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A 72-year-old African American man with a history of renal dysfunction, congestive heart failure, and previous myocardial infarction is currently undergoing dialysis.
Until the past few weeks, he has been in good spirits and has a strong family support system that helps him in getting to and from dialysis daily.
Over the past few weeks, however, he has been feeling increasingly depressed and has begun to act bizarrely, with persecutory delusions that the government is poisoning the chemicals used on him for dialysis.
Also in the last few weeks, due to increased stomach pain, his medications have been adjusted and now include cimetidine for stomach ulcers, digoxin, and a baby aspirin daily. He also takes docusate sodium as needed for stool softening and ibuprofen as needed for mild arthritis pain.
Which of the following medications would be most likely to have induced the symptoms the patient is now experiencing?
A. Aspirin
B. Cimetidine
C. Digoxin
D. Docusate sodium
E. Ibuprofen
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its bbbbbbbbbbbbbbbbb 110%
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The correct answer is B.
Explanation:
Cimetidine is the only drug listed known to cause psychiatric effects of clinical significance, including delusions and psychosis. The exact mechanism is unknown, but is thought to be related to the effects of cimetidine on the H-2 histamine receptor in the brain. The treatment of cimetidine-induced psychosis is to reduce the dosage of the medication, and discontinue it if an alternative therapy is available.
Aspirin (choice A) has not been shown to induce any clinically significant psychiatric changes.
Digoxin (choice C) has been known to cause delirium in toxic levels, but does not cause the long standing delusion that the patient above demonstrates.
Docusate sodium (choice D) and ibuprofen (choice E) are medications not known to cause demonstrable psychiatric effects.
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thx alot nice q and information
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gd one maddy ............i dint know this concept b4
wat is the cause of death in dialysis patient ??
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Anemia is one of the most frequent complications of hemodialysis, and its correction is an important factor in restoring a tolerable quality of life to dialysis-dependent patients.
11/14/2007
WASHINGTON”A new indicator of variations in hemoglobin level over time is a strong predictor of the risk of death among patients receiving dialysis for end-stage renal disease, according to a study in the December Journal of the American Society of Nephrology.
The researchers used data on nearly 35,000 dialysis patients to analyze the effects of hemoglobin variability on the risk of death. They focused on a newly developed metric, termed œHb-Var, that measures variability in hemoglobin levels independent of their absolute values and trends over time.
Hemoglobin is the oxygen-carrying compound in the blood. Anemia, or low hemoglobin levels, is one of the most frequent complications of kidney failure and a common cause of death in dialysis patients. Treatment including erythropoietin and intravenous iron has been a major advance in the management of kidney failure-related anemia, yet low blood counts and variation in hemoglobin levels continue to be a problem for many dialysis patients.
The new study found that high Hb-Var scores”indicating greater hemoglobin variability”predicted a higher risk of death in dialysis patients. For each 1 g/dL increase in Hb-Var, the risk of death increased by 33 percent, after adjustment for other factors.
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Dialysis Patients With Metabolic Syndrome Show Increased Risk For Heart Disease.
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so anemia right ??
thanx for ur research ...
