PubMed Health⌕ Search

Biomedical subjects

Andy Jagoda

Publications and source records attributed to Andy Jagoda.

9 recordsLinked to original sources
PubMed2006

Guidelines for the pharmacologic treatment of neurobehavioral sequelae of traumatic brain injury.

There is currently a lack of evidence-based guidelines to guide the pharmacological treatment of neurobehavioral problems that commonly occur after traumatic brain injury (TBI). It was our objective to review the current literature on the pharmacological treatment of neurobehavioral problems after traumatic brain injury in three key areas: aggression, cognitive disorders, and affective disorders/anxiety/ psychosis. Three panels of leading researchers in the field of brain injury were formed to review the current literature on pharmacological treatment for TBI sequelae in the topic areas of affective/anxiety/ psychotic disorders, cognitive disorders, and aggression. A comprehensive Medline literature search was performed by each group to establish the groups of pertinent articles. Additional articles were obtained from bibliography searches of the primary articles. Group members then independently reviewed the articles and established a consensus rating. Despite reviewing a significant number of studies on drug treatment of neurobehavioral sequelae after TBI, the quality of evidence did not support any treatment standards and few guidelines due to a number of recurrent methodological problems. Guidelines were established for the use of methylphenidate in the treatment of deficits in attention and speed of information processing, as well as for the use of beta-blockers for the treatment of aggression following TBI. Options were recommended in the treatment of depression, bipolar disorder/mania, psychosis, aggression, general cognitive functions, and deficits in attention, speed of processing, and memory after TBI. The evidence-based guidelines and options established by this working group may help to guide the pharmacological treatment of the person experiencing neurobehavioral sequelae following TBI. There is a clear need for well-designed randomized controlled trials in the treatment of these common problems after TBI in order to establish definitive treatment standards for this patient population.

Aggression↗
PubMed2006

The evaluation and management of the acutely agitated elderly patient.

Delirium is an organic mental syndrome defined by a global disturbance in consciousness and cognition, which develops abruptly and often fluctuates over the course of the day. It is precipitated by medical illness, substance intoxication/withdrawal or medication effect. Delirium is associated with significant morbidity and mortality, and is a leading presenting symptom of illness in the elderly. Elderly patients with altered mental status, including agitation, should be presumed to have delirium until proven otherwise. The clinical manifestations of delirium are highly variable. A mental status evaluation is crucial in the diagnosis of delirium. Medical evaluation and stabilization should occur in parallel. Life-threatening etiologies including hypoxia, hypoglycemia and hypotension require immediate intervention. The differential diagnosis of etiologies of delirium is extensive. Patients with delirium need thorough evaluations to determine the underlying causes of the delirium. Pharmacological agents should be considered when agitated patient has the potential to harm themselves or others, or is impeding medical evaluation and management. Unfortunately, the evidence to guide pharmacologic management of acute agitation in the elderly is limited. Current pharmacologic options include the typical and atypical antipsychotic agents and the benzodiazepines. These therapeutic options are reviewed in detail.

Aged↗
PubMed2004

Intramuscular antipsychotics: clinical experience review.

Acute agitation is a therapeutic dilemma. Rapid control of agitation is necessary to minimize danger both to recipients of care and to caregivers. Although a comprehensive assessment may ultimately be necessary to determine the cause of agitation and to identify or exclude underlying medical illness, it is often imperative to treat agitation immediately. In this imperfect clinical world, it is essential to have treatments that are both safe and effective for patients with a wide variety of causes of agitation.

Antipsychotic Agents↗