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(Nurse Magazine)   New report suggest that staying on statins might stave off delirium in ICU patients. Hail statin   (news.nurse.com) divider line 18
    More: Spiffy, statins, ICU, admission note, ICU patients, cult, anti-inflammatory, placebo-controlled study, patients  
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838 clicks; posted to Geek » on 19 Jan 2014 at 10:42 AM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



18 Comments   (+0 »)
   
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2014-01-19 10:46:21 AM  
Well, I guess if you get the ones that don't have glass particles in them.
 
2014-01-19 10:52:46 AM  

NewportBarGuy: Well, I guess if you get the ones that don't have glass particles in them.


Citation?
 
2014-01-19 11:02:05 AM  
ICU nurse here, cardiac, trauma, surgical.  The study talks about delirium in ventilated patients.  The natural human reaction to having a tube down your mouth, nose, or in a hole in your throat is to paw or tongue it out.  Most ventilated patients need something to knock them out and give them some retrograde amnesia so they forget their time in the ICU.  The ones who are awake and tolerating of a vent are rare.

I remember one whose lung function was so bad they were on a vecuronium (paralytic) drip to decrease oxygen demand and they were ventilated with Nitric (NO) oxide to improve gas exchange.  We made sure to knock them out because paralyzing without some kind of sedation is considered torture and grounds for lawsuits and losing your license (barring circumstances of course).

I'll bring this up sometime in rounds and make the residents scratch their heads.  Thanks, subs.
 
2014-01-19 11:41:57 AM  

Tillmaster: NewportBarGuy: Well, I guess if you get the ones that don't have glass particles in them.

Citation?


http://www.foxnews.com/health/2012/11/30/ranbaxy-halts-production-ge ne ric-lipitor-after-glass-particles-found/

It's been resolved, but I don't really trust Ranbaxy.
 
2014-01-19 11:47:34 AM  

JonZoidberg: ICU nurse here, cardiac, trauma, surgical.  The study talks about delirium in ventilated patients.  The natural human reaction to having a tube down your mouth, nose, or in a hole in your throat is to paw or tongue it out.  Most ventilated patients need something to knock them out and give them some retrograde amnesia so they forget their time in the ICU.  The ones who are awake and tolerating of a vent are rare.

I remember one whose lung function was so bad they were on a vecuronium (paralytic) drip to decrease oxygen demand and they were ventilated with Nitric (NO) oxide to improve gas exchange.  We made sure to knock them out because paralyzing without some kind of sedation is considered torture and grounds for lawsuits and losing your license (barring circumstances of course).

I'll bring this up sometime in rounds and make the residents scratch their heads.  Thanks, subs.


I've been ventilated and awake. Not for very long, less than an hour, but it sucks. Especially if you keep trying to puke, because any dose of morphine high enough to provide a measure of pain relief will inevitably also result in vertigo and projectile vomiting. Toradol actually worked better. Too bad they won't let me have it anymore. I'd be using that constantly. Every horribly wrenched and abused joint you've ever had feels better, you know where the fark you are and what you're doing, and no puking. What's not to like?
 
2014-01-19 12:11:24 PM  

forgotmydamnusername: JonZoidberg: ICU nurse here, cardiac, trauma, surgical.  The study talks about delirium in ventilated patients.  The natural human reaction to having a tube down your mouth, nose, or in a hole in your throat is to paw or tongue it out.  Most ventilated patients need something to knock them out and give them some retrograde amnesia so they forget their time in the ICU.  The ones who are awake and tolerating of a vent are rare.

I remember one whose lung function was so bad they were on a vecuronium (paralytic) drip to decrease oxygen demand and they were ventilated with Nitric (NO) oxide to improve gas exchange.  We made sure to knock them out because paralyzing without some kind of sedation is considered torture and grounds for lawsuits and losing your license (barring circumstances of course).

I'll bring this up sometime in rounds and make the residents scratch their heads.  Thanks, subs.

I've been ventilated and awake. Not for very long, less than an hour, but it sucks. Especially if you keep trying to puke, because any dose of morphine high enough to provide a measure of pain relief will inevitably also result in vertigo and projectile vomiting. Toradol actually worked better. Too bad they won't let me have it anymore. I'd be using that constantly. Every horribly wrenched and abused joint you've ever had feels better, you know where the fark you are and what you're doing, and no puking. What's not to like?


Many hospitals have preventive phenergan on most inpatients for nausea and PRN zofran or other antiemitics for that reason.  Why can't you have toradol?  Cardiac history? GI or head bleeds?
 
2014-01-19 12:40:12 PM  

JonZoidberg: forgotmydamnusername: JonZoidberg: ICU nurse here, cardiac, trauma, surgical.  The study talks about delirium in ventilated patients.  The natural human reaction to having a tube down your mouth, nose, or in a hole in your throat is to paw or tongue it out.  Most ventilated patients need something to knock them out and give them some retrograde amnesia so they forget their time in the ICU.  The ones who are awake and tolerating of a vent are rare.

I remember one whose lung function was so bad they were on a vecuronium (paralytic) drip to decrease oxygen demand and they were ventilated with Nitric (NO) oxide to improve gas exchange.  We made sure to knock them out because paralyzing without some kind of sedation is considered torture and grounds for lawsuits and losing your license (barring circumstances of course).

I'll bring this up sometime in rounds and make the residents scratch their heads.  Thanks, subs.

I've been ventilated and awake. Not for very long, less than an hour, but it sucks. Especially if you keep trying to puke, because any dose of morphine high enough to provide a measure of pain relief will inevitably also result in vertigo and projectile vomiting. Toradol actually worked better. Too bad they won't let me have it anymore. I'd be using that constantly. Every horribly wrenched and abused joint you've ever had feels better, you know where the fark you are and what you're doing, and no puking. What's not to like?

Many hospitals have preventive phenergan on most inpatients for nausea and PRN zofran or other antiemitics for that reason.  Why can't you have toradol?  Cardiac history? GI or head bleeds?


Mechanical heart valve with accompanying anticoagulation, because of a bicuspid heart valve that quit in my early 40s. It was interesting, to me anyway. I went from completely asymptomatic, to a murmur, to unable to run for any great distance uphill, to constant, heart attack-like symptoms in about 2 years.
 
2014-01-19 12:52:04 PM  
Too bad the article didn't call out whether the statin is fat vs. water soluble is relevant. The fat soluble options are the ones that can cross the blood-brain barrier. I looked into this because, when I started taking low-dose Zocor, I started having very, very wild and vivid dreams. Not scary, not sexual (sadly). Just extremely complex and bizarre plot lines often involving complete strangers to me - with good recall after waking. Seems that lots of people have this same experience. It's continued for 4 years and isn't a major problem, but the possibility that the statin may be altering +/- brain chemistry - when it's supposed to be hanging out in my liver - is a bit disconcerting.

Fat soluble statins
Atorvastatin (Lipitor)
Cerivastatin (Baycol)**
Fluvastatin (Lescol)
Lovastatin (Mevacor)
Simvastatin (Zocor)
Water soluble statins
Pravastatin (Pravachol)
Rosuvastatin (Crestor)
 
2014-01-19 02:08:39 PM  

NewportBarGuy: Tillmaster: NewportBarGuy: Well, I guess if you get the ones that don't have glass particles in them.

Citation?

http://www.foxnews.com/health/2012/11/30/ranbaxy-halts-production-ge ne ric-lipitor-after-glass-particles-found/

It's been resolved, but I don't really trust Ranbaxy.


Thanks. I'll check the manufacturer of my pills.
 
2014-01-19 02:35:52 PM  
Staying on Staten Island, not so much.
 
2014-01-19 02:55:49 PM  
www-tc.pbs.org
 
2014-01-19 03:12:03 PM  
Beginning to wonder when medical science will finally catch on to the fact that anytime you go beyond natural balance, you fark up at least 3 other things. Next article: "Staying on statins found to give you cancers and impotence!"

Eat natural foods, exercise, get sunshine, and fresh air. Stay the blue hell out of hospitals if you can help it, they are utter failures. Go in with one thing wrong with you, come out with three more (if you come out at all).
 
2014-01-19 03:26:38 PM  
Came here for snarky comments.
Leaving disappointed.
 
2014-01-19 03:32:47 PM  
I'm not a big Statin fan; but that is specifically for me - my whole family is not 'medicine friendly'. Ex. My mother had cataract surgery, the doc gave her a simple coritcosteroid and it almost killed her.

I took statins for two years - Since the docs had me taking a lot of things, I don't know if it was just the statins or interaction with the other stuff they had me take... but what little I've read makes me believe they were the major culprit; I'm certainly no expert - feel free to disagree. What I can tell you was the changes to my system while taking them:

My memory - both long and short term was almost completed destroyed (I'd estimate close to 60% during the worst period. Supposedly people who have memory issues their memory comes right back if they quit taking it, but it wasn't the case for me). My kidneys used to gurgle like trying to pour soda out of a plastic bottle held at too steep an angle. I was exhausted walking 100 feet. My LAD (pipe to the heart) was 80% blocked. The doc insisted I had to have immediate bypass, I refused because every family member who has had bypass or angio died within seven years. And just to be clear, this isn't a mordantly obese issue - I weighed 17 lbs more than I did when I was in the service and in the best shape of my life.

Short version: I fired the docs; quit taking everything (first couple weeks really really sucked btw). The docs said I wouldn't live to see my son go to kindergarten (that was with treatment), he turns 14 this spring. My metabolic rate is still boned - if I eat 1200 cal a day, every day, I'll gain weight.

The meds were brutal on my system - I gained crazy weight in combination with their diet (four different dieticians in two years) I went from 212 to 258 before I fired them.

Roughly ten years after, just dicking with my diet, stress, sleep, and activity, my weight is now 195 (I hope to hit 185 this year). They did a follow up catheter check last year to see the extent of my blockage - the doc says it's only about 20% now. The dog and I walk five miles a day, and I'm slowly trying to increase muscle mass and time in the pool; but it's slow going; like I have a built in governor.

Lately I've taken to learning a musical instrument I didn't have previous experience with, and learning a foreign language (thanks Duolingo!). Since then, maybe half my memory has come back, with maybe half of the rest like someone shook them up in a bag and poured them back into my head. Memories of time/places/people but no connections to anything, no sense of time or order. It's pretty cool actually, I'll play and sing the same songs over and over (and over) almost every day, and on a bad day, if I adjust the capo (so I'm playing the exact same fingerings, but playing a half or whole step up/down... and on 'bad' days my brain will go completely blank - the chords, the words, or both. I go back to the 'normal' key and I can play it no worries... Weird huh?
 
2014-01-19 04:08:35 PM  
Yet more statist nonsense. WAKE UP SHEEPLE!
 
2014-01-19 05:55:00 PM  
Wikipedia: The mevalonate pathway or HMG-CoA reductase pathway or mevalonate-dependent (MAD) route or isoprenoid pathway, is an important cellular metabolic pathway present in all higher eukaryotes and many bacteria. It is important for the production of dimethylallyl pyrophosphate (DMAPP) and isopentenyl pyrophosphate (IPP), which serve as the basis for the biosynthesis of molecules used in processes as diverse as terpenoid synthesis, protein prenylation, cell membrane maintenance, hormones, protein anchoring, and N-glycosylation. It is also a part of steroid biosynthesis.

The idea behind statins is to turn down this whole natural metabolic pathway as much as possible because one of the many products, a few more enzymes down the way, is cholesterol.  This is the kind of thing I'd kind of want to see a human generation of results and possible side effects for, before vigorously endorsing like many seem to be.
 
2014-01-19 06:21:48 PM  
funded by lipitor.

/brought to you by carls jr.
 
2014-01-19 11:56:54 PM  
No jokes about Delirium, one of the Endless? Tsk.
 
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