MedWorm: Ativan

Anticonvulsants for alcohol withdrawal.

Cochrane Database of Systematic Reviews — Sat, 20 Mar 2010 06:22:03 +0100

CONCLUSIONS: Results of this review do not provide sufficient evidence in favour of anticonvulsants for the treatment of AWS. There are some suggestions that carbamazepine may actually be more effective in treating some aspects of alcohol withdrawal when compared to benzodiazepines, the current first-line regimen for alcohol withdrawal syndrome. Anticonvulsants seem to have limited side effects, although adverse effects are not rigorously reported in the analysed trials. PMID: 20238337 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

ATIVAN (Lorazepam) Tablet [BTA Pharmaceuticals Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 18 Mar 2010 05:00:00 +0100

Updated Date: Mar 18, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Phenytoin-induced acute generalized exanthemous pustulosis

Journal of the American Academy of Dermatology — Tue, 16 Mar 2010 14:28:14 +0100

To the Editor: A 57-year-old African American male with a history of a seizure disorder caused by a traumatic head injury presented to the emergency department with a recent onset of multiple pustular lesions that started on his face and spread to his trunk and upper extremities. He had presented to the same emergency department 5 days earlier in status epilepticus. He was treated with 1 g phenytoin for the first time in addition to increased doses of his other medicines (lorazepam and levetiracetam). His seizure resolved and he was discharged 2 days later on increased doses of levetiracetam and valproic acid. (Source: Journal of the American Academy of Dermatology)

Effect of dexmedetomidine versus lorazepam on outcome in patients with sepsis: an a priori-designed analysis of the MENDS randomized controlled trial

BioMed Central — Tue, 16 Mar 2010 00:00:00 +0100

Conclusions: In this subgroup analysis, septic patients receiving dexmedetomidine had more days free of brain dysfunction and mechanical ventilation and were less likely to die than those that received a lorazepam-based sedation regimen. These results were more pronounced in septic patients than in non-septic patients. Prospective clinical studies and further preclinical mechanistic studies are needed to confirm these results.Trial Registration: NCT00095251. (Source: BioMed Central)

Catatonia Is not Schizophrenia: Kraepelin's Error and the Need to Recognize Catatonia as an Independent Syndrome in Medical Nomenclature

Schizophrenia Bulletin — Fri, 05 Mar 2010 19:18:35 +0100

Catatonia is a motor dysregulation syndrome described by Karl Kahlbaum in 1874. He understood catatonia as a disease of its own. Others quickly recognized it among diverse disorders, but Emil Kraepelin made it a linchpin of his concept of dementia praecox. Eugen Bleuler endorsed this singular association. During the 20th century, catatonia has been considered a type of schizophrenia. In the 1970s, American authors identified catatonia in patients with mania and depression, as a toxic response, and in general medical and neurologic illnesses. It was only occasionally found in patients with schizophrenia. When looked for, catatonia is found in 10% or more of acute psychiatric admissions. It is readily diagnosable, verifiable by a lorazepam challenge test, and rapidly treatable. Even in its m...

ATIVAN (Lorazepam) Tablet [STAT RX USA LLC]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Fri, 05 Mar 2010 05:00:00 +0100

Updated Date: Mar 5, 2010 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Experimental design for optimization of microwave-assisted extraction of benzodiazepines in human plasma.

Analytical and Bioanalytical Chemistry — Fri, 05 Mar 2010 00:00:00 +0100

Authors: Fernández P, Vázquez C, Lorenzo RA, Carro AM, Alvarez I, Cabarcos P A simple and fast microwave-assisted-extraction (MAE) method has been evaluated as an alternative to solid-phase extraction (SPE) for the determination of six benzodiazepines widely prescribed in European countries (alprazolam, bromazepam, diazepam, lorazepam, lormetazepam and tetrazepam) in human plasma. For MAE optimization a Doehlert experimental design was used with extraction time, temperature and solvent volume as influential parameters. A desirability function was employed in addition to the simultaneous optimization of the MAE conditions. The analysis of variance showed that the solvent volume had a positive influence on the extraction of all the analytes tested, achieving a statistically sig...

Use of EEG Monitoring and Management of Non-Convulsive Seizures in Critically Ill Patients: A Survey of Neurologists

Neurocritical Care — Wed, 03 Mar 2010 08:07:18 +0100

Conclusions Continuous EEG monitoring (cEEG) is commonly employed in critically ill patients to detect NCS and NCSE. However, there is substantial variability in current practice related to cEEG indications and duration and to management of NCS and NCSE. The fact that such variability exists in the management of this common clinical problem suggests that further prospective study is needed. Multiple points of uncertainty are identified that require investigation. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s12028-010-9337-2Authors Nicholas S. Abend, The Children’s Hospital of Philadelphia Division of Neurology 34th Street and Civic Center Blvd Philadelphia PA 19104 USADennis J. Dlugos, The Children’s Hospital of Philadelphia Division of Neu...

Dexmedetomidine Controls Agitation and Facilitates Reliable, Serial Neurological Examinations in a Non-Intubated Patient with Traumatic Brain Injury

Neurocritical Care — Wed, 03 Mar 2010 08:07:18 +0100

Conclusion Given the large numbers of alcohol-dependent patients who suffer a traumatic brain injury and subsequently develop agitation and alcohol withdrawal in hospital, dexmedetomidine offers a novel strategy to facilitate sedation without neurological or respiratory depression. As this case report demonstrates, dexmedetomidine is an emerging treatment option for agitation in patients who require reliable, serial neurological testing to monitor the course of their traumatic brain injury. Content Type Journal ArticleCategory Practical PearlDOI 10.1007/s12028-009-9315-8Authors Julin F. Tang, University of California San Francisco, San Francisco General Hospital Department of Anesthesia and Critical Care Medicine 1001 Potrero Avenue San Francisco CA 94110 USAPo-Lia...

Michael Jackson toxicology report released

The Poison Review — Sat, 13 Feb 2010 19:25:32 +0100

This week, the Los Angeles medical examiner’s office released the autopsy report on Michael Jackson. Included in the release are toxicology findings, and a discussion by an anesthesiologist concerning the effects and proper administration of propofol. The cause of death was listed as “acute propofol intoxication”, with the “benzodiazepine effect” contributing. The toxicology tests determined the following: Propofol: Heart blood – 3.2 mcg/ml; Hospital blood – 4.1 mcg/ml; Femoral blood – 2.6 mcg/ml Lidocaine: Heart blood - 0.68 mcg/ml; Hospital blood – 0.5 mcg/ml; Femoral blood – 0.34 mcg/ml Lorazepam: Heart blood – 0....

Jimsonweed poisoning – Maryland

The Poison Review — Sun, 07 Feb 2010 18:14:04 +0100

This report is an excellent example of how recognition of a toxidrome can aid in diagnosis of management of puzzling cases. (Source: The Poison Review)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

ECT in the Treatment of a Patient With Catatonia: Consent and Complications [Clinical Case Conference]

Am J Psychiatry — Mon, 01 Feb 2010 19:01:27 +0100

Discussions were held with the patient's guardian outlining the clinical issues and the risks of additional ECT. The patient responded to eight subsequent ECT sessions administered with rocuronium, a nondepolarizing muscle relaxant. The authors provide a brief review of the diagnosis and treatment of catatonia and address issues surrounding ECT, cardiac effects, use of muscle relaxants, and the consent process. (Source: Am J Psychiatry)

ECT in the Treatment of a Patient With Catatonia: Consent and Complications.

The American Journal of Psychiatry — Mon, 01 Feb 2010 00:00:00 +0100

A tendency for re-offending in drug-facilitated crime

Forensic Science International — Mon, 01 Feb 2010 00:00:00 +0100

Abstract: The authors present 3 cases that demonstrate a return to DFC following periods of inactivity. The offences occurred in Paris and its suburbs and in each of the cases there were two distinct periods of activity by the offenders with 2, 8 and 22 victims attributed to each of the perpetrators.To 20mg of decontaminated and cut hair, 100pg/mg of clonazepam-d4 was added as internal standard. Hair specimens were extracted with CH2Cl2/ether after incubation overnight at 56°C in pH 7.6 buffer. Extractions were performed on blood and urine using Toxi-tube A® with 5ng/mL of clonazepam-d4. The residues were analyzed by LC–ESI-MS/MS. Calibration curves in blood and urine (0.5–500ng/mL) were prepared by spiking aliquots of blank fluids (r2>0.9816 for all drugs). LOD in body fluids ranged...

Treatment of Catatonia With Methylphenidate in an Elderly Patient With Depression [CASE REPORTS]

Psychosomatics — Fri, 29 Jan 2010 22:22:42 +0100

DISCUSSION: Methylphenidate may be effective as an adjunct in elderly depression patients with catatonia, as well as in medically ill, apathetic patients. However, there have been few attempts to study the role of psychostimulants in alleviating catatonia in general, or catatonia associated specifically with an underlying depressive disorder, even though catatonia is frequently associated with mood disorders. (Source: Psychosomatics)

Severe Lactic Acidosis After an Iatrogenic Propylene Glycol Overdose

Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy — Tue, 26 Jan 2010 00:00:00 +0100

We describe a 50-year-old man who experienced severe lactic acidosis after receiving an accidental overdose of lorazepam, which contains propylene glycol. The patient was acutely intoxicated, with a serum ethanol concentration of 406 mg/dl. He had choked on a large piece of meat and subsequently experienced pulseless electrical activity with ventricular fibrillation cardiac arrest. He was brought to the emergency department; within 2 hours, he was admitted to the intensive care unit for initiation of the hypothermia protocol. The patient began to experience generalized tonic-clonic seizures 12 hours later, which resolved after several boluses of lorazepam. A lorazepam infusion was started; however, it was inadvertently administered at a rate of 2 mg/minute instead of the standard rate of 2...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Psychotropic PRN use among older people's inpatient mental health services

Journal of Psychiatric and Mental Health Nursing — Wed, 20 Jan 2010 00:00:00 +0100

Concern has been expressed about the use of antipsychotic medicines with older people. Antipsychotics prescribed for pro re nata can cause high doses and polypharmacy. Pro re nata in these older people's services appeared to be used at lower doses and less frequently than reported in previous studies. More research is required to explore alternative non-pharmacological interventions. Concerns have been expressed about the use of antipsychotics with older people, particularly in those who have dementia. Pro re nata (PRN) psychotropic medications including antipsychotics are commonly used to manage disturbed and distressed behaviour. This audit aimed to understand the use of PRN psychotropic medications in older people's inpatient mental health services and the quality of prescriptions and n...

Memory in humans is unaffected by central H1-antagonism, while objectively and subjectively measured sedation is increased

European Neuropsychopharmacology — Mon, 18 Jan 2010 00:00:00 +0100

This study aimed to determine whether a centrally active antihistamine impairs memory performance and to dissociate such effects from sedation. Eighteen healthy volunteers received single oral doses of dexchlorpheniramine 4mg, lorazepam 1mg and placebo in a 3-way, double blind, crossover designed study. The active control lorazepam impaired episodic- and working memory performance and increased sedation, while dexchlorpheniramine only increased sedation. (Source: European Neuropsychopharmacology)

Efficacy of Sodium Valproate and Haloperidol in the Management of Acute Mania: A Randomized Open-Label Comparative Study.

The Journal of Clinical Pharmacology — Thu, 14 Jan 2010 00:00:00 +0100

This study was carried out to compare the efficacy of intravenous sodium valproate with intramuscular haloperidol in patients with acute mania. A total of 30 patients meeting DSM-IV criteria for acute manic episodes were enrolled. They were randomly assigned to 2 groups of 15 patients each. Both groups were treated twice daily with haloperidol (10 mg, intramuscular) and sodium valproate (500 mg, intravenous). The patients were assessed on days 1, 5, 9, and 13. Improvement in symptoms was assessed by reduction in the Young Mania Rating Scale (YMRS). Outcome criterions for analysis were latency of response and remission; additional drugs were required for sedation. At the end of the 2-week study period, overall response rate in both the groups was similar (P> .1). In comparison to haloper...

Benzodiazepines medazepam and midazolam are activators of pregnane X receptor and weak inducers of CYP3A4: Investigation in primary cultures of human hepatocytes and hepatocarcinoma cell lines.

Toxicology Letters — Thu, 14 Jan 2010 00:00:00 +0100

In conclusion, Alprazolam, Bromazepam, Chlordiazepoxide, Clonazepam, Diazepam, Lorazepam, Nitrazepam, Oxazepam, Tetrazepam and Triazolam can be considered as safe drugs in term of their inability to induce PXR- and AhR-dependent cytochrome P450 enzymes CYP1A2 and CYP3A4. Medazepam and Midazolam slightly activated pregnane X receptor and displayed weak potency to induce CYP3A4 mRNA in human hepatocytes. PMID: 20080160 [PubMed - as supplied by publisher] (Source: Toxicology Letters)

Recurrent opisthotonus in catatonia: An atypical presentation

Indian Journal of Medical Sciences — Tue, 12 Jan 2010 15:37:06 +0100

Manjunatha Narayana, Mehta Urvakhsh Meherwan, John PIndian Journal of Medical Sciences 2009 63(11):512-516Opisthotonus is known to occur in tetanus, rabies, cerebral malaria, neurosyphilis, acute cerebral injury and other medical conditions. Opisthotonus, so far, has not been reported in any major psychiatric disorder. Authors report a case of recurrent opisthotonus presenting concurrently with other catatonic signs which showed dramatic response to combination of lorazepam and electroconvulsive therapy (ECT). Clinicians should consider the possibility of catatonia in the differential diagnosis of opisthotonus since catatonia can be treated easily with benzodiazepines and ECT. (Source: Indian Journal of Medical Sciences)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Rupatadine: pharmacological profile and its use in the treatment of allergic rhinitis

Indian Journal of Otolaryngology and Head & Neck Surgery — Fri, 08 Jan 2010 21:33:59 +0100

Abstract Rupatadine is a once-daily, non-sedating, selective and long-acting new drug with a strong antagonist activity towards both histamine H1 receptors and platelet-activating factor receptors. The use of rupatadine is indicated in adult and adolescent patients (>12 years of age) suffering from intermittent and persistent allergic rhinitis. In the treatment of these conditions, rupatadine is at least as effective as ebastine, cetirizine, loratadine and desloratadine. Avery good safety profile of rupatadine has been evidenced in various studies, including a long-term (1-year) safety study. Rupatadine does not present drug-drug interactions with azithromycin, fluoxetine and lorazepam, but should not be administered concomitantly with known CYP3A4 inhibitors. Content...

EFNS guideline on the management of status epilepticus in adults

European Journal of Neurology — Wed, 30 Dec 2009 00:00:00 +0100

The objective of the current article was to review the literature and discuss the degree of evidence for various treatment strategies for status epilepticus (SE) in adults. We searched MEDLINE and EMBASE for relevant literature from 1966 to January 2005 and in the current updated version all pertinent publications from January 2005 to January 2009. Furthermore, the Cochrane Central Register of Controlled Trials (CENTRAL) was sought. Recommendations are based on this literature and on our judgement of the relevance of the references to the subject. Recommendations were reached by informative consensus approach. Where there was a lack of evidence but consensus was clear, we have stated our opinion as good practice points. The preferred treatment pathway for generalised convulsive status epil...

Lorazepam modulates orbitofrontal signal changes during emotional processing in catatonia

Human Psychopharmacology: Clinical and Experimental — Tue, 29 Dec 2009 00:00:00 +0100

Catatonia is a psychomotor syndrome characterized by concomitant emotional, behavioural and motor symptoms. In many cases clinