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Palliative Care

Inpatient Management Guide Definition What is palliative care? Palliative care is specialized medical care, focused on improving the quality of life for patients and caregivers by relieving the symptoms and stresses of a serious illness. It is appropriate at any age and at any stage in a serious illness and can be provided along with … Read more

Opioid Withdrawal

Inpatient Management Guide Definition Constellation of symptoms/signs related to abrupt decrease or cessation of opioid use or administration of opioid antagonist (e.g. naloxone) or partial agonist (e.g. buprenorphine, stadol). Etiology Pathophysiology Opioid receptors (mu, kappa, delta, and sigma) are located in the CNS and peripheral tissues. They are typically stimulated by endogenous peptides (endorphins, etc). … Read more

Hypoactive Delirium

Inpatient Management Guide Definition Delirium: a syndrome characterized by the acute onset of cerebral dysfunction, with a fluctuating course, featuring change in cognition and/or perception, attention (hallmark feature), and decreased awareness of environment. Other terms for delirium: acute organic brain syndrome, acute confusional state, metabolic encephalopathy, toxic encephalopathy, septic encephalopathy, postoperative psychosis, ICU psychosis, ICU … Read more

Dementia

Inpatient Management Guide Definition Delirium Disturbance of consciousness, ↓ attention, rapid onset, waxing and waning severity. Drug Rx Meds: opioids, sedative-hypnotics, anxiolytics, antidepressants, antipsychotics, valproic acid, lithium, muscle relaxants, quinolones, NSAIDs, corticosteroids, diuretics, polypharmacy (also consider serotonin syndrome in the right context) OTC meds: antihistamines Drugs of abuse: EtOH, heroin, hallucinogenics, THC Withdrawal: EtOH, benzo … Read more

Delirium Tremens

Inpatient Management Guide Definition Alcohol Withdrawal Abrupt CNS overactivity/excitability in the setting of acute cessation of EtOH consumption (CNS depressant) leading to dysregulation of three primary neurotransmitters: GABA (inhibitory), glutamate (excitatory) and dopamine. Typically beginning within 5–10 h of decreased EtOH, peak at 2–3 days and improvement/resolution within 4–5 days. Pathophysiology Dysregulation of three primary … Read more

Delirium

Inpatient Management Guide Definition Delirium: a syndrome characterized by the acute onset of cerebral dysfunction, with a fluctuating course, featuring change in cognition and/or perception, attention (hallmark feature), and decreased awareness of environment. Other terms for delirium: acute organic brain syndrome, acute confusional state, metabolic encephalopathy, toxic encephalopathy, septic encephalopathy, postoperative psychosis, ICU psychosis, ICU … Read more

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