Time for a master class in pruritus! #hapc21
Thanks to pruritus presenters @AMehtaMD, @mlmcpherson, Eric Prommer, Mellar Davis, Kathryn Walker. #hapc21
Pruritus definition: Note that chronic pruritus is itching that lasts 6 weeks or longer (this is different than chronic pain). #hapc21
When assessing pruritus, keep in mind the 4 main causes. #hapc21
Location, location, location! Where pruritis is occurring can also offer a clue as to the cause. #hapc21
How do you assess pruritus? #hapc21
Clinical assessment of pruritus. Rash can be important: a regional rash can indicate shingles or contact dermatitis whereas a generalized rash can indicate a systemic cause. #hapc21.
No talk at #hapc21 would be complete without a slide on neurotransmitters. Pruritus is no exception.
Pruritis and pain. #hapc21
Lots of treatment avenues for pruritus. #hapc21
Key takeaway: xerosis is the most common skin disease so consider topical therapies! #hapc21
Did I say there were lots of treatments for pruritus? These agents have different & overlapping uses. Examples: gabapentin is helpful for uremic itch and can be effective within several days. Naltrexone is helpful for cholestatic itch, not so much for uremic itch. #hapc21
Don't forget physical treatments for pruritus. #hapc21
Take-aways for pruritus! #hapc21

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More from @Top_Gundersen

18 Feb
Next talk at #hapc21! Controlling the dyspnea-anxiety cycle.
Remember that dyspnea is very common. Not just in COPD but in other diagnoses, and not just in hospice patients but in the ICU and other settings as well. #hapc21
The complicated and vicious cycle of breathlessness. #hapc21
Read 13 tweets
18 Feb
Diving into a difficult topic at #hapc21. Dr. Horowitz is starting with his mother, who had dementia and was considering voluntarily stopping eating and drinking (VSED).
Key points about the key clinical considerations around VSED: note that life should be unacceptable and IRREVERSIBLY difficult. This can't be an impulsive decision. #hapc21.
Psychiatric considerations are important too. There is an important difference between the wish to die vs. the wish to "not live like this" when considering VSED. #hapc21
Read 10 tweets
18 Feb
#hapc21 day #2's plenary is starting! Thank you @questmd @RonitElk @palliator for sharing your wisdom.
.@questmd shares her story. #hapc21
Thank you @questmd for such a heartfelt reflection. Such a complex story of oppression, mistrust, compassion, and hope. #hapc21.
Read 9 tweets
17 Feb
You don't have to be a SEXpert to validate your patients' feelings around their sexuality!

1st take home point from #hapc21's session on "Setting SEXpectations with Patients and Families." @SexANDDeathPos @PalCareErin @CaitlynMooreNP @PCMagicMo
Remember: sex is more than intercourse. #hapc21 Image
The circles of sexuality. #hapc21 Image
Read 9 tweets

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