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Assessment
Published in Benita Wilson, Andrea Woollands, David Barrett, Care Planning, 2018
Benita Wilson, Andrea Woollands, David Barrett
States has always been a ‘coper’, but not coping at the moment – seen GP 10 times in 4 weeks. States ‘never been like this, tired, with constant colds and sore throats’. Six weeks ago experienced ‘overwhelming sense of impending doom’, felt as if she was ‘going to suffocate’, and thought she ‘would die’. Palpitation, tightness in chest, sweaty palms, tingling lips and fingers. Admitted to A/E – discharged later that evening – diagnosis ‘panic attack’. Has had six further episodes of panic – ‘no apparent reason’, now very frightened of repeat episodes. Panic rating – 9 at worst and 5 at best, using scale of 1–10. Is very stressed, has high caffeine intake. Convinced there is something seriously wrong – heart problems or brain tumour – that doctors are missing the signs. Full health check given by GP – no abnormalities detected in lungs or heart.
Summer, pain and shame
Published in Cathy Wield, Keith Matthews, Chris Thompson, Life After Darkness, 2018
Cathy Wield, Keith Matthews, Chris Thompson
Two days after I had seen Prof Thompson, Ruth came to see me and she felt that this time there was no question, I required readmission. I was confused with a sense of impending doom and once again feelings of unreality. At least there were no voices at this time. Once back on B ward, I was still encouraged to go home for the evening and weekends to see the children, but with the proviso that I should not be left alone. That was fine by me; I was frightened when I was alone, scared that I would be unable to resist the urges to kill myself. Somewhere in the recesses of my mind there must have been some self-preservation instinct, although my concern for the wellbeing of the family was probably the most powerful protection I had – part of the reason why the medical team were keen for me to maintain as much contact with my children as possible.
Anxiolytics: Predicting Response/Maximizing Efficacy
Published in Mark S. Gold, R. Bruce Lydiard, John S. Carman, Advances in Psychopharmacology: Predicting and Improving Treatment Response, 2018
Anxiety is a fear-like emotion associated with a subjective sense of impending doom which motivates escape. It is a response to situations perceived as dangerous. It can be associated with new situations by conditioned response learning. The emotional response is disproportionate to the objective threat. Anxiety is associated with characteristic posture, muscle tone, and neuroendocrine changes. Anxiety is an epiphenomenon of nervous system physiology. Anxiety problems usually present as fear complexed with other emotions. Universal agreement upon any specific definition of anxiety is unlikely, but an integration of the preceding features approximates the truth. Anxiety is defined here simply to mean morbid fear.
Stoned on spices: a mini-review of three commonly abused household spices
Published in Clinical Toxicology, 2021
Kelly Johnson-Arbor, Susan Smolinske
Nutmeg contains volatile (essential) oil, fixed (fatty) oil, and fiber. The fixed oil has no culinary value and lacks clinical effects. The essential oil contains from 4–12% myristicin as well as monoterpenes, eugenol, and toluene [3]. One tablespoon of ground nutmeg (or a single nutmeg seed) weighs approximately 7 g [8]. Typical recreational doses of nutmeg range from 5–30 g, and ingestion of less than 10 g generally does not result in toxicity [3]. However, the concentrations of nutmeg’s active components are variable and may be influenced by factors such as botanical source, quality, and storage [9]. This is evidenced by the unpredictability in clinical symptoms encountered after nutmeg overdose. While ingestion of 14 g of nutmeg in one case resulted in flushing, a sense of impending doom, and dry mouth lasting for up to 60 h, ingestion of 28 g of nutmeg in another case resulted in tachycardia, miosis, paranoia, and hallucinations which lasted only 18 h [8,10].
Clinical electrophysiology of the aging heart
Published in Expert Review of Cardiovascular Therapy, 2022
Kyle Murray, Muizz Wahid, Kannayiram Alagiakrishnan, Janek Senaratne
Adenosine (class IIe) activates adenosine A1 receptors in the SAN, atria, and AVN, causing SAN hyperpolarization and shortening the AP duration within atrial and AVN tissues [47,48]. An adenosine bolus of 6–12 mg IV causes transient, complete AVN block within 15–20 seconds of administration that can acutely terminate AVN-dependent arrhythmias and help differentiate aberrant SVTs from VT. Patients often feel a short-lived sense of ‘impending doom’ [46].