Sundowning syndrome or nocturnal delirium is used to describe a wide range of behaviours of neuropsychiatric (NPS) symptoms that often happen in people with dementia. The behavioural and neuropsychiatric symptoms seen in people with dementia and Alzheimer’s disease include; repetitive behaviours, delusions, misidentification, wandering, suicidal and sociopathic behaviours. Both normal ageing and dementia are associated with changes to the circadian regulation of physiology and behaviour (Cipriani et al., 2015)
Inflammation is a pathological response that engages hundreds of mediators and different cells and tissue types. It can be initiated by any stimulus causing cell injury. Often the inflammation is a response to some sort of infection. In some cases, chemical or physical injury can also induce an inflammatory reaction. The goal of the inflammatory response is to remove the causative agent with minimal destruction to the body, and to repair the damage caused by the toxin. The duration of the inflammatory response is dependent on whether the causative agent has been eliminated. Acute inflammation is a relatively short process, lasting from minutes to a few day
Palliative care can be defined as an approach to health that involves improving the quality of life of patients and their families that are facing issues related to chronic, incurable and life-threatening illnesses (Wallerstedt et al., 2019). It is vital to note that, palliative care is not just limited to the elderly, but can be anyone with an incurable illness and the goal is to improve quality of life. The stages of palliative care include; stable, unstable, deteriorating, terminal and bereavement (McClelland et al., 2020).
There are two main ways that heroin is metabolised; one of the ways is through the Hepatic First Pass. This is done via the removal of an acetyl group when taken orally. The other way is through injections. Heroin that is administered via this route will evade the Hepatic First Pass and will quickly cross the blood-brain barrier. This is because of the presence of an acetyl group that makes it more soluble to fat. Once, in the brain, the acetyl group is removed, and heroin is reduced to 3-monoacetylmorphine and 6-monoacetylmorphine.