The Effect of Adding Lorazepam to Haloperidol on Agitated Delirium in Patients with Advanced Cancer

Kayla Peltier, Mercer University College of Pharmacy

Delirium has been identified as the most common serious neuropsychiatric complication in cancer patients. First-line treatment for delirium is often non-pharmacological and includes re-orienting the patient frequently, encouraging cognitively stimulating activities, avoiding immobility if possible, and promoting good sleep patterns and sleep hygiene. If non-pharmacological therapies are not effective or the patient is displaying severe agitation and poses a risk to self-harm or harm others, then treatment with pharmacological agents (including antipsychotic and sedating medications) may be considered. [1]

The authors of the study state that while antipsychotics and benzodiazepines are often used to treat delirium, the use of benzodiazepines is controversial due to a lack of adequate, well-controlled randomized trials. Therefore, this study aims to compare the effect of lorazepam to placebo as an adjuvant to haloperidol therapy in patients with agitated delirium in the setting of advanced cancer. [2]

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Is the Use of Low-Intensity Therapy Effective in Adults with Burkitt’s Lymphoma?

Tanya Huang, Mercer University College of Pharmacy

Burkitt’s lymphoma (BL) is a type of non-Hodgkin lymphoma that is most prevalent in equatorial Africa. [1] There are three epidemiological subtypes of BL: endemic (African), sporadic (non-endemic), and immunodeficiency-related. [2] Chemotherapy treatments for BL are usually intensive short-cycle regimens due to the highly proliferative nature of the disease. However, they are associated with severe side effects in patients with immunodeficiencies, such as human immunodeficiency virus (HIV).

Previous attempts to use a significantly reduced intensity for BL in adults have not been successful. However, researchers have hypothesized that BL may be sensitive to genotoxic stress, leading to the prediction that prolonged exposure, not increased dose, as the therapeutic strategy for maximizing tumor cell death. Based on the concept, a study was conducted to compare efficacy of two different low-intensity regimens composed of etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab (EPOCH-R) for sporadic or immunodeficiency-associated BL patients. [3] A summary is provided below. Continue reading