Propoxyphene hydrochloride (Darvon) poisoning in a three-year-old child.
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Biomedical subjects
Publications and source records attributed to N Billig.
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BACKGROUND: Ongoing regimens of haloperidol, thioridazine, and lorazepam are commonly administered to manage behavior problems in nursing home residents. Nevertheless, there is controversy over whether periodic drug withdrawal should be attempted when those medications are prescribed. This study addressed that issue by examining the effects of discontinuing treatment with haloperidol, thioridazine, and lorazepam among residents of a large suburban nursing home. METHODS: In a double-blind, crossover study, half of 58 nursing home residents (43 women and 15 men with a mean age of 86 years) continued to take the psychotropic medication they had been prescribed, whereas the other half were tapered to placebo. After 6 weeks of taking placebo or original drug, patients were tapered to the reverse schedule and remained on it for 6 weeks. Assessments included informant ratings by the nursing staff who completed the Brief Psychiatric Rating Scale and the Cohen-Mansfield Agitation Inventory. RESULTS: Analyses comparing residents taking placebo to those taking medication after completion of the first phase showed no impact of drug therapy discontinuation on their behavior. Similarly, using the crossover design to compare residents' behaviors while taking placebo vs. taking drugs, withdrawal of medication had no impact on Cohen-Mansfield Agitation Inventory or Brief Psychiatric Rating Scale scores. CONCLUSIONS: Results of this work suggest that longterm use of haloperidol, thioridazine, and lorazepam in nursing homes to manage agitation should be closely monitored for their efficacy. Furthermore, routine attempts at drug withdrawal should be considered for most residents taking psychotropic medication.
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A prospective study of vision-related outcomes of cataract surgery as well as cognitive functioning, activities of daily living (ADL) functioning, and depressed affect was conducted with 19 nursing home residents scheduled for cataract surgery. Also studied were 22 candidates for cataract surgery who decided against it. Comparison of both groups at baseline revealed that residents who chose cataract surgery were less cognitively and ADL impaired. Analysis after cataract surgery showed that visual acuity improved significantly at 4 months and was maintained at 1 year after surgery.
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