Introducción: El dolor es el síntoma más común en pacientes con cáncer, y se ha convertido en un reto para el personal de salud en el quehacer diario debido a que su abordaje y manejo es multidimensional y complejo. El inadecuado control del dolor genera incapacidad física o emocional afectando la calidad de vida del paciente. Objetivo: Desarrollar una guía de práctica clínica para ofrecer a los especialistas en medicina de dolor y cuidados paliativos, y otros profesionales de salud implicados en la atención del paciente con dolor oncológico, recomendaciones sobre las intervenciones terapéuticas disponibles para el manejo de esta condición. Métodos: Para la elaboración de la presente guía de práctica clínica se siguieron los lineamientos contenidos en la “Guía metodológica para la elaboración de Guías de Práctica Clínica” del Ministerio de Salud y Protección Social. Se conformó un grupo desarrollador de la guía que diseñó 20 preguntas clínicas con la estrategia PICO. Se realizó la búsqueda de guías preexistentes en sitios reconocidos. Un consenso informal de expertos, basados en la literatura encontrada, definió las recomendaciones para su elaboración, socialización y aprobación institucional. Resultados: Se dio respuesta a las preguntas clínicas sobre definición, clasificación, evaluación, y manejo del dolor oncológico mediante las recomendaciones basadas en la revisión de literatura no sistemática. Conclusión: La presenta guía ayuda al soporte de las decisiones clínicas en el manejo del dolor oncológico acorde con las necesidades del paciente y de los recursos disponibles en la institución.
Introduction Acute mania can have behavioral effects such as agitation, being a frequent cause of presentation in the emergency department. Pharmacological treatments include mood stabilizers and atypical antipsychotics. Valproate is an effective drug. However, the intravenous formulation is relegated to other pathologies, such as epilepsy. Objectives The objective was to review the use of intravenous valproate in acute mania in the literature and present its use through a clinical case. Methods A clinical case using intravenous valproate to treat an episode of acute mania is described and the scientific literature of the last 5 years is reviewed. Results A 43-year-old patient attended the emergency department with a diagnosis of bipolar disorder type I in manic episode with agitation, rejection of oral medication, brought in by the police due to risk of aggression against family members, who reported that the patient had stopped taking her usual medication with valproate 500 mg / 24h and quetiapine 200 mg / 24h threemonths ago. Due to the possibility of having intravenous valproate, it was decided to administer 300 mg intravenously, as well as haloperidol 5 mg intravenously, and hospitalization was decided. The patient had a favorable evolution, with no side effects to the medication, and oral treatment was started after 8 hours, with a good response. In the literature there are few studies in this regard, although the most of them approved the use of valproate as a loading dose in acute mania. Conclusions Intravenous valproate is an effective, safe, and tolerated treatment in acute mania. More studies are needed to collect precise information. Disclosure No significant relationships.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.