I love genuine questions and people putting in the effort to love and understand each other better. If you come at me just wanting to argue I’m going to troll you back. FAFO.

  • 0 Posts
  • 13 Comments
Joined 1 year ago
Cake day: June 12th, 2023
  • Apytele@sh.itjust.workstoTechnology@lemmy.world•*Permanently Deleted*English
    1·
    14 days ago

    I’m surprised that particular aspect of the side effect profile comes into play with acute usage.

    Well obvs. It’s basically,“idk which receptor is making them _____ (punch people, refuse to eat or drink, or whatever other immediate harm to themselves / others), but we need it to stop 3 days ago and can figure out the details or a potential cross-taper to something better later.”

    Ah, yes, this happens a lot. No, I don’t work in the medical field at all. I just know things, for reasons.

    Color me fascinated, lol. My guesses are personal experience / reading up on your own treatment or that of a loved one, tangential relation to the field such as clinical research, or just plain personal fascination. Given you linked to a drug that appears to be in trials my first guess is actually the second one. Hadn’t heard of it, and I’m hopeful, but after seeing abilify get approved for acute agitation I’m… skeptical.

    i.e. the psychosis has done so much cumulative damage at this point that you need to fall back to the typicals. That explains why the third-gens are useless.

    Yeah a lot of people don’t realize the damage is additive, both people w/ these disorders and unrelated laypeople who think “talented artist stops taking their meds and continues to be talented but starts creating art with weirder subject matter as their brain boils” is a cool story.

    I’m mostly replying to add though that risperdal also has the distinction of being avaliable as a long-acting injectable, and if you’re trialing oral meds before committing to an LAI, your options are somewhat narrowed. Zyprexa does have an LAI available, but I’ve actually never seen it used and while I can’t tell you why for certain, I do have a guess.

    If you have a patient sick enough that you’re considering an LAI, you don’t want to take benzos off the table for an entire month, especially if it turns out to be inadequate after discharge and they wind up in an ED agitated and unable to report their own med hx and get B52ed and stop breathing. I’ve had a pharmacist tell me considering that interaction is going out of style but a history of that kind of adverse event is difficult for a med to shake. Accutane still has suicidal ideation in adolescents listed as a side effect but I have a strong suspicion that it’s less causation and more correlation with the impact of pizza face on the self and social esteem of a teenager.

  • Apytele@sh.itjust.workstoTechnology@lemmy.world•*Permanently Deleted*English
    4·
    15 days ago

    Dude sometimes we still give thorazine. And tbh ime the 3rd gens don’t do shit for my typical patient. For context also though, I’m essentially providing ICU level care, so when you say the word “symptom control” it’s often referring to like, fists.

    We had a Lady maxxed on Haldol BID one time and she managed to cheek for a week and eventually she just hauled off and rapid fire punched a nurse in the head three times. She legit thought a man was entering through her window every night on a beam of light to forcibly impregnate her and deliver the baby. She kept demanding to see the 50 babies she had up on L&D from the past few months. I’ve actually seen quite a few pregnancy delusions and they’re almost always completely wild psychosis. Another was such an angry manic but high insight enough that when she couldn’t take it anymore she would just come scream at me for the thorazine.

    I’m unsure if you don’t work inpatient psychiatry or you just work somewhere significantly classier than I do. I do work in an inner city area that’s flush with people stuck in a cycle of drugs / homelessness so I’m also not going to tell you that any of this is the best solution, just that it’s the only one avaliable to any of us right now due to shitty government policies.

  • Apytele@sh.itjust.workstoLemmy Shitpost@lemmy.world•Trump cosplaying
    342·
    23 days ago

    THANK YOU.

    It’s not gross because he’s not wearing gloves, it’s gross because he probably never washes his hands after digging in his ass all day.

    Get your reasons this man is disgusting straight people!

    I wrote a similar comment about this exact same situation on another post but from a more healthcare oriented perspective. Specifically that unless you have open cuts / sores on your hands as a healthcare worker, clean but nonsterile gloves do not protect the patient! They are an OSHA requirement in place to protect the worker from exposure to bodily fluids and caustic cleaning chemicals. And for chemo you glove twice.

    Sterile gloves, which are used to protect a patient from infection and are used for surgeries and specific types of bedside procedures like urine catheterization, are packed in sealed packages in single pairs and must be applied in a highly specific way by a trained individual, the minimum license usually being an LPN and more often an RN.

    Unless that beef patty is acidic enough to burn your hands while preparing it (and if it is I shudder to think what it would do to a stomach) gloves out of a 100-count box ain’t protecting anybody from anything and at their worst are bamboozling people out of washing their damn hands.

  • Apytele@sh.itjust.workstoComic Strips@lemmy.world•Put that in writing
    9·
    1 month ago

    I quit my last job without notice because I had one lined up (but it turned out I couldn’t start immediately) and in retrospect my rent situation would have been a lot better if I’d just scrupulously covered my ass for a month. And I’m lucky enough to have the kind of job where people call back within 12h of me submitting a resume but that’s exactly because I do the kind of 100% essential jobs that have a coinflip’s worth of shitty bosses and the kind of pay that leaves you paycheck to paycheck if you’ve had bad enough luck and/or life choices in a particular year. I guess I could’ve just called places and got some temp work from the first employer to offer but then I’m still having to cover my ass but now against the devil I don’t know while learning a whole new set of policies that I’m only gonna use for one month before I’m learning the next ones. If you’re in a secure enough position in your life that you can just quit because you have a good enough balance of savings and demand for your skillset then please take a moment today and practice gratitude to whatever entity or lack thereof that you attribute your good fortune to.