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30 Cards in this Set

  • Front
  • Back
Examples of behavioral emergencies?
agitation & aggression
Examples of medical emergencies?
delirium, ADRs (NMS, OD, serotonin syndrome)
Emergencies that require medical intervention?
panic attacks, mania, catatonia, psychosis, delirium, substance intoxication and withdrawl, AP ADRs
Sx of delirium?
irritability, excess energy, pacing, psychotic features, withdrawal, worse late in day
Most common cause of delirium in elderly?
side effects
Pathophysiology of delirium?
Too much dopamine (hyperactive delirium) or imbalance in DA/ACh (hypoactive delirium- may be caused by muscarinic antagonists)
What medications can cause delirium?
Antiparkinson drugs
Corticosteroids
Urinary incontinence drugs
Theophylline
Emptying drugs (metocloperamide)
CV drugs (CCB, BB)
H2 blockers
Antimicrobials (quinolones)
NSAIDs
Geropsych drugs
ENT
Insomnia drugs
Narcotics
Muscle relaxants
Seizure meds
Delirium Tx
D/C all unneccesary drugs, rehydrate, feed

Haloperidol, atypical AP, low-dose lorazepam
Sx of agitation
motor restlessness, hyperactivity, irritability, distractable, uncooperative
Psychiatric & personality disorders that cause agitation?
schizophrenia, bipolar, PTSD, antisocial, paranoid, histrionic
Medical etiologies of agitation?
Infections
Withdrawl
Acute metabolic (organ failure, electrolytes)
Trauma
CNS (tumor, stroke, etc)
Hypoxia
Deficiences (B vit)
Endocrinopathy
Acute Vascular
Toxin
Heavy metals
Substance abuse
Meds used to treat acute agitation
Antihistamines
Beta blockers
BZD
Antipsychotics
Barbiturates
Muscle relaxants
Which BZD has highest potential for abuse?
alprazolam
Common dosage of AP+BZD
haloperidol 5mg + lorazepam 1-2mg
Problem with olanzapine?
fatal in combination with other IM drugs
Which atypical may cause paradoxical agitation?
ziprasidone
Preferred Tx if Agitation with: COPD
typical, atypical
Preferred Tx if Agitation with: cardiac arrhythmia
BZD, typical, atypical
Preferred Tx if Agitation with: delirium
typical, atypical
Preferred Tx if Agitation with: dementia
atypical, typical
Preferred Tx if Agitation with: elderly
atypical, typical
Preferred Tx if Agitation with: akathisia
BZD, atypical
Preferred Tx if Agitation with: Tardive dyskinesia or NMS
BZD, atypical
Preferred Tx if Agitation with: seizures
BZD, atypical
Drugs that cause anticholinergic toxicity?
TCAs (esp. amitriptyline & imipramine), chlorpromazine, antihistamines, meperidine, benztropine
Tx for anticholinergic toxicity?
physostigmine IM or IV
bethanechol
Tx for NMS?
hydration, bromocriptine, dantrolene
Sx of hypertensive crisis?
HTN, headache, stiff neck, sweating
Tx of hypertensive crisis?
phentolamine IV
labetalol IV
Tx of serotonin syndrome?
cyproheptadine, dantrolene