Non-pain treatments Flashcards

1
Q

First line treatment for delirium

A

Haldol
Works quickly
Treats both hyper and hypoactive
Cant use in parkinsons
Can prolong QTc

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2
Q

Treatment for parkinson’s related hallucinations

A

Quetiapine

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3
Q

Second line for delirium treatment

A

Quetiapine
Can also use for night time sedation
Contraindications: Hypotension, seizures

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4
Q

Indication for valproic acid in delirium

A

Indication: mood and behavior fluctuation (episodes of aggressive sexual behavior)
Weak evidence for agitation in dementia

Contraindications: Liver disease

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5
Q

Indication of risperidone in delirium

A

Better for long term use because lower risk of extrapyramidal symptoms
Live expectancy weeks to months

Contraindication: parkinsons dz

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6
Q

Indication for aripiorazole for delirium

A

Does not effect QTc, less sedating than other antipsychotics
Maybe better for hypoactive delirium

Contraindications: parkinsons, seizures
SE: sedation, EPS, weight gain, HA

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7
Q

Digoxin toxicity in elderly

A

Anorexia, nausea and confusion

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8
Q

Risk factors for developing anxiety disorder in cancer survivor

A

1 younger age

  1. living alone
    female
    shorter time since cancer diagnosis
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9
Q

Signs of serotonin syndrome

A

Neurologic- seizures, AMS, myoclonus, tremors, ataxia
autonomic - tachy, hyperthermia, HTN, flushing
Diarrhea

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10
Q

Common side effect of modafinil

A

Headache

Overdose: agitation, palpitations, HTN, insomnia

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11
Q

Insomnia dosing for Mirtazapine

A

7.5mg or higher

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12
Q

Use for Kava-kava

A

anxiety/adjustment disorder

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13
Q

Use of sympathyl

A

anxiety

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14
Q

Which TCAs have less anticholinergic side effects

A

Desipramine and nortriptyline

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15
Q

Presentation of neuroleptic malignant syndrome

A

Fever, muscle rigidity, hyperthermia, AMS, autonomic dysfunction

Usually caused by antipsychotics

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16
Q

Neuroleptic malignant syndrome caused by clozapine

A

Atypical
less likely to have muscle rigidity or tremors

17
Q

MOA Tizanidine

A

Central alpha 2 adrenergic receptor agonist

inhibits presynaptic motor neurons

(msk relaxer)

18
Q

MOA Baclofen

A

GABA agonist
reduces the release of excitatory neurotransmitters and substance P

19
Q

MOA orphenadrine

A

muscarinic antagonist

blocks NMDA receptors

20
Q

MOA cyclobnzaprine

A

similar to first gen TCA
inhibits norepi reuptake receptors and sertonergic pathways in spinal cord

21
Q

Tx for diarrhea

A

BRAT diet
Kaolin and Pectin (bulk forming agent, can take 48hr to work and interfere with absorption of other meds)
Loperamide (opioid, only for noninfectious)

22
Q

tx for infectious diarrhea

A

Antibiotics (if infectious cause)
Bismuth (added to abx if e. coli)

23
Q

tx for radiation induced enteritis

A

Aspirin
cholestyramine
psyllium

24
Q

MOA loperamide

A

opioid
decreases gut peristalsis
increases water reabsorption
promotes fecal continence

only weakly crosses BBB

initial dose 4mg (max 54mg/day)

25
Q

Tx for diarrhea iso IBS

A

Mesalamine

26
Q

tx for secretory diarrhea in pt with HIV

A

octreotide

27
Q

Tx hiccups

A

Chlorpromazine (haldol as alternative)
Gabapentin
Phenytoin (if CNS etiology)
Baclofen (did not eliminate but improved sx)
Metaclopramide (if stomach distention is etiology)