RESUMEN
The coronavirus disease 2019 (COVID-19) pandemic has brought challenges to delivery of care for older adults on inpatient psychiatry. We describe two cases: patient A, a 62-year-old woman who initially refused screening for potential COVID-19, bringing up questions about threshold for capacity when public health is at risk and questions about whether screening for infection should be different in older adults. The other case, patient B, is that of an 83-year-old man who was on the unit when patient A tested positive, and brought up concerns for risk of dissemination in the context of wandering, spitting behaviors, and inability to adhere to room isolation or masking measures. We review measures taken to decrease risk of transmission and improve screening for infection in older adults.
Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Pacientes Internos/psicología , Servicios de Salud Mental/ética , Servicios de Salud Mental/normas , Atención al Paciente/ética , Neumonía Viral/epidemiología , Anciano de 80 o más Años , COVID-19 , Femenino , Humanos , Masculino , Servicios de Salud Mental/organización & administración , Persona de Mediana Edad , Pandemias , SARS-CoV-2RESUMEN
The anticonvulsant drug gabapentin is used off-label to treat alcohol-related withdrawal, cravings, anxiety, and insomnia. Although it is well tolerated and has demonstrated efficacy for mild alcohol withdrawal and early abstinence, there is concern about its potential for abuse. Gabapentin should be prescribed only as a second-line alternative to standard therapies, and only after screening for opioid or other prescription drug abuse to determine if heightened monitoring is warranted. Clinicians should be aware of gabapentin's limitations for treating alcohol use disorder and be attentive to emerging data on risks and benefits.
