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Alpha Alert: Utilization of Transdermal Clonidine for Refractory Agitation
Samantha Grable, Gary Houchard1, Zach Rossfeld2,1
1MD, MA are with the Division of Palliative Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
Abstract:
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.
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