Lesson 3 Flashcards by Ben Frush

megestrol acetate side effects

adrenal insufficiency
VTE
andogren deficiency in males

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SIDS

stillbirth significantly more common than SIDS
SIDS more common in boys than in girls

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carisoprodol (soma)

has potentiating effects on opioids and alcohol

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most common means of suicide in men >50 years old

firearms

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neonate pharmacokinetics of morphine

half-life is prolonged
greater first-pass toxicity

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opioid misuse: most patients who misuse prescriptions first started using opiods in their…

20s

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duration of taking opiods that increases risk for SUD

90 days

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opioid misuse screening tools

little evidence

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complicated grief explained by

attachment relationship model

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spinal cord compression management

corticosteroids
NSGY consult

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most common psychiatric disorder in those with HIV, SUD

depression

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advance directive consists of

durable power of attorney
living will

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side effects of opioids without tolerance

constipation
mioisis

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constipation work up

digital rectal exam

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organ donation in HIV+ patients

only can be for other HIV+ patients

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malignant bowel obstruction management

octreotide
haldol

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complicated grief length before dx

loss of loved one had to occur >1 year ago

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complicated grief sx

intense longing
preoccupation

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meperidine side effect

tachycardia

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preferential opioid in CKD

hydromorphone
avoid oxycodone if possible

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black people with cancer

less likely than whites to get treatment for cancer

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fluoxetine washout period

5 weeks

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phenelzine risk for

serotonin syndrome

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most common type of elder abuse

neglect/abandonment

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mirtazapine sedating dose

7.5 mg or higher

naltrexone

treats opioid and EtOh dependence

morphine epidural

delayed respiratory depression

cancer patients age depression

younger rather than older at higher risk

cancers with highest risk of depression

head and neck pancreatic

leading cause of death from blood transfusions

TRALI

bleeding at home management

crisis pack including dark towels TXA: can be given GI or ENT bleed

methylnaltrexone

mu opioid receptor antagonist reduces opioid-associated constipation and urinary retention does not cross BBB

minimum age at which screening EKG should be obtained when started on TCA

40 years

3 day rule

patient need to be hospitalized for 3 days to qualify for SNF

totodal inpatient days (inpatient and GIP) cannot exceed

20% of total days

metabolite of carisoprodol (soma)

meprobamate

codeine metabolites

morphine morphine-6-glucuronide

dyspnea without hypoxia rx

hand held fan morphine

dry mouth (xerostomia) rx

ice chips sugarless gum pilocarpine

buprenorphine

25-50x more potent than morphine can be given IM, SQ, SL, transdermal, neuraxially partial mu agonist

Hindu female patients may prefer

female providers

Extrapyramidal side effects

first-gen anti-psychotics fluphenazine, haloperidol

classic five stages of death

denial, anger, bargaining, depression, acceptance

lymphedema contraindication to compression

severe neuropathic pain DVT thrombocytopenia acute CHG

IV: oral morphine ratio

3:1

SBP dx

>250 PMNs in ascitic fluid

SBP treatment

CTX or cefotaxime (3rd gen cephalosporin) albumin

certification of terminal illness must be completed

within two calendar days after patient has started to receive hospice services

percentage of patients with advanced cancer who meet dx criteria for psychiatric disorder

50%

most common complementary meds for cancer patients in US

vitamins and minerals

anorexia and cachexia in advanced cancer patients management

megestrol glucocorticoids

dronabinol FDA approved for

anorexia and weight loss in patients with HIV treatment of refractory CINV

screening tool to assess for elder mistreatment

elder abuse suspicion index

morphine epidural injection

cannot be done outpatient, need to monitor for at least 24 hours

morphine PO bio-availability

10-45%

notification of death

should be notified within 2 minutes of starting conversation

notification of death in person vs. phone

can do by phone if >1 hour away

HIV neuorapthy

allodynia and hyperalgesia present

adjustment disorder first-line rx

psychotherapy

opioid med without active metabolites

methadone

buprenorphineshould be used in caution in patients taking

class III anti-arrythmmics

pulmonary rehab beneficial in

COPD

gabapentinoids plusthiazolideinediones

increased risk of fluid retention

wound management, topical Metronidazole

anti-inflammatory anti-microbial

wound management dressings

silver dressings

Hindu dietary beliefs

can eat pork, but not other meat

rx for opioid induced sedation

methylphenidate dextroamphetamine modafinil not caffeine

preferred opioid in CKD/ESRD

dilaudid or fentanyl

delirium definition

inattention acute onset fluctuating sx

buprenorphine patch duration

seven days

buprenorphine patch how long should elapse before using same site?

21 days

spinal cord compression management

IV loading dose of 10 mg dexamethasone

malignant ascites

SAAG<1.1 paracentesis does not respond well to diuresis

best predictor for favorable prognosis in schizophrenia

medical compliance

schizophrenia symptoms on meds

positive symptoms (psychosis) respond well to meds negative symptoms do not respond as well

better outcomes for those with schizophrenia on meds: females or males?

females

cancer most associated with chronic cough

head and neck cancer

morphine metabolite that causes seizures

morphine-3-glucuronide (M3G)

stage 4 pressure injury treatment

debridement dressings

incidence of what anxiety disorder is increased in cancer patients?

agoraphobia

incidence of anxiety disorders in cancer patients

10-20%

screening tool for anxiety

General Anxiety Disorder Scale

Insomnia treatment in cancer survivors

CBT

fall prevention

exercise program

treatment for pruritus

gabapentin paroxetine sertraline, mirtazapine

most common opioid cause of prurirtus

morphine

opioid-induced pruritus rx

low-dose naloxone continuous infusion

depression meds for patients on tamoxifen

venlafaxine desvenlafaxine

most common side effects of celiac plexus block via trans-aortic approach

orthostatic hypotension diarrhea

Sikh beliefs surrounding death

if not present, family members will want to know about patient's death as soon as possible

Muslim beliefs about death

body needs to be cleaned before praying (5x day) prefer quick burial ill are exempt from fasting

Lidocaine patch interacts with

oral anti-arrhythmic meds

lidocaine patch dosing

no dose escalation necessary no tolerance

use lidocaine patch cautiously in patients with

hepatic disease

serotonin syndrome

high fevers muscle stiffness, pain

Hospice nursing home medicare spending

higher medicare spending in nursing home for hospice beneficiaries

most comprehensive pain scale

McGill Pain Questionnaire

buprenorphine mechanism

mixed agonist-antagnosit

first-line delirium rx

haloperidol

Fatigue supplement

American ginseng