Lesson 3 Flashcards
megestrol acetate side effects
adrenal insufficiency
VTE
andogren deficiency in males
SIDS
stillbirth significantly more common than SIDS
SIDS more common in boys than in girls
carisoprodol (soma)
has potentiating effects on opioids and alcohol
most common means of suicide in men >50 years old
firearms
neonate pharmacokinetics of morphine
half-life is prolonged
greater first-pass toxicity
opioid misuse: most patients who misuse prescriptions first started using opiods in their…
20s
duration of taking opiods that increases risk for SUD
90 days
opioid misuse screening tools
little evidence
complicated grief explained by
attachment relationship model
spinal cord compression management
corticosteroids
NSGY consult
most common psychiatric disorder in those with HIV, SUD
depression
advance directive consists of
durable power of attorney
living will
side effects of opioids without tolerance
constipation
mioisis
constipation work up
digital rectal exam
organ donation in HIV+ patients
only can be for other HIV+ patients
malignant bowel obstruction management
octreotide
haldol
complicated grief length before dx
loss of loved one had to occur >1 year ago
complicated grief sx
intense longing
preoccupation
meperidine side effect
tachycardia
preferential opioid in CKD
hydromorphone
avoid oxycodone if possible
black people with cancer
less likely than whites to get treatment for cancer
fluoxetine washout period
5 weeks
phenelzine risk for
serotonin syndrome
most common type of elder abuse
neglect/abandonment
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
