J: Chachexia- Lauer Flashcards
Define anorexia
reduced desire to eat
may report: abdominal pain, gastric dumping, nausea/vomiting
or may not notice
What is primary anorexia?
hypothalamus fails to respond to orexigenic signals, usually secondary to inflammatory process
What is secondary anorexia?
Due to early satiety Constipation Nausea or vomiting Depressed mood Dysgeusia Dysphagie Dry mouth Mucositis Dental pain
Define Malnutrition
imbalance of energy of specific nutrients that leads to adverse effects on the body’s form or function
Define sarcopenia
muscle wasting (different from malnutrition!) Temporal/mandibular Thenar wasting Supraclavicular Decreased grip strength
Define Anorexia/Cachexia syndrome
a multifactorial syndrome characterized by an ongoing loss of skeletal muscle mass (with or without loss of fat mass) that cannot be fully reversed by conventional nutritional support and leads to progressive functional impairment
What are the primary symptoms and signs of ACS?
Muscle loss
Anorexia
Fatigue
Early Satiety
What are the stages of cachexia?
Pre-cachexia: 10% wt loss, irreversible,
When do you intervene with ACS?
Early (during pre-cachexia)
When cure is a possibility
When patient enjoys eating
***NOT to return to previous level of function in a terminal patient (not realistic)
What are three pharmaceuticals that can be used to treat ACS?
Methylphenidate- antidepressent that may increase lean body mass
Dronabinol - weed derivative, increases appetite and pleasure received from eating (no change in GF/cytokines)
Megestrol acetate (pregnancy hormone)- hypothalamic stimulation and down stream effects
What is oral assisted feeding?
Personal assisstance (support not cheerleading) Accommodating changing tastes Adaptive utensils Aromatherapy Liberalizing diets
