Typical antipsychotic medication
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Welcome to part 2 of the top 10 things I have learned in my first 10 years as a hospice provider!In this episode I cover items 6-10 of my list.6. Work/life balance doesn't happen by accident7. Hospice is about repeatable and predictable behavior in every department8. Haloperidol is the best first option to treat terminal restlessness9. Staff centric agencies build the best foundation for success10. Hospice is 80% psychosocial….for everyoneIn this episode I encourage everyone to check out 3 different episodes of the show.Episode 15 at https://www.confessionsofahospicenurse.net/episode-fifteen-success-in-the-alf/Episode 16 at https://www.confessionsofahospicenurse.net/episode-sixteen-the-last-7-days/Episode 17 at https://www.confessionsofahospicenurse.net/episode-seventeen-the-ltc-facility/I also reference an interview with Mark Randolph. One of the men who started Netflix.https://youtu.be/HSVbD7RhOHU?si=THv7ehzCNj-4iApa==============================As always, don't forget to call, text or email to leave feedback! I would love to hear from you!816-834-9191James@confessionsofahospicenurse.net==============================Be sure to check out thehospicenursingcommunity.com for extra content as well as hope, help and encouragement from other hospice nurses just like you!
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode990. In this episode, I’ll discuss the lowest effective dose of IV or IM haloperidol for elderly hospitalized patients with agitation. The post 990: Lowest Effective Dose of Haloperidol for Agitation in Elderly Patients appeared first on Pharmacy Joe.
Episode 181: Cannabinoid Hyperemesis SyndromeFuture Dr. Johnson explains the pathophysiology, assessment, and management of Cannabinoid Hyperemesis syndrome. Dr. Arreaza adds some insights on the topic. Written by Tyler Johnson, MSIV, Western University of Health Sciences, College of Osteopathic Medicine of the Pacific-Northwest. Editing and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.Definition Cannabinoid hyperemesis syndrome (CHS) is a syndrome of cyclic abdominal pain, vomiting, or nausea in older adolescents and adults who have chronic ϲаnոаbis use.The term “marijuana” is considered racist by some people. In the 1930s, American politicians popularized the term “marijuana” in the U.S. to portray the drug as a “Mexican vice” and to have a justification to persecute Mexican immigrants. Epidemiology The overall prevalence of cannabinoid hyperemesis syndrome is unknown due to a lack of definitive criteria or diagnostic tests. It occurs in a population that may not disclose substance use. One study conducted in 2015 in a United States urban emergency department not named, found one-third of patients with near-daily cannabis use met criteria for having had CНЅ in the prior six months.Why are rates of CHS increasing?Between 2005-2014 hospitalizations cyclic vomiting syndromes increased by 60 %. concurrent cannabis use in hospitalized patients increasing from 2 to 21 percent. 7 years after the commercialization of cannabis in Canada, the Canadian health services found a 13-fold increase in cyclic vomiting syndromesPotential correlations for the increase in CHS are increased legalization and commercialization of cannabis, higher tetrahydrocannabinol concentrations in cannabis products, and increased recognition of the syndrome.Legal status of Cannabis in the USCannabis is legal in 24 states: Alaska, Arizona, California, Colorado, Connecticut, Delaware, Illinois, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nevada, New Jersey, New Mexico, New York, Ohio, Oregon, Rhode Island, Vermont, Virginia, and Washington. It is also legal in Washington, D.C. Cannabis is approved for medical use in 38 states.Federal level: Cannabis is a Schedule I drug, under the Controlled Substance Act (added in 1970) in the group of Hallucinogenic or psychedelic substances. Tetra-hydro-cannabinol (THC, a “mind-altering substance in cannabis”) is on the same list. However, cannabidiol (CBD, derived from hemp or non-hemp plants) was removed from the Controlled Substances Act in 2018. CBD is FDA-approved (under the name of Epidiolex®) to treat rare seizure disorders. CBD is still on the list of controlled substances in some states. I see THC as a problem.THC increased concentration As recreational Cannabis becomes more normalized, innovators look to find new ways to differentiate their product and increasing THC has become a common way to perform this similar to alcohol content in the beer, wine, and liquor industry. An article by Yale School of Medicine titled “Marijuana: Rising THC Concentrations in Cannabis Can Pose Health Risks” states, “In 1995, the average THC content in cannabis seized by the Drug Enforcement Administration was about 4%. By 2017, it had risen to 17% and continues to increase. Beyond the plant, a staggering array of other cannabis products with an even higher THC content like dabs, oils, and edibles are readily available—some as high as 90%.”Recently, cannabis-infused water started to be sold in some grocery stores.Pathophysiology of CHSIt is not entirely understood. Some suggest multifactorial