| Therapeutic Class
|
Alternatives
|
Exclusions
|
| Barbiturates
|
- Epilepsy: use other anticonvulsants (e.g., lamotrigine, levetiracetam).
- Agitation: treat pain first with acetaminophen then low-dose opioid.
- Severe agitation: use low-dose second-generation antipsychotic (eg, olanzapine, risperidone, quetiapine [Lewy body dementia]).
|
- Seizures disorders, benzodiazepine or ethanol withdrawal, barbiturates are acceptable to use.
|
| Benzodiazepines
|
- Epilepsy: use other anticonvulsants (eg, lamotrigine, levetiracetam).
- Agitation: treat pain first with acetaminophen then low-dose opioid.
- Severe agitation: use nonpharmacologic approach then low-dose second-generation antipsychotic (eg, olanzapine, risperidone,
quetiapine [Lewy body dementia]).
|
- Seizure disorders: benzodiazepine or ethanol withdrawal, severe generalized anxiety disorder, and end of life, benzodiazepines are acceptable to use.
|
| First-Generation Antihistamines
|
- Allergies: use intranasal saline or steroid (eg, fluticasone, beclomethasone), topical antihistamines (eg, azelastine), or second-generation antihistamines (eg, fexofenadine, loratadine).
- Vertigo: use short-term steroids and canalith repositioning maneuvers.
|
- For allergic reactions, first-generation antihistamines are acceptable to use.
|
