Alpha Alert: Utilization of Transdermal Clonidine for Refractory Agitation.
Samantha GrableGary HouchardZach RossfeldPublished in: Journal of pain & palliative care pharmacotherapy (2024)
Alpha-2 agonists are under-recognized for their class effects yet offer potential benefit in specialty palliative care via decreasing sympathetic output, inducing sedation, and modulating pain. Especially in clinical contexts where agitation predominates and patients are intolerant of oral medication route, transdermal medication delivery is advantageous. We report a case of agitated behaviors in setting of mixed Alzheimer/vascular-type dementia limiting hospital discharge to nursing facility that were ameliorated with transdermal clonidine. We suggest palliative clinicians routinely conceptualize the seemingly disparate alpha-2 agonists as a class for effective symptom palliation especially as new clinical evidence becomes available.
Keyphrases
- palliative care
- end stage renal disease
- healthcare
- advanced cancer
- newly diagnosed
- ejection fraction
- chronic kidney disease
- chronic pain
- mental health
- peritoneal dialysis
- signaling pathway
- mild cognitive impairment
- adverse drug
- pain management
- emergency department
- neuropathic pain
- cognitive impairment
- patient reported
- climate change
- mechanical ventilation