involving cannabinoid metabolism, exposure dose and tolerance modifying receptor regulation, complex pharmacodynamics at Cannabinoid receptors, and even changes in genetics and cannabinoid variation in plants. CB1 receptors are involved in gastric secretion, sensation, motility, inflammation, and lipogenesis. The activation of CB1 and CB2 receptors has been suggested as the possible cause of CHS.Risk FactorsCHS can occur after acute or acute on chronic use but many report daily 3-5x cannabis use cannabis use over one year and many over at least two years. Median age 24 years. Interesting factsMedical visits for inhaled cannabis are more likely associated with CHS while edibles are more likely for acute psychiatric reactions.Also, CHS is a paradoxical effect since cannabis and cannabinoid receptor agonists are known antiemetics (as seen in nabilone and dronabinol (synthetic analogs of THC)) and prescribed by some physicians to combat chemotherapy effects.Clinical Features of CHSCyclical pattern with abdominal pain, severe nausea, and vomiting up to 30 episodes daily. Pain is intense and even referred to as “scromiting” due to its intense nature, causing patients to scream and vomit concurrently.Typically, it presents with 2 or more episodes over a 6-month period with no symptoms in between. It starts within 24 hours of last cannabis use (differentiating from cannabis withdrawal) and occurs at day or night. There is a gradual symptom resolution of nausea and vomiting after several days of cannabis cessation. Some patients had symptoms 2 days to 2 weeks after cessation. Diagnosis of CHSClinical diagnosisRule out neurological symptoms such as migraine headaches, acute abdomen, motion sickness, and medications, such as recent antibiotics and chemotherapy.Often the diagnosis is discovered with a thorough history reporting a decrease in symptoms with hot showers/baths.Management of CHS AcuteRehydrate with Fluids Dopamine Antagonists– Droperidol (0.625 or 1.25mg) /Haloperidol (0.05 to 0.1mg/kg with max dose of 5mg initially) favored over typical antiemetics like Zofran or Reglan.If needed, combine with an antiemetic like metoclopramide IM or ondansetron IV and consider patients' dehydration status likely requiring US-guided IV.Topical capsaicin cream 0.025 – 0.1% on the abdomen. Long term97% resolution of symptoms completely in a systematic review of patients who stopped cannabis use.Reinforce it may take several weeks of abstinence for symptoms to resolve and symptoms can worsen if cannabis is resumed. It is unknown if a reduction in use can prevent recurrence.Approaches in the clinicEducate patients on the etiology of their symptoms with complete cessation of cannabis use.Consider referral to counseling for cannabis use disorder and abstinence support for treatment-seeking cannabis users. Approach topics such as changing one's environment, seeking social support, and using self-help techniques to non-treatment-seeking individuals.Consider referring patients with polysubstance use and significant comorbidities to a supervised withdrawal management setting. Conclusion: Cannabis use is increasing with legalization and commercialization across the United States. With increased use, Cannabinoid hyperemesis syndrome incidence increases. Often it can be diagnosed with a thorough history including chronic cannabis consumption and symptomatic relief by showers. Physicians will need to develop counseling approaches to better understand CHS patients and how to approach an often-difficult topic.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:Angulo MI. Cannabinoid Hyperemesis Syndrome. JAMA. 2024;332(17):1496. doi:10.1001/jama.2024.9716. Link: https://jamanetwork.com/journals/jama/fullarticle/2824833#:~:text=Cannabinoid%20hyperemesis%20syndrome%20(CHS,last%20less%20than%201%20week.Backman, Isabella, Marijuana: Rising THC Concentrations in Cannabis Can Pose Health Risks, Yale School of Medicine, August 30, 2023. https://medicine.yale.edu/news-article/not-your-grandmothers-marijuana-rising-thc-concentrations-in-cannabis-can-pose-devastating-health-risks/Buchanan, Jennie A and George Sam Wang, Cannabinoid Hyperemesis Syndrome, Up To Date, updated July 17, 2024. https://www.uptodate.com/contents/cannabinoid-hyperemesis-syndromeTheme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
On this episode, I cover cinacalcet, solifenacin, haloperidol, hydrocortisone (focused on topical), and insulin NPH. Cinacalcet is a calcimimetic medication that can be helpful in hyperparathyroidism and useful for managing hypercalcemia. Solifenacin is a urinary antimuscarinic used primarily for overactive bladder. It is an anticholinergic medication that can be problematic in our geriatric patients. Haloperidol is a first generation antipsychotic that has a high incidence of EPS relative to many newer antipsychotics. Hydrocotorisone is one of the most common topical corticosteroids that can be used to reduce inflammation and redness from skin reactions. Insulin NPH is an intermediate acting insulin that is meant to be given on a routine basis. It has fallen out of favor since insulin glargine and other long acting agents allow for few injections and more stable kinetics.
In this episode, we explore a recent study challenging the safety concerns surrounding haloperidol use in older patients post-surgery. We discuss its implications for managing delirium and compare it to other antipsychotics. Could haloperidol be the unsung hero in our psychopharmacological arsenal? Faculty: Scott Beach, M.D. Host: Richard Seeber, M.D. Learn more about our membership here Earn 0.5 CMEs: Quick Take Vol. 59 Comparative Safety of Oral Antipsychotics for Adverse Events in Adults After Surgery
Today, we will be discussing one of the most commonly used first generation anti-psychotics, Haloperidol (Haldol). Answer to Poll Question Below (SPOILER) —————————————————— Answer: Choice C (Fluphenazine) --- Support this podcast: https://podcasters.spotify.com/pod/show/psychrounds/support
Contributor: Taylor Lynch, MD Educational Pearls: What is NMS? Neuroleptic Malignant Syndrome Caused by anti-dopamine medication or rapid withdrawal of pro-dopamenergic medications Mechanism is poorly understood Life threatening What medications can cause it? Typical antipsychotics Haloperidol, chlorpromazine, prochlorperazine, fluphenazine, trifluoperazine Atypical antipsychotics Less risk Risperidone, clozapine, quetiapine, olanzapine, aripiprazole, ziprasidone Anti-emetic agents with anti dopamine activity Metoclopramide, promethazine, haloperidol Not ondansetron Abrupt withdrawal of levodopa How does it present? Slowly over 1-3 days (unlike serotonin syndrome which has a more acute onset) Altered mental status, 82% of patients, typically agitated delirium with confusion Peripheral muscle rigidity and decreased reflexes. AKA lead pipe rigidity. (As opposed to clonus and hyperreflexia in serotonin syndrome) Hyperthermia (>38C seen in 87% of patients) Can also have tachycardia, labile blood pressures, tachypnea, and tremor How is it diagnosed? Clinical diagnosis, focus on the timing of symptoms No confirmatory lab test but can see possible elevated CK levels and WBC of 10-40k with a left shift What else might be on the differential? Sepsis CNS infections Heat stroke Agitated delirium Status eptilepticus Drug induced extrapyramidal symptoms Serotonin syndrome Malignant hyperthermia What is the treatment? Start with ABC's Stop all anti-dopaminergic meds and restart pro-dopamine meds if recently stopped Maintain urine output with IV fluids if needed to avoid rhabdomyolysis Active or passive cooling if needed Benzodiazapines, such as lorazepam 1-2 mg IV q 4hrs What are active medical therapies? Controversial treatments Bromocriptine, dopamine agonist Dantrolene, classically used for malignant hyperthermia Amantadine, increases dopamine release Use as a last resort Dispo? Mortality is around 10% if not recognized and treated Most patients recover in 2-14 days Must wait 2 weeks before restarting any medications References Oruch, R., Pryme, I. F., Engelsen, B. A., & Lund, A. (2017). Neuroleptic malignant syndrome: an easily overlooked neurologic emergency. Neuropsychiatric disease and treatment, 13, 161–175. https://doi.org/10.2147/NDT.S118438 Tormoehlen, L. M., & Rusyniak, D. E. (2018). Neuroleptic malignant syndrome and serotonin syndrome. Handbook of clinical neurology, 157, 663–675. https://doi.org/10.1016/B978-0-444-64074-1.00039-2 Velamoor, V. R., Norman, R. M., Caroff, S. N., Mann, S. C., Sullivan, K. A., & Antelo, R. E. (1994). Progression of symptoms in neuroleptic malignant syndrome. The Journal of nervous and mental disease, 182(3), 168–173. https://doi.org/10.1097/00005053-199403000-00007 Ware, M. R., Feller, D. B., & Hall, K. L. (2018). Neuroleptic Malignant Syndrome: Diagnosis and Management. The primary care companion for CNS disorders, 20(1), 17r02185. https://doi.org/10.4088/PCC.17r02185 Summarized by Jeffrey Olson MS2 | Edited by Meg Joyce & Jorge Chalit, OMSIII
When should women begin receiving biennial screening for breast cancer? Find out about this and more in today's PeerDirect Medical News Podcast.
Nina Christine Andersen-Ranberg presents the AID-ICU trial, investigating haloperidol for the management of delirium in the ICU. Danny McAuley delivers an editorial. Anders Perner joins the discussion and the session is chaired by Paul Mouncey.
Trial of the Week: REDUCE Special Guest: Matt Duprey, PharmD, PhD, BCCCP Matt Duprey joins to discuss the March Trial of the Week, published in 2018 in JAMA: “The Effect of Haloperidol on Survival Among Critically Ill Adults with a High Risk of Delirium: the REDUCE Randomized Clinical Trial.” We review the history of antipsychotic pharmacotherapy treatment and prophylaxis in delirium, reviewing guideline recommendations from that time. Then we dive into the Trial of the Week: REDUCE trial and discuss its findings as well as study design. Would results be the same with another medication? Why is delirium research so challenging? Prevalent v. incident delirium? What's the best outcome to measure? What questions still need answered? These questions and so much more are answered in today's episode. Reference list: https://pharmacytodose.files.wordpress.com/2024/03/reduce-references.pdf PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode887. In this episode, I'll discuss a pre-planned analysis of long term outcomes of haloperidol use in the Agents Intervening against Delirium in the ICU Trial. The post 887: Long Term Outcomes of Haloperidol Use in the Agents Intervening against Delirium in the ICU Trial appeared first on Pharmacy Joe.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode887. In this episode, I ll discuss a pre-planned analysis of long term outcomes of haloperidol use in the Agents Intervening against Delirium in the ICU Trial. The post 887: Long Term Outcomes of Haloperidol Use in the Agents Intervening against Delirium in the ICU Trial appeared first on Pharmacy Joe.
Dr. Mark Oldham, Associate Professor of Psychiatry at University of Rochester Medical Center, President-Elect of the American Delirium Society, and Deputy Editor of the Journal of the Academy of Consultation-Liaison Psychiatry, takes us through a deep dive on delirium. This episode covers an enormous amount of material. Contrast encephalopathy and delirium before diving into the dangerousness of delirium and prevention strategies. Explore the neurobiology of delirium and tie it to validated assessment tools and treatment approaches. We also discuss areas for future research, and learn to appreciate the evolutionary function that delirium serves.This episode also deserves some references! (3:38) Lipowski ZJ. Delirium: Acute Brain Failure in Man. Springfield, IL: Charles C Thomas, 1980. (7:55) Slooter AJC, Otte WM, Devlin JW, et al. Updated nomenclature of delirium and acute encephalopathy: statement of ten Societies. Intensive Care Med. 2020;46(5):1020-1022. (21:46) Marcantonio ER, Ngo LH, O'Connor M, et al. 3D-CAM: derivation and validation of a 3-minute diagnostic interview for CAM-defined delirium: a cross-sectional diagnostic test study [published correction appears in Ann Intern Med. 2014 Nov 18;161(10):764]. Ann Intern Med. 2014;161(8):554-561. (29:50) Kunicki ZJ, Ngo LH, Marcantonio ER, et al. Six-Year Cognitive Trajectory in Older Adults Following Major Surgery and Delirium. JAMA Intern Med. 2023;183(5):442-450. (41:40) Mews MR, Tauch D, Erdur H, Quante A. Comparing consultation-liaison psychiatrist's and neurologist's approaches to delirium - A retrospective analysis. Int J Psychiatry Med. 2016;51(3):284-301. = (1:08:08) Girard TD, Exline MC, Carson SS, et al. Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness. N Engl J Med. 2018;379(26):2506-2516. (1:09:33) Hui D, Frisbee-Hume S, Wilson A, et al. Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial. JAMA. 2017;318(11):1047-1056. (1:31:36) By the 2023 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2023 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2023;71(7):2052-2081. (1:33:54) Burton JK, Craig LE, Yong SQ, et al. Non-pharmacological interventions for preventing delirium in hospitalised non-ICU patients. Cochrane Database Syst Rev. 2021;7(7):CD013307. Published 2021 Jul 19. (1:35:41) Skrobik Y, Duprey MS, Hill NS, Devlin JW. Low-Dose Nocturnal Dexmedetomidine Prevents ICU Delirium. A Randomized, Placebo-controlled Trial. Am J Respir Crit Care Med. 2018;197(9):1147-1156. (1:36:00) Subramaniam B, Shankar P, Shaefi S, et al. Effect of Intravenous Acetaminophen vs Placebo Combined With Propofol or Dexmedetomidine on Postoperative Delirium Among Older Patients Following Cardiac Surgery: The DEXACET Randomized Clinical Trial [published correction appears in JAMA. 2019 Jul 16;322(3):276]. JAMA. 2019;321(7):686-696.
This episode delves into the pivotal EuRIDICE randomized clinical trial published in Critical Care in 2023. This episode provides an in-depth analysis of the trial's findings on using haloperidol in managing delirium among critically ill adults in the ICU. We'll explore the implications of these results for clinicians and the broader healthcare community, discussing whether haloperidol truly impacts the duration of delirium and coma in ICU patients. This discussion is essential for medical professionals, from students to board-certified physicians, seeking to stay informed on the latest in critical care medicine. Tune in to gain valuable insights and broaden your understanding of ICU delirium management. This Podcast was Editing Using Descript: https://www.descript.com?lmref=BGOxjQ TrueLearn Link: https://truelearn.referralrock.com/l/EDDYJOEMD25/ Discount code: EDDYJOEMD25 --- Support this podcast: https://podcasters.spotify.com/pod/show/eddyjoemd/support
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode868. In this episode, I’ll discuss haloperidol for ICU delirium. The post 869: Three Recent Studies About Haloperidol and ICU Delirium appeared first on Pharmacy Joe.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode868. In this episode, I’ll discuss haloperidol for ICU delirium. The post 869: Three Recent Studies About Haloperidol and ICU Delirium appeared first on Pharmacy Joe.
Trial of the Week: AID-ICU Special Guest: Grace Erdman, PharmD Grace Erdman, 2023 Pharmacy to Dose Award Winner, joins to discuss “Haloperidol for the treatment of delirium in ICU patients: AID-ICU trial” published in NEJM in 2022. We review studies that led to the AID-ICU study, discuss difficulties with delirium research, deep-dive into the AID-ICU trial, compare treatment in hyper-, and hypoactive delirium, research priorities moving forward, and much more. Reference list: https://pharmacytodose.files.wordpress.com/2023/10/aid-icu-tow-references.pdf PharmacyToDose.Com @PharmacyToDose PharmacyToDose@Gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices
Visit: https://nursing.com/140meds to request your free copy of "140 Must Know Meds" Generic Name haloperidol Trade Name Haldol Indication Schizophrenia, mania, aggressive and agitated patient Action Alters the effect of dopamine Therapeutic Class Antipsychotic Pharmacologic Class butyrophenones Nursing Considerations • extrapyramidal symptoms, tardive dyskinesia • use caution in QT prolongation • may cause seizures, constipation, dry mouth, agranulosytosis • assess for hallucinations • monitor hemodynamics • monitor for neuroleptic malignant syndrome (fever, muscular rigidity, altered mental status, and autonomic dysfunction) • monitor CBC with differential
Episode 10! In this episode we rambled a little bit and limited ourselves to just our new article which was "Haloperidol for the Treatment of Delirium in ICU Patients" published by Andersen-Ranberg et al in NEJM 2022. Of note, we go back and forth a little bit between "haloperidol" and the brand name "Haldol" but we hope it is similar enough it doesn't impede your listening!AID-ICU: https://pubmed.ncbi.nlm.nih.gov/36286254/AID-ICU Bayesian: https://pubmed.ncbi.nlm.nih.gov/36971791/MIND-USA: https://pubmed.ncbi.nlm.nih.gov/30346242/If you enjoy the podcast please share on social media or by word of mouth! Thank you!Be sure to follow us on the social @icucast for the associated figures, comments, and other content not available in the audio format! Email us at icuedandtoddcast@gmail.com with any questions or suggestions! Thank you Mike Gannon for the intro and exit music!
Real Life Pharmacology - Pharmacology Education for Health Care Professionals
On this episode of the Real Life Pharmacology podcast, I discuss haloperidol pharmacology, adverse effects, drug interactions and much more. Haloperidol comes in multiple dosage forms. Be very careful with the use of injectable haloperidol as there is an immediate and extended release formulation. Haloperidol is a dopamine antagonist which means that EPS adverse effects are going to be concerning. In hospice patients, haloperidol is frequently used for its antiemetic properties as well as its potential to help end-of-life restlessness and agitation.
In this episode, we discuss the classification of anti-psychotic medications and haloperidol pharmacology in depth.
In this “Breathe Easy Critical Perspective” podcast, Dr. Dominique Pepper interviews Dr. Nina Andersen-Ranberg. They discuss her recent RCT published in the NEJM investigating haloperidol for delirium in ICU patients. Dr. Andersen-Ranberg is a physician undergoing her PhD training in Anesthesiology in Zealand University Hospital, Køge Denmark.
We're back with Season 4! Sorry for the unplanned hiatus. Today we talk about the CLOVERS trial, which tested the hypothesis that early vasopressors and restrictive fluid would be superior to liberal fluids plus rescue vasopressors. We also looked at the TRANSFORM-HF study, which compared torsemide and furosemide in congestive heart failure, the PREVENT CLOT study, which compared aspirin to enoxaparin for VTE prophylaxis after a traumatic fracture, and the AID-ICU study, which compared haloperidol to placebo in the treatment of ICU delirium. CLOVERS trialTorsemide vs Furosemide in CHFAspirin vs Enoxaparin for VTE ppx after FractureIV Haloperidol in ICU DeliriumWe also quickly review some papers we missed in 2022:Apixaban for VTE in ESRD Acetazolamide for Congestive Heart FailureModerate or Aggressive IV Fluids for PancreatitisPerioperative Management of AnticoagulationCRISTAL study (aspirin vs enoxaparin after TKA/THA)Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode785. In this episode, I’ll discuss the lowest effective dose of IV or IM haloperidol for elderly hospitalized patients with agitation. The post 785: Haloperidol for Agitation in Elderly Patients – How Low Can You Go? appeared first on Pharmacy Joe.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode785. In this episode, I’ll discuss the lowest effective dose of IV or IM haloperidol for elderly hospitalized patients with agitation. The post 785: Haloperidol for Agitation in Elderly Patients – How Low Can You Go? appeared first on Pharmacy Joe.
In this podcast episode, Leslie Citrome, MD, MPH, and Adam Lowy, MD, share a wealth of knowledge about long-acting injectable (LAI) antipsychotics. Their conversation begins with an overview of the pharmacokinetic profiles of LAI antipsychotics and how they differ from their oral counterparts, as well as injection intervals available with current formulations. The experts also discuss the clinical utility of LAI antipsychotics in psychiatry practice, highlighting their role in assuring medication adherence and their application in both first- and later-episode psychosis. Finally, Drs Citrome and Lowy hit on practical aspects of incorporating LAI antipsychotics into patient care: communicating with patients to dispel myths and stigma surrounding injectable medications, identifying injection resources in your medical community, and strategies to navigate insurance barriers.Throughout the podcast, Drs Citrome and Lowy reference several links to outside sources that can provide valuable education on LAI antipsychotics. Those links are listed below for your convenience.Administering LAI Into Dorsal Gluteal Site: https://bit.ly/3XjSm5aAdministering LAI Into Deltoid Site: https://bit.ly/3Xlyq1LAdministering LAI Into Abdominal Site: https://bit.ly/3wgGJ2ZPresenters:Leslie Citrome, MD, MPHClinical ProfessorDepartment of Psychiatry and Behavioral SciencesNew York Medical CollegeValhalla, New YorkAdam Lowy, MDStaff PsychiatristEllenhornLos Angeles, CaliforniaThis activity is supported by educational funding provided byOtsuka America Pharmaceutical, Inc. and Lundbeck.For additional activities in this program, visit:https://bit.ly/3iM0HiP
Could some Naloxone Products Be Sold Without a Prescription? Find out this and more in today's PVRoundup podcast.
https://psychiatry.dev/wp-content/uploads/speaker/post-11344.mp3?cb=1672401914.mp3 Playback speed: 0.8x 1x 1.3x 1.6x 2x Download: Haloperidol for the Treatment of Delirium in ICU Patients – PubMed Randomized Controlled Trial Nina C Andersen-Ranberg et al. The New EnglandFull EntryHaloperidol for the Treatment of Delirium in ICU Patients – PubMed
Trade – HaldolClass – Antipsychotic agent MOA – Selectively blocks postsynaptic dopamine receptorsIndications – Psychotic disorders, agitation Contraindications – Depressed mental status, Parkinson diseaseSide effects – extrapyramidal symptoms, drowsiness, tardive dyskinesia, hypotension, hypertension, VT, sinus tachycardia, QT prolongation, torsades de pointes. Dosing Adult: Mild agitation : 0.5-2mg PO/IMModerate agitation : 5-10mg PO/IM Severe agitation : 10mg PO/IMPedi: 1-5mg IM/PO
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode762. In this episode, I'll discuss haloperidol for the treatment of delirium in ICU patients. The post 762: Haloperidol for the Treatment of Delirium in ICU Patients – NEJM misses the point??? appeared first on Pharmacy Joe.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode762. In this episode, I ll discuss haloperidol for the treatment of delirium in ICU patients. The post 762: Haloperidol for the Treatment of Delirium in ICU Patients – NEJM misses the point??? appeared first on Pharmacy Joe.
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.09.29.509499v1?rss=1 Authors: Chakroun, K., Wiehler, A., Wagner, B., Mathar, D., Ganzer, F., vanEimeren, T., Sommer, T., Peters, J. Abstract: Dopamine fundamentally contributes to reinforcement learning by encoding predictions errors, deviations of an outcome from expectation. Prediction error coding in dopaminergic regions in human functional neuroimaging studies is well replicated. In contrast, replications of behavioral and neural effects of pharmacological modulations of the dopamine system in human reinforcement learning are scarce. Additionally, dopamine contributes to action selection, but direct evidence and process-specific accounts in human reinforcement learning are lacking. Here we examined dopaminergic mechanisms underlying human reinforcement learning in a within-subjects pharmacological approach in male human volunteers (n=31, within-subjects design; Placebo, 150mg L-dopa, 2mg Haloperidol) in combination with functional magnetic resonance imaging and a stationary reinforcement learning task. We had two aims. First, we aimed to replicate previously reported beneficial effects of L-dopa vs. Haloperidol on reinforcement learning from gains. This replication was not successful. We observed no performance benefit of L-Dopa vs. Haloperidol, and no evidence for alterations in neural prediction error signaling. In contrast, Bayesian analyses provided moderate evidence in favor of the null hypothesis. This unsuccessful replication is likely at least partly due to a number of differences in experimental design. Second, using combined reinforcement learning drift diffusion models, we tested the recent proposal that dopamine contributes to action selection by regulating decision thresholds. Model comparison revealed that the data were best accounted for by a reinforcement learning drift diffusion model with separate learning rates for positive and negative prediction errors. The model accounted for both reductions in RTs and increases in accuracy over the course of learning. The only parameter showing robust drug effects was the boundary separation parameter, which revealed reduced decision thresholds under both L-Dopa and Haloperidol, compared to Placebo, and the degree of threshold reduction accounted for individual differences in RTs between conditions. Results are in line with the idea that striatal dopamine regulates decision thresholds during action selection, and that lower dosages of D2 receptor antagonists increase striatal DA release via an inhibition of autoreceptor-mediated feedback mechanisms. Copy rights belong to original authors. Visit the link for more info Podcast created by PaperPlayer
Link to bioRxiv paper: http://biorxiv.org/cgi/content/short/2022.09.10.507436v1?rss=1 Authors: Onimus, O., Valjent, E., Fisone, G., Gangarossa, G. Abstract: Antipsychotics share the common pharmacological feature of antagonizing the dopamine 2 receptor (D2R) which is abundant in the striatum and involved in both the therapeutic and side effects of this drugs class. Pharmacological blockade of striatal D2R, by disinhibiting the D2R-containing medium-size spiny neurons (MSNs), leads to a plethora of molecular, cellular and behavioral adaptations which are central in the action of antipsychotics. Here, we focused on the cell type-specific (D2R-MSNs) regulation of some striatal immediate early genes (IEGs), such as cFos, Arc and Zif268. Taking advantage of transgenic mouse models, pharmacological approaches and immunofluorescence analyses, we found that haloperidol-induced IEGs in the striatum required the synergistic activation of A2a (adenosine) and NMDA (glutamate) receptors. At the intracellular signaling level, we found that the PKA/DARPP-32 and mTOR pathways synergistically cooperate to control the induction of IEGs by haloperidol. By confirming and further expanding previous observations, our results provide novel insights into the regulatory mechanisms underlying the molecular/cellular action of antipsychotics in the striatum. Copy rights belong to original authors. Visit the link for more info Podcast created by PaperPlayer
Download the cheat: https://bit.ly/50-meds View the lesson: https://bit.ly/HaloperidolHaldolNursingConsiderations Generic Name haloperidol Trade Name Haldol Indication Schizophrenia, mania, aggressive and agitated patient Action Alters the effect of dopamine Therapeutic Class Antipsychotic Pharmacologic Class butyrophenones Nursing Considerations • extrapyramidal symptoms, tardive dyskinesia • use caution in QT prolongation • may cause seizures, constipation, dry mouth, agranulosytosis • assess for hallucinations • monitor hemodynamics • monitor for neuroleptic malignant syndrome (fever, muscular rigidity, altered mental status, and autonomic dysfunction) • monitor CBC with differential
Podcast summary of articles from the May 2022 edition of the Journal of Emergency Medicine from the American Academy of Emergency Medicine. Topics include High Sensitivity Troponins, Modified Shock Index in Dementia, Tramadol, Haloperidol vs Ziprasidone, Masking for COVID, and REBOA. Guest speaker is Dr. Tyler Hughes.
El haloperidol es un antipsicótico de primera generación (típico) que es un fármaco de uso común en todo el mundo. El haloperidol se usa para controlar los síntomas positivos de la esquizofrenia, como las alucinaciones y los delirios. Rahman S, Marwaha R. Haloperidol. [Updated 2022 May 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560892/ --- Send in a voice message: https://anchor.fm/las-poderosas-celulas-nk/message
Haloperidol also known by the brand name Haldol is a first generation antipsychotic. Haldol is commonly used in the treatment of Psychosis and Tourette Syndrome. There is also an off label use for acute agitation. When using Haldol it is important to use the lowest effective dose. A common dosing range is between 0.5-2 mg which is taken by mouth and divided two to three times daily. In severe treatment cases the treatment range can be as high as 3-5 mg PO 2-3x daily. The mechanism of action is proposed to be from selective antagonism of dopamine D2 receptors. Haldol is widely distributed throughout the body and is 92% protein bound. There is a black box warning for dementia-related psychosis. Haldol is not approved in dementia-related psychosis due to an increased risk of cardiovascular or infectious events that can lead to mortality in elderly patients. Amazon Affiliate link: https://amzn.to/31OkKVe for NAPLEX Math Review: The Foundation of a Logical NAPLEX Prep Strategy. FREE Drug Card Sheet is available for this episode at DrugCardsDaily.com along with ALL past FREE drug card sheets! Please SUBSCRIBE, FOLLOW, and RATE on Spotify, Apple Podcasts, or wherever your favorite place to listen to podcasts are. I'd really appreciate hearing from you! Leave a voice message at anchor.fm/drugcardsdaily or find me on most all socials @drugcardsdaily or send an email to contact.drugcardsdaily@gmail.com to leave feedback, request a drug, or say hello! DISCLAIMER: This content may contain sponsored content or the use of affiliate links. Partnerships, sponsorships, and the use of affiliate links provide monetary commissions for Drug Cards Daily at no cost to you! This is done in order to keep providing as much free content to everyone that comes to Drug Cards Daily. Thanks for your support! Drug Cards Daily provides drug information for educational and entertainment use. The information provided is not intended to be a sole source of drug information that is to be acted upon for patient care. If there are drug-related patient care concerns please contact your primary care Physician or local Pharmacist. --- Send in a voice message: https://anchor.fm/drugcardsdaily/message
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode664. In this episode, I'll discuss the effects of ED length of stay when using either midazolam+haloperidol or lorazepam+haloperidol for acute agitation. The post 664: Does the shorter duration of midazolam vs lorazepam persist when combined with haloperidol? appeared first on Pharmacy Joe.
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show notes at pharmacyjoe.com/episode664. In this episode, I ll discuss the effects of ED length of stay when using either midazolam+haloperidol or lorazepam+haloperidol for acute agitation. The post 664: Does the shorter duration of midazolam vs lorazepam persist when combined with haloperidol? appeared first on Pharmacy Joe.
Are post-WWII society and your husband putting too much pressure on you? Are you expected to look presentable at all times, cook every meal, clean the house, and take care of the children? Does it seem like too much? TRY DRUGS TODAY!
It's the JournalFeed Podcast for the week of September 20-24, 2021. We cover EM workforce projections, ETCO2 for OHCA in PEA, NSAIDs and non-union risk, IM droperidol vs olanzapine for agitation, and IM ketamine vs midazolam/haloperidol for agitation.
This podcast offers a discussion on the use of antipsychotics for managing delirium. Topics covered include: Choosing an antipsychotic, the advantages of IV haloperidol, different dosing strategies, and concerns regarding QT prolongation. We also examine chlorpromazine, olanzapine, quetiapine, and aripiprazole for managing delirium. Faculty: Scott Beach, M.D. Hosts: Jessica Diaz, M.D.; Flavio Guzman, M.D. Learn more about Premium Memberships here Earn 1 CME: Management of Delirium Haloperidol, Chlorpromazine, and Atypical Antipsychotics for Managing Delirium
En este video hablamos de la farmacología de los antipsicóticos, tanto los típicos como los atípicos, fármacos como la olanzapina, risperidona, aripiprazol, haloperidol entre otras.Y revisamos los eventos adversos como el incremento de peso, los problemas motores y el síndrome neuroléptico.Checa el video aquí: https://youtu.be/gyA7oi0RvTsVisita nuestra tienda en línea para comprar nuestros libros y material educativo:https://bit.ly/3i6eAnGSi necesitas una consulta aquí nos puedes encontrar:http://bit.ly/3aUSt12Unete al equipo de Mecenas en YouTube desde 1 dolar al mes: http://bit.ly/2O1AtsXSupport the show (https://www.paypal.com/donate?hosted_button_id=2ENWQ7V289PBE)
Do you really want to ruin the surprise of this episode by reading the description first? Well, I WON'T WRITE ONE! HA! ...enjoy the audio WEIRDNESS. Episode 67, “Haloperidol” is presented by NBSM exclusively on Apple Podcast and Soundcloud. Summary completed 1630/22Apr21. APPLE PODCAST LINK: https://podcasts.apple.com/us/podcast/another-podcast/id1468668195#episodeGuid=tag%3Asoundcloud%2C2010%3Atracks%2F1034882281 SOUNDCLOUD.COM/ANOTHER_PODCAST INSTAGRAM.COM/ANOTHERPODCASTWEEKLY TWITTER.COM/_ANOTHERPODCAST 281-330-8004 or 223-9797 HIT ME UP!
The Elective Rotation: A Critical Care Hospital Pharmacy Podcast
Show note at pharmacyjoe.com/episode602 . In this episode, I ll discuss whether using haloperidol for ICU delirium reduces mortality. The post 602: Does using haloperidol for ICU delirium reduce mortality? appeared first on Pharmacy Joe.
A study from Critical Care Medicine suggests that haloperidol may reduce mortality in patients who develop delirium in ICU. Association Between Incident Delirium Treatment With Haloperidol and Mortality in Critically Ill Adults
The paper we discuss is TD Girard et al. Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness. N Engl J Med 2018; 379(26):2506-2516. This paper is part of the ABPN MOC program. The podcast authors are not associated with the MOC program and have no knowledge of the questions about the article included in the MOC program.The JAMA Guide to Statistics and Methods has an easy-to-read, 1.5 page overview of the odds ratio.
Dr. Rosenblum reads and reviews ASRAs Chronic Pain Guidelines and provides a commentary. Download the PainExam App for iPhone and Android References https://journals.lww.com/rapm/Fulltext/2018/07000/Consensus_Guidelines_on_the_Use_of_Intravenous.11.aspx Subscribe to our mailing list * indicates required Email Address * DISCLAIMER: Doctor Rosenblum IS HERE SOLELY TO EDUCATE, AND YOU ARE SOLELY RESPONSIBLE FOR ALL YOUR DECISIONS AND ACTIONS IN RESPONSE TO ANY INFORMATION CONTAINED HEREIN. This podcasts is not intended as a substitute for the medical advice of physician to a particular patient or specific ailment. You should regularly consult a physician in matters relating to yours or another's health. You understand that this podcast is not intended as a substitute for consultation with a licensed medical professional. Copyright © 2018 QBazaar.com, LLC All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, recording or otherwise, without the prior written permission of the author.
This week we discuss pearls from a talk from Reuben Strayer on sedation of the agitated patient focusing on patient and staff safety. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_56_0_Final_Cut.m4a Download 3 Comments Tags: Agitation, Droperidol, Excited Delirium, Haloperidol, Lorazepam, Midazolam Show Notes
This week we discuss pearls from a talk from Reuben Strayer on sedation of the agitated patient focusing on patient and staff safety. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Episode_56_0_Final_Cut.m4a Download 3 Comments Tags: Agitation, Droperidol, Excited Delirium, Haloperidol, Lorazepam, Midazolam Show Notes