiving a cholinergic blocking drug at frequent intervals for excitement, agitation, mental confusion, drowsiness urinary retention, or other adverse effects. If any of these should occur, it is important to withhold the next dose of the drug and contact the primary health care provider. The nurse ensures patient safety until these adverse reactions disappear. 

Older adults are especially sensitive to the effects of the CNS stimulants and may exhibit excessive anxiety, nervousness insomnia, and mental confusion. Cardiovascular disorders common in the older adult, maybe worsened by the CNS stimulants Careful monitoring is important because the presence of these reactions may result in the need to discontinue use of the drug. 

Gastrointestinal symptoms occur frequently with the administration of ethosuximide (Zarontin), methsux-imide (Celontin Kapseals), and phensuximide (Milontin Kapseals). Mental confusion and other personality changes, pruritus, urticaria, urinary frequency, weight loss, and hematologic changes may also be seen. 

Sedation and dry mouth are the most common adverse reactions seen with the use of TCAs. Tolerance to these effects develops with continued use. Orthostatic hypotension can occur with the administration of the TCAs. Orthostatic hypotension is a drop in blood pressure of 20 to 30 points when a person changes position, such as going from a lying position to a standing position. Mental confusion, lethargy, disorientation, rash, nausea, vomiting, constipation, urinary retention, visual disturbances, photosensitivity, and nasal congestion also may be seen. Sexual dysfunction may occur with administration of clomipramine. 

Irritability, anxiety, listlessness, mental confusion, nausea, diarrhea, abdominal distress, gastrointestinal hyperactivity, paresthesias, weakness and heaviness of the legs, flaccid paralysis, hypotension, cardiac arrhythmias, ECG changes... 

Uremia A condition that results from accumulation of metabolic waste products and endogenous toxins in the body resulting from impaired kidney function. Symptoms of uremia include nausea, vomiting, weakness, loss of appetite, and mental confusion. 

Riot control/incapacitants, which cause extreme discomfort or mental confusion such as tear gas, chloroacetophenone (CN), or 3-quinuclidinylben-zilate (BZ). 

Von Schnitzler was seriously disturbed and no doubt somewhat mentally confused by the calamities that had befallen Germany, his firm of Farben, and himself personally. His eagerness to tell his interrogators what he thought they wanted to hear is apparent throughout. 

Signs and Symptoms Sudden onset of fever, headache, vomiting and possibly abdominal pain, progressing to neck stiffness, mental confusion, motor disturbances, and difficulty with equilibrium. Survivors may suffer significant impairment of mental functions. 

Signs and Symptoms Most infections are asymptomatic or produce a nonspecific flulike illness. Symptoms include mild fever, headache, swollen lymph nodes, mental confusion, tremors, and flaccid paralysis. Liver and/or spleen may be enlarged. A maculopapular rash may be present on the trunk of the body. May progress to encephalitis and/or meningitis (meningoencephalitis) producing changes in mental status, seizures, and coma. 

Treatment of aminoacidurias with a low-protein diet may influence brain chemistry. It should be emphasized that the treatment of the patient with an aminoaciduria may affect brain chemistry, perhaps in an adverse manner. Nearly all patients receive a low-protein diet. Indeed, undiagnosed patients sometimes avoid consumption of protein, which they feel intuitively can cause lethargy, headache, nausea and mental confusion. As dietary protein declines, the intake of carbohydrate frequently increases. The concomitant rise of endogenous insulin secretion favors an increase in the ratio of the concentration of blood tryptophan to that of other amino acids, thereby promoting the entry of tryptophan to the brain. The latter amino acid is precursor to brain serotonin, which tends to increase. This physiology is known to be operative in patients with urea cycle defects. 

Needs assistance in walking total mental confusion. Dysphoria with nausea and some... 

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