1/168. A case of gamma-hydroxybutyric acid withdrawal syndrome during alcohol addiction treatment: utility of diazepam administration.Gamma-hydroxybutyric acid (GHB) is an emerging drug for alcoholism therapy. We present a case of GHB withdrawal syndrome secondary to GHB addiction during alcoholism treatment. A complete disappearance of drug withdrawal syndrome was achieved with oral diazepam and the symptoms resolved without sequelae. GHB has been used for alcoholism therapy for only a few years now, but the trend is increasing, and other cases similar to this one are foreseeable. This risk could be higher in some countries in which GHB use is increasing not for alcoholism therapy, but for its euphoric and anabolic effects. The present experience indicates that administration of benzodiazepines would seem to be sufficient to achieve total regression of the withdrawal syndrome in a short time, at least if recognized early.- - - - - - - - - - ranking = 1keywords = alcohol, alcoholism (Clic here for more details about this article) |
2/168. methadone withdrawal when starting an antiretroviral regimen including nevirapine.Antiretrovirals from three drug classes, nucleoside analogs, nonnucleoside analogs, and protease inhibitors, can be combined to achieve viral suppression. The nonnucleoside analog nevirapine is an inducer of cytochrome P450 3A4 liver metabolism and has interactions with protease inhibitors and oral contraceptives. methadone has two roles in human immunodeficiency viral infection: pain management and treatment of opioid abuse. A drug-drug interaction may result in decreased methadone blood levels when administered with nevirapine. A patient experienced methadone withdrawal symptoms when combining these agents.- - - - - - - - - - ranking = 0.018695824574457keywords = abuse (Clic here for more details about this article) |
3/168. nevirapine induced opiate withdrawal among injection drug users with hiv infection receiving methadone.BACKGROUND: Pharmacokinetic interactions complicate and potentially compromise the use of antiretroviral and other hiv therapeutic agents in patients with hiv disease. This may be particularly so among those receiving treatment for substance abuse. OBJECTIVE: We describe seven cases of opiate withdrawal among patients receiving chronic methadone maintenance therapy following initiation of therapy with the non-nucleoside reverse transcriptase inhibitor, nevirapine. DESIGN: Retrospective chart review. RESULTS: In all seven patients, due to the lack of prior information regarding a significant pharmacokinetic interaction between these agents, the possibility of opiate withdrawal was not anticipated. Three patients, for whom methadone levels were available at the time of development of opiate withdrawal symptoms, had subtherapeutic methadone levels. In each case, a marked escalation in methadone dose was required to counteract the development of withdrawal symptoms and allow continuation of antiretroviral therapy. Three patients continued nevirapine with methadone administered at an increased dose; however, four chose to discontinue nevirapine. CONCLUSION: To maximize hiv therapeutic benefit among opiate users, information is needed about pharmacokinetic interactions between antiretrovirals and therapies for substance abuse.- - - - - - - - - - ranking = 0.037391649148915keywords = abuse (Clic here for more details about this article) |
4/168. Medical treatment of the adolescent drug abuser. An opportunity for rehabilitative intervention.Illnesses related to both the pharmacologic properties of abused substances and their methods of administration often bring the teenager to medical attention and may provide sufficient motivation for the adolescent to seek help beyond the acute problem. Successful treatment of an overdose reaction, an abstinence syndrome, or any other medical complication of drug abuse may give the physician a unique opportunity to begine further evalution for future care.- - - - - - - - - - ranking = 0.11217494744674keywords = abuse (Clic here for more details about this article) |
5/168. Phenomenology of gasoline intoxication and withdrawal symptoms among adolescents in india: a case series.Inhalant withdrawal symptoms have previously been described but not well documented. This case-series describes the sociodemographic and clinical characteristics of nine children and adolescents with gasoline abuse. gasoline inhalation was the drug of choice in our patients. The mean age was 13.6 years and all the subjects belonged to low socioeconomic status. Most of the subjects used daily and all subjects reported alcohol abuse in the father. All subjects reported a syndrome of intoxication as described in previous reports. All subjects also reported a withdrawal syndrome including irritability, psychomotor retardation, anhedonia, dry mouth, sleep disturbances, craving, and increased lacrimation.- - - - - - - - - - ranking = 0.26255971315254keywords = alcohol, alcohol abuse, abuse, intoxication (Clic here for more details about this article) |
6/168. Substance abuse and emergency psychiatry.Given the high rates of comorbidity, patients commonly present with multiple diagnoses to PESs or crisis services. Clinicians must be well versed in the evaluation, differential diagnosis, and treatment of patients with substance-abuse disorders or other axis I, II, or III conditions if they are to provide state-of-the-art treatment of patients in need of emergency care.- - - - - - - - - - ranking = 0.093479122872287keywords = abuse (Clic here for more details about this article) |
7/168. A therapeutic use of the methadone fluvoxamine drug interaction.BACKGROUND: methadone has been effectively used in the treatment of opiate dependence. Adequate dose and blood level have correlated with success in treatment. A number of factors including the regular use of alcohol, medications, and urinary pH can influence blood level and thereby effectiveness. fluvoxamine has been shown to increase methadone blood levels. methods: Single case report. RESULTS: A patient unable to maintain an effective methadone blood level despite a dose of 200 mg per day was administered fluvoxamine with subsequent increase in her methadone blood level and reduction of opiate withdrawal symptoms. CONCLUSIONS: In patients unable to maintain an effective methadone blood level throughout the dosing interval, fluvoxamine can help increase the methadone blood level and alleviate opiate withdrawal symptoms.- - - - - - - - - - ranking = 0.094396091825881keywords = alcohol (Clic here for more details about this article) |
8/168. Alcohol withdrawal in critical care.Alcohol withdrawal syndrome can be fatal if not recognized and treated immediately. An estimated 10% to 50% of hospitalized patients abuse alcohol, and they may develop withdrawal syndrome during hospitalization. However, nurses can successfully treat alcohol withdrawal syndrome, even in critically ill patients, with benzodiazepines, the treatment of choice.- - - - - - - - - - ranking = 0.20748800822622keywords = alcohol, abuse (Clic here for more details about this article) |
9/168. Severe gamma-hydroxybutyrate withdrawal: a case report and literature review.We report a case of gamma-hydroxybutyrate (GHB) withdrawal resulting in severe agitation, mental status changes, elevated blood pressure, and tachycardia hours after stopping chronic use of GHB. The patient admitted to substantial GHB abuse on a daily basis for 2.5 years. Previous attempts at cessation reportedly resulted in diaphoresis, tremors, and agitation. The patient's symptoms, negative polypharmacy history, and negative urine and blood toxicological analysis for alcohol, benzodiazepines, sedative-hypnotics, or other substances suggested the diagnosis of GHB withdrawal. Later analysis of a patient drug sample confirmed the presence of GHB. The patient required 507 mg of lorazepam and 120 mg of diazepam over 90 h to control agitation. This is one of the few reported cases of GHB withdrawal and one of the most severe. Given the increasing use of GHB, more cases of severe GHB withdrawal should be anticipated.- - - - - - - - - - ranking = 0.11309191640034keywords = alcohol, abuse (Clic here for more details about this article) |
10/168. Alcohol withdrawal and hypokalaemia: a case report.A case is presented where a 25-year-old man developed a serious hypokalaemia (K( ) 2.2 mmol/l) during alcohol withdrawal, despite intravenous saline treatment and normal feeding. As hypokalaemia can be symptom-free, we want to draw attention to the combination of vomiting, malnutrition and alcohol withdrawal, as these can cause lethal complications. We therefore recommend that potassium serum level should be routinely monitored during alcohol withdrawal, even when this is being managed in the community.- - - - - - - - - - ranking = 0.28318827547764keywords = alcohol (Clic here for more details about this article) |
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