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30 Cards in this Set
- Front
- Back
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Examples of behavioral emergencies?
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agitation & aggression
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Examples of medical emergencies?
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delirium, ADRs (NMS, OD, serotonin syndrome)
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Emergencies that require medical intervention?
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panic attacks, mania, catatonia, psychosis, delirium, substance intoxication and withdrawl, AP ADRs
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Sx of delirium?
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irritability, excess energy, pacing, psychotic features, withdrawal, worse late in day
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Most common cause of delirium in elderly?
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side effects
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Pathophysiology of delirium?
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Too much dopamine (hyperactive delirium) or imbalance in DA/ACh (hypoactive delirium- may be caused by muscarinic antagonists)
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What medications can cause delirium?
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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 |
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Delirium Tx
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D/C all unneccesary drugs, rehydrate, feed
Haloperidol, atypical AP, low-dose lorazepam |
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Sx of agitation
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motor restlessness, hyperactivity, irritability, distractable, uncooperative
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Psychiatric & personality disorders that cause agitation?
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schizophrenia, bipolar, PTSD, antisocial, paranoid, histrionic
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Medical etiologies of agitation?
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Infections
Withdrawl Acute metabolic (organ failure, electrolytes) Trauma CNS (tumor, stroke, etc) Hypoxia Deficiences (B vit) Endocrinopathy Acute Vascular Toxin Heavy metals Substance abuse |
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Meds used to treat acute agitation
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Antihistamines
Beta blockers BZD Antipsychotics Barbiturates Muscle relaxants |
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Which BZD has highest potential for abuse?
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alprazolam
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Common dosage of AP+BZD
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haloperidol 5mg + lorazepam 1-2mg
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Problem with olanzapine?
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fatal in combination with other IM drugs
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Which atypical may cause paradoxical agitation?
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ziprasidone
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Preferred Tx if Agitation with: COPD
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typical, atypical
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Preferred Tx if Agitation with: cardiac arrhythmia
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BZD, typical, atypical
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Preferred Tx if Agitation with: delirium
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typical, atypical
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Preferred Tx if Agitation with: dementia
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atypical, typical
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Preferred Tx if Agitation with: elderly
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atypical, typical
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Preferred Tx if Agitation with: akathisia
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BZD, atypical
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Preferred Tx if Agitation with: Tardive dyskinesia or NMS
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BZD, atypical
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Preferred Tx if Agitation with: seizures
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BZD, atypical
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Drugs that cause anticholinergic toxicity?
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TCAs (esp. amitriptyline & imipramine), chlorpromazine, antihistamines, meperidine, benztropine
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Tx for anticholinergic toxicity?
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physostigmine IM or IV
bethanechol |
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Tx for NMS?
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hydration, bromocriptine, dantrolene
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Sx of hypertensive crisis?
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HTN, headache, stiff neck, sweating
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Tx of hypertensive crisis?
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phentolamine IV
labetalol IV |
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Tx of serotonin syndrome?
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cyproheptadine, dantrolene
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