Alcohol Withdrawal Protocol Lorazepam
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Benzodiazepines: Uses and Risks Charlie Reznikoff, MD Hennepin Healthcare
Benzodiazepines: Uses and Risks Charlie Reznikoff, MD Hennepin healthcare 4/22/2020 Overview benzodiazepines • Examples of benzos and benzo like drugs • Indications for benzos • Pharmacology of benzos • Side effects and contraindications • Benzo withdrawal • Benzo tapers 12/06/2018 Sedative/Hypnotics • Benzodiazepines • Alcohol • Z-drugs (Benzo-like sleeping aids) • Barbiturates • GHB • Propofol • Some inhalants • Gabapentin? Pregabalin? 12/06/2018 Examples of benzodiazepines • Midazolam (Versed) • Triazolam (Halcion) • Alprazolam (Xanax) • Lorazepam (Ativan) • Temazepam (Restoril) • Oxazepam (Serax) • Clonazepam (Klonopin) • Diazepam (Valium) • Chlordiazepoxide (Librium) 4/22/2020 Sedatives: gaba stimulating drugs have incomplete “cross tolerance” 12/06/2018 Effects from sedative (Benzo) use • Euphoria/bliss • Suppresses seizures • Amnesia • Muscle relaxation • Clumsiness, visio-spatial impairment • Sleep inducing • Respiratory suppression • Anxiolysis/disinhibition 12/06/2018 Tolerance to benzo effects? • Effects quickly diminish with repeated use (weeks) • Euphoria/bliss • Suppresses seizures • Effects incompletely diminish with repeated use • Amnesia • Muscle relaxation • Clumsiness, visio-spatial impairment • Seep inducing • Durable effects with repeated use • Respiratory suppression • Anxiolysis/disinhibition 12/06/2018 If you understand this pharmacology you can figure out the rest... • Potency • 1 mg diazepam <<< 1 mg alprazolam • Duration of action • Half life differences • Onset of action • Euphoria, clinical utility in acute -
Alcohol Effects on People; 00 Social Responsibility for the Control of the Use of Beverage; and (5) the Social Responsibility for the Treatment of Individuals
DOC- NT RESUME ED 140 180 CG 011 461 TITLE Alcohol Education: Curriculum Guide for Grades 7-12. INSTITUTION New York State Education Dept., Albany. Bureau of Drug Education. PUB DATE 76 NOTE 144p.; For relat d document, see CG 011 462 EERS PRICE MF-$0.83 BC-$7.35 Plus Postage. DESCRIPTORS *Alcohol Education; *Alcoholic Beverages; Class Activities; Curriculum Guides; *Drinking; Drug Education; Health Education; *Learning Activities; Recreational Activities; *Secondary Education; Socially Deviant Behavior; Teaching Guides AB TRACT This curriculum guide is designed as an interdisciplinary resource on alcohol education for teachers of Grades 7-12. tevelopmental traits are discussed, and objectives and learning experiences are presented. The following topics are covered: ro the nature of alcohci;(2) factors influencing the use of alcoholic beverages; (3) alcohol effects on people; 00 social responsibility for the control of the use of beverage; and (5) the social responsibility for the treatment of individuals. A division is made between Grades 7-9 and 10-12, with each set of three grades considered separately. (Author/OLL)' Documents acquired by ERIC include many informal unpublished materials not available from other sources. ERIC makes every effort * * to obtain the best copy available. Nevertheless, items of marginal * * reproducibility are often encountered and this affects the quality * * of the microfiche and hardcopy reproductions ERIC makes available * via the ERIC Document Reproduction Service (EDRS). EDRS is not * responsible for -
Acute Migraine Treatment
Acute Migraine Treatment Morris Levin, MD Professor of Neurology Director, Headache Center UCSF Department of Neurology San Francisco, CA Mo Levin Disclosures Consulting Royalties Allergan Oxford University Press Supernus Anadem Press Amgen Castle Connolly Med. Publishing Lilly Wiley Blackwell Mo Levin Disclosures Off label uses of medication DHE Antiemetics Zolmitriptan Learning Objectives At the end of the program attendees will be able to 1. List all important options in the acute treatment of migraine 2. Discuss the evidence and guidelines supporting the major migraine acute treatment options 3. Describe potential adverse effects and medication- medication interactions in acute migraine pharmacological treatment Case 27 y/o woman has suffered ever since she can remember from “sick headaches” . Pain is frontal, increases over time and is generally accompanied by nausea and vomiting. She feels depressed. The headache lasts the rest of the day but after sleeping through the night she awakens asymptomatic 1. Diagnosis 2. Severe Headache relief Diagnosis: What do we need to beware of? • Misdiagnosis of primary headache • Secondary causes of headache Red Flags in HA New (recent onset or change in pattern) Effort or Positional Later onset than usual (middle age or later) Meningismus, Febrile AIDS, Cancer or other known Systemic illness - Neurological or psych symptoms or signs Basic principles of Acute Therapy of Headaches • Diagnose properly, including comorbid conditions • Stratify therapy rather than treat in steps • Treat early -
Accurate Measurement, and Validation of Solubility Data † ‡ ‡ § † ‡ Víctor R
Article Cite This: Cryst. Growth Des. 2019, 19, 4101−4108 pubs.acs.org/crystal In the Context of Polymorphism: Accurate Measurement, and Validation of Solubility Data † ‡ ‡ § † ‡ Víctor R. Vazqueź Marrero, , Carmen Piñero Berríos, , Luz De Dios Rodríguez, , ‡ ∥ ‡ § Torsten Stelzer,*, , and Vilmalí Lopez-Mej́ ías*, , † Department of Biology, University of Puerto RicoRío Piedras Campus, San Juan, Puerto Rico 00931, United States ‡ Crystallization Design Institute, Molecular Sciences Research Center, University of Puerto Rico, San Juan, Puerto Rico 00926, United States § Department of Chemistry, University of Puerto RicoRío Piedras Campus, San Juan, Puerto Rico 00931, United States ∥ Department of Pharmaceutical Sciences, University of Puerto RicoMedical Sciences Campus, San Juan, Puerto Rico 00936, United States *S Supporting Information ABSTRACT: Solubility measurements for polymorphic com- pounds are often accompanied by solvent-mediated phase transformations. In this study, solubility measurements from undersaturated solutions are employed to investigate the solubility of the two most stable polymorphs of flufenamic acid (FFA forms I and III), tolfenamic acid (TA forms I and II), and the only known form of niflumic acid (NA). The solubility was measured from 278.15 to 333.15 K in four alcohols of a homologous series (methanol, ethanol, 1- propanol, n-butanol) using the polythermal method. It was established that the solubility of these compounds increases with increasing temperature. The solubility curves of FFA forms I and III intersect at ∼315.15 K (42 °C) in all four solvents, which represents the transition temperature of the enantiotropic pair. In the case of TA, the solubility of form II could not be reliably obtained in any of the solvents because of the fast solvent- mediated phase transformation. -
Staying Connected Is Important: Virtual Recovery Resources
STAYING CONNECTED IS IMPORTANT: VIRTUAL RECOVERY RESOURCES • Refuge Recovery: Provides online and virtual INTRODUCTION support In an infectious disease outbreak, when social https://www.refugerecovery.org/home distancing and self-quarantine are needed to • Self-Management and Recovery Training limit and control the spread of the disease, (SMART) Recovery: Offers global community continued social connectedness to maintain of mutual-support groups, forums including a recovery is critically important. Virtual chat room and message board resources can and should be used during this https://www.smartrecovery.org/community/ time. Even after a pandemic, virtual support may still exist and still be necessary. • SoberCity: Offers an online support and recovery community This tip sheet describes resources that can be https://www.soberocity.com/ used to virtually support recovery from mental/ substance use disorders as well as other • Sobergrid: Offers an online platform to help resources. anyone get sober and stay sober https://www.sobergrid.com/ • Soberistas: Provides a women-only VIRTUAL RECOVERY PROGRAMS international online recovery community https://soberistas.com/ • Alcoholics Anonymous: Offers online support • Sober Recovery: Provides an online forum for https://aa-intergroup.org/ those in recovery and their friends and family https://www.soberrecovery.com/forums/ • Cocaine Anonymous: Offers online support and services • We Connect Recovery: Provides daily online https://www.ca-online.org/ recovery groups for those with substance use and -
ALCOHOLICS ANONYMOUS 1 Renewed Relevance of Alcoholics Anonymous and Adlerian Psychology
Running head: ALCOHOLICS ANONYMOUS 1 Renewed Relevance of Alcoholics Anonymous and Adlerian Psychology ____________________ Presented to The Faculty of the Adler Graduate School ____________________ In Partial Fulfillment of the Requirement for the Degree of Master of Arts in Adlerian Counseling and Psychotherapy ____________________ By Megan Teale ____________________ Chair: Rashida Fisher MS, LPCC, LADC Reader: Jamie Hedin MA, LPC, LADC ____________________ July 2017 ALCOHOLICS ANONYMOUS 2 Abstract The incorporation of psychological approaches to the Alcoholics Anonymous (AA) is established as a sound way of improving the treatment of alcoholism. Despite mounting evidence of the clinical effectiveness of AA, and its enduring legacy as the prominent approach for healing alcoholism; there remains skepticism regarding its use as a clinical intervention. The literature on the Adlerian orientation has noted the similarity between the two methods, little investigation of the congruence between the two and the implications for an integrated treatment approach has occurred. The purpose of this literature review is to examine how Adlerian theory and positive psychology complement the philosophies and practices of AA. The results support the integration of Adlerian Psychology and AA as ideal for working with clients struggling with alcohol dependence. Furthermore, this literature review suggests that the integration of Adlerian Psychology will enhance and complement the therapeutic dynamics inherent in the AA program, improving the competence of clinicians to treat individuals living the alcoholism and participating in the 12- step programs. Keywords: Adlerian Psychology, Alcoholics Anonymous, Alcoholism, Spirituality ALCOHOLICS ANONYMOUS 3 Dedication To my husband, Eric Teale, for allowing me to turn my dreams into a reality. Thank you for supporting me through my graduate school experience. -
S1 Table. List of Medications Analyzed in Present Study Drug
S1 Table. List of medications analyzed in present study Drug class Drugs Propofol, ketamine, etomidate, Barbiturate (1) (thiopental) Benzodiazepines (28) (midazolam, lorazepam, clonazepam, diazepam, chlordiazepoxide, oxazepam, potassium Sedatives clorazepate, bromazepam, clobazam, alprazolam, pinazepam, (32 drugs) nordazepam, fludiazepam, ethyl loflazepate, etizolam, clotiazepam, tofisopam, flurazepam, flunitrazepam, estazolam, triazolam, lormetazepam, temazepam, brotizolam, quazepam, loprazolam, zopiclone, zolpidem) Fentanyl, alfentanil, sufentanil, remifentanil, morphine, Opioid analgesics hydromorphone, nicomorphine, oxycodone, tramadol, (10 drugs) pethidine Acetaminophen, Non-steroidal anti-inflammatory drugs (36) (celecoxib, polmacoxib, etoricoxib, nimesulide, aceclofenac, acemetacin, amfenac, cinnoxicam, dexibuprofen, diclofenac, emorfazone, Non-opioid analgesics etodolac, fenoprofen, flufenamic acid, flurbiprofen, ibuprofen, (44 drugs) ketoprofen, ketorolac, lornoxicam, loxoprofen, mefenamiate, meloxicam, nabumetone, naproxen, oxaprozin, piroxicam, pranoprofen, proglumetacin, sulindac, talniflumate, tenoxicam, tiaprofenic acid, zaltoprofen, morniflumate, pelubiprofen, indomethacin), Anticonvulsants (7) (gabapentin, pregabalin, lamotrigine, levetiracetam, carbamazepine, valproic acid, lacosamide) Vecuronium, rocuronium bromide, cisatracurium, atracurium, Neuromuscular hexafluronium, pipecuronium bromide, doxacurium chloride, blocking agents fazadinium bromide, mivacurium chloride, (12 drugs) pancuronium, gallamine, succinylcholine -
Problems Other Than Alcohol
ALCOHOLICS ANONYMOU S® is a fellowship of men and women who share their experience, strength and hope with each other that they may solve their common problem and help others to recover from alcoholism. • The only requirement for membership is a desire to stop drinking. There are no dues or fees for A.A. membership; we are self-supporting through our own contributions. • A.A. is not allied with any sect, denomination, politics, organization or institution; does not wish to engage in any controversy; neither endorses nor opposes any causes. • Our primary purpose is to stay sober and help other alcoholics to achieve sobriety. Copyright © by A.A. Grapevine, Inc.; reprinted with permission Copyright © The A.A. Grapevine, Inc., February 1958 Reprinted with permission by A.A. World Services, Inc. Available from: A.A. General Service Office Box 459, Grand Central Station New York, NY 10163 www.aa.org 100M 03/15 (Ripon) Problems other than alcohol By Bill W. (co-founder, Alcoholics Anonymous) Perhaps there is no suffering more horrible than drug addiction, especially that kind which is pro - duced by morphine, heroin, and other narcotics. Such drugs twist the mind, and the awful pro- cess of withdrawal racks the sufferer’s body. Compared with the addict and his woes, we alcoholics are pikers. Barbiturates, carried to extremes, can be almost as bad. In A.A. we have members who have made great recoveries from both the bottle and the needle. We also have a great many others who were — or still are — victimized by “goofballs” and even by the new tranquilizers. -
Benzodiazepines Vs Barbiturates for Alcohol Withdrawal: Analysis of 3 Different Treatment Protocols
American Journal of Emergency Medicine 37 (2019) 733–736 Contents lists available at ScienceDirect American Journal of Emergency Medicine journal homepage: www.elsevier.com/locate/ajem Brief Report Benzodiazepines vs barbiturates for alcohol withdrawal: Analysis of 3 different treatment protocols Amelia C. Nelson a, Joy Kehoe a, Jeffrey Sankoff b, David Mintzer c, Julie Taub c, Kevin A. Kaucher a,⁎ a Department of Pharmacy, Denver Health Medical Center, 777 Bannock ST. MC #0056, Denver, CO 80204, United States of America b Department of Emergency Medicine, Denver Health Medical Center, 777 Bannock Street, MC #0108, Denver, CO 80204, United States of America c Department of Medicine, Denver Health Medical Center, 601 Broadway Street, MC 4000, Denver, CO 80203, United States of America article info abstract Article history: Introduction: Alcohol withdrawal treatment varies widely. Benzodiazepines are the standard of care, with rapid Received 19 December 2018 onset and long durations of action. Recent drug shortages involving IV benzodiazepines have required incorpo- Accepted 2 January 2019 ration of alternative agents into treatment protocols. Phenobarbital has similar pharmacokinetics to select ben- zodiazepines frequently used for alcohol withdrawal. The objective of this study is to describe the effectiveness Keywords: and safety of our institutional protocols during three time periods utilizing benzodiazepines and barbiturates Phenobarbital for the acute treatment of alcohol withdrawal in the emergency department. Benzodiazepines Methods: Adult patients presenting to the ED for acute alcohol withdrawal from April 1st, 2016 to January 31st, Diazepam Lorazepam 2018 were reviewed. Patients who received at least one dose of treatment were included. Treatments were Alcohol withdrawal based on availability of medication and given protocol at time of presentation. -
Al‑Anon/Alateen
Al-Anon/Alateen Service Manual 2018-2021 Al-Anon and Alateen Digest of Al-Anon and Groups at Work Alateen Policies “Al-Anon and Alateen Groups at Work” The “Digest of Al-Anon and Alateen provides a framework within which each Policies” reflects policy group can develop and grow. statements that grew It offers basic information to out of questions all group members concerning and experiences the group structure and how from the Al-Anon it relates to other groups and fellowship worldwide. Al-Anon as a whole. They are interpretations of our basic guides, the Twelve Traditions and the Twelve Concepts of Service. Al-Anon's Twelve World Concepts of Service Service “Al-Anon’s Twelve Concepts of Service” Handbook deals with the “why” of our service The “World Service Handbook” structure in such explains how Al-Anon is held a way that the together worldwide, how it valuable experience is structured, and how our of the past and the trusted servants can best function lessons drawn from within our structure. that experience can never be forgotten or lost. version two (2) Suggested Meeting Readings This format is printed for your convenience. While not every group chooses to plan its meeting in this way, many find a general outline helpful. See also the pamphlet This Is Al-Anon (P‑32). Alateen Groups at Work Al-Anon and Meeting Opening Most groups open with a moment of silence followed by the Se‑ renity Prayer. The Serenity Prayer Chairperson: Will you join me in a moment of silence, followed by the Serenity Prayer? God grant me the serenity To accept the things I cannot change, Courage to change the things I can, And wisdom to know the difference. -
Who Want Sobriety More Than Anything Else in Life
This booklet is published in the interest of alcoholics who want sobriety more than anything else in life... who have been unable to find release from alcoholism. THE UNHAPPIEST person in the world is the chronic alcoholic who has an insistent yearning to enjoy life as he once knew it, but cannot picture life without alcohol. He has a heart-breaking obsession that by some miracle of control he will be able to do so. AA General Service Office, P.O. Box 1, 10 Toft Green, York YOl 7NJ heart disease cancer alcoholism Yes It does belong on this list Alcoholism is a fatal illness for which there is no known medical cure, and many of its victims are forced to wage a losing battle, not only against the ravages of the illness, but also against the ignorance of a society which largely refuses to regard the alcoholic as a sick person. To many people, the word ‘alcoholic’ means someone who is perverse and weakwilled. “Why on earth doesn’t he control his drinking?” they ask. Those of us who are alcoholics, and who have tried to control our drinking know just how impossible a task that is. This is because alcoholism is an illness. While we stay away from drink, we function much like other people. But if we take any alcohol whatsoever into our systems, something happens both physically and mentally which makes it difficult or impossible for us to stop. We have lost control of our drinking, but... What is this elusive illness called ALCOHOLISM ? The action of alcohol on the alcoholic is similar to the manifestation of an allergy. -
Drug and Medication Classification Schedule
KENTUCKY HORSE RACING COMMISSION UNIFORM DRUG, MEDICATION, AND SUBSTANCE CLASSIFICATION SCHEDULE KHRC 8-020-1 (11/2018) Class A drugs, medications, and substances are those (1) that have the highest potential to influence performance in the equine athlete, regardless of their approval by the United States Food and Drug Administration, or (2) that lack approval by the United States Food and Drug Administration but have pharmacologic effects similar to certain Class B drugs, medications, or substances that are approved by the United States Food and Drug Administration. Acecarbromal Bolasterone Cimaterol Divalproex Fluanisone Acetophenazine Boldione Citalopram Dixyrazine Fludiazepam Adinazolam Brimondine Cllibucaine Donepezil Flunitrazepam Alcuronium Bromazepam Clobazam Dopamine Fluopromazine Alfentanil Bromfenac Clocapramine Doxacurium Fluoresone Almotriptan Bromisovalum Clomethiazole Doxapram Fluoxetine Alphaprodine Bromocriptine Clomipramine Doxazosin Flupenthixol Alpidem Bromperidol Clonazepam Doxefazepam Flupirtine Alprazolam Brotizolam Clorazepate Doxepin Flurazepam Alprenolol Bufexamac Clormecaine Droperidol Fluspirilene Althesin Bupivacaine Clostebol Duloxetine Flutoprazepam Aminorex Buprenorphine Clothiapine Eletriptan Fluvoxamine Amisulpride Buspirone Clotiazepam Enalapril Formebolone Amitriptyline Bupropion Cloxazolam Enciprazine Fosinopril Amobarbital Butabartital Clozapine Endorphins Furzabol Amoxapine Butacaine Cobratoxin Enkephalins Galantamine Amperozide Butalbital Cocaine Ephedrine Gallamine Amphetamine Butanilicaine Codeine