Non-pain treatments Flashcards
First line treatment for delirium
Haldol
Works quickly
Treats both hyper and hypoactive
Cant use in parkinsons
Can prolong QTc
Treatment for parkinson’s related hallucinations
Quetiapine
Second line for delirium treatment
Quetiapine
Can also use for night time sedation
Contraindications: Hypotension, seizures
Indication for valproic acid in delirium
Indication: mood and behavior fluctuation (episodes of aggressive sexual behavior)
Weak evidence for agitation in dementia
Contraindications: Liver disease
Indication of risperidone in delirium
Better for long term use because lower risk of extrapyramidal symptoms
Live expectancy weeks to months
Contraindication: parkinsons dz
Indication for aripiorazole for delirium
Does not effect QTc, less sedating than other antipsychotics
Maybe better for hypoactive delirium
Contraindications: parkinsons, seizures
SE: sedation, EPS, weight gain, HA
Digoxin toxicity in elderly
Anorexia, nausea and confusion
Risk factors for developing anxiety disorder in cancer survivor
1 younger age
- living alone
female
shorter time since cancer diagnosis
Signs of serotonin syndrome
Neurologic- seizures, AMS, myoclonus, tremors, ataxia
autonomic - tachy, hyperthermia, HTN, flushing
Diarrhea
Common side effect of modafinil
Headache
Overdose: agitation, palpitations, HTN, insomnia
Insomnia dosing for Mirtazapine
7.5mg or higher
Use for Kava-kava
anxiety/adjustment disorder
Use of sympathyl
anxiety
Which TCAs have less anticholinergic side effects
Desipramine and nortriptyline
Presentation of neuroleptic malignant syndrome
Fever, muscle rigidity, hyperthermia, AMS, autonomic dysfunction
Usually caused by antipsychotics
Neuroleptic malignant syndrome caused by clozapine
Atypical
less likely to have muscle rigidity or tremors
MOA Tizanidine
Central alpha 2 adrenergic receptor agonist
inhibits presynaptic motor neurons
(msk relaxer)
MOA Baclofen
GABA agonist
reduces the release of excitatory neurotransmitters and substance P
MOA orphenadrine
muscarinic antagonist
blocks NMDA receptors
MOA cyclobnzaprine
similar to first gen TCA
inhibits norepi reuptake receptors and sertonergic pathways in spinal cord
Tx for diarrhea
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)
tx for infectious diarrhea
Antibiotics (if infectious cause)
Bismuth (added to abx if e. coli)
tx for radiation induced enteritis
Aspirin
cholestyramine
psyllium
MOA loperamide
opioid
decreases gut peristalsis
increases water reabsorption
promotes fecal continence
only weakly crosses BBB
initial dose 4mg (max 54mg/day)
Tx for diarrhea iso IBS
Mesalamine
tx for secretory diarrhea in pt with HIV
octreotide
Tx hiccups
Chlorpromazine (haldol as alternative)
Gabapentin
Phenytoin (if CNS etiology)
Baclofen (did not eliminate but improved sx)
Metaclopramide (if stomach distention is etiology)
