Mental state alteration

Signs and Symptoms Symptoms in immunocompromised individuals may include fever, difficulty breathing (dyspnea), nonproductive cough, bloody sputum (hemoptysis), bloody nose (epistaxis), a vague feeling of bodily discomfort (malaise), pneumonia, weakness, chest pain, and anorexia. May progress to inflammation of the eyes (endophthalmitis), sensitivity to light (photophobia), and/or inflammation of the heart (endocarditis). May also cause abscesses in the heart, kidneys, liver, spleen, other soft tissue, or the bone. If the central nervous system becomes involved, can cause altered mental states and seizures. 

Over the centuries, people developed by such methods a list of medicinal and recreational drugs that made up the earliest informal pharmacopoeia, a catalog of drugs, chemicals, and medicinal preparations. Chemicals that "worked (that brought relief, cured, or altered a mental state) made that list. Those that did not (killed people or caused serious harm) usually did not. 

The Mini Mental State Examination (Folstein et ah, 1975) has been adapted and studied for use with children (Ouvrier et ah, 1993 Besson and Labbe, 1997) and other screening tools to assess cognitive function in children have also been developed (Ouvrier et ah, 1999). These tools are invaluable, as so often altered mental status in a child can be related to impaired cognitive function or early delirium. 

Agitated delirious state Delirious state altered mental state No Nondirected destruction of property injury to self or others Probable... 

Shock is a complex acute cardiovascular syndrome that results in a critical reduction in perfusion of vital tissues and a wide range of systemic effects. Shock is usually associated with hypotension, an altered mental state, oliguria, and metabolic acidosis. If untreated, shock usually progresses to a refractory deteriorating state and death. The three major mechanisms responsible for shock are hypovolemia, cardiac insufficiency, and altered vascular resistance. Volume replacement and treatment of the underlying disease are the mainstays of the treatment of shock. Although sympathomimetic drugs have been used in the treatment of virtually all forms of shock, their efficacy is unclear. 

Symptomatic hypoglycemia occurred in a healthy 30-year-old primigravida after a second 5 ml bolus of 0.25% bupivacaine administered epidurally during labor (703). She developed an altered mental state, which responded rapidly to 50 ml of 50% dextrose administered intravenously. 

Co-trimoxazole can cause reversible hypoglycemia, which may be prolonged, particularly in patients with risk factors for hypoglycemia. Common risk factors include compromised renal function, prolonged fasting, malnutrition, and the use of excessive doses. It has been postulated that the sulfonamide mimics the action of sul-fonylureas, stimulating pancreatic islet cells to secrete insulin. In elderly people, co-trimoxazole-induced hypoglycemia can cause altered mental state (1146,1147). 

Taking thorough general history aids in the effective treatment of an intoxicated patient. Often it may not be possible to communicate directly with the patient due to a lack of consciousness, altered mental state leading to inaccurate information, or deliberate submission of misleading information. The type of information that is essential and helpful include ... 

Effects When smoked, produces mild marijuana-like euphoria and improves mental clarity. Tea acts simultaneously as a stimulant and relaxant. Lesser amounts tend to act as stimulant larger amounts as a relaxant. Also, may cause tingling body sensations and altered mental state. 

Adverse effects Nausea, vomiting, diarrhea, and severe myelo-suppression (primarily granulocytopenia) are the major toxicities. Hepatic dysfunction is also occasionally encountered. At high doses or intrathecal injection, ara-C may cause seizures or altered mental states. 

A previously healthy 18-year-old woman had an altered mental state after using ecstasy, followed by excessive thirst and consumption of a lot of water... 

An 18-year-old man at the same rave developed an altered mental state after taking two tulips (slang... 

Persistent acute body zinc loss has resulted in many symptoms in addition to taste and smell dysfunction if losses continue at significant levels for periods of 14 days or more. These symptoms Include mental confusion, cerebellar dysfunction, including intention tremor and ataxia, an erythrematous, Intracrural rash, buccal epithelial lesions and ulcers, and acute toxic psychosis (,6). The altered mental state of these patients can be related to the rapid depletion of the relatively high zinc content in the limbic system of the brain (16.17), demonstrating that zinc can cross the blood brain barrier bidirectionally, dependent upon the gradient, and that it can be readily mobilized from brain tissue. 

An epileptic seizure is a transient symptom of abnormal, excessive or synchronous neuronal activity in the brain (normal brain activity is marked by unsynchronised firing of neurons). It can manifest as an alteration in mental state, tonic or clonic movements and convulsions. The medical syndrome of recurrent, unprovoked seizures is termed epilepsy, but seizures can occur in people who do not have epilepsy. 

Features include muscle weakness and cramps, paraesthesia, nausea, vomiting, constipation, abdominal pain, polyuria, polydipsia, depression, confusion and psychosis. Hypokalaemia may cause brady/tachyarrhythmias, hypotension, respiratory failure, ileus and altered mental state. It also increases the toxicity of cardiac glycosides. There are several associated disease states (e.g. diarrhoea, vomiting, renal tubular acidosis types I and II, hypomagnesaemia, Conn s syndrome, Cushing s disease, Gitelman s syndrome, villous adenoma, pyloric stenosis, intestinal fistulae). 

Drug interaction-induced failure of antibiotics for common infections is invariably a result of inadequate blood concentrations (increased metabolism or reduced absorption, and infrequently increased elimination). The persistence of symptoms such as fever, shivering, pain or altered mental state should be reported immediately. In children, persistent crying or irritability and going off feeds may be early features of failure of therapy. 

Case reports on adverse reactions to ecstasy show that it can cause altered mental states, increased heart rate, and increased rate of... 

A 7-year-old boy with Duchenne muscular dystrophy and attention deficit hyperactivity disorder (ADHD) developed acute hepatic failure, with features of autoimmune hepatitis (2). The only medications he had taken were pemoline (56 mg/day) and cjrproheptadine (2 mg/day). Pemoline was withdrawn after 8 months as the presumed cause of his raised transaminases. Two weeks later he developed an altered mental state, jaundice, and encephalopathy. The histological features of the liver and his autoimmune antibody panel were consistent with autoimmune hepatitis. He was treated with corticosteroids and azathioprine and recovered. 

Intoxication refers to an acutely altered mental state due to ingestion of (or exposure to) a substance that is not caused by a medical condition or other mental disorder. 

Medication abuse occurs gradually, so much so that the patient is unable to recognize the addiction and steadfastly denies that he or she is addicted. Addiction results in an altered mental state that leads to deviation from normal behavioral patterns. These deviations are ... 

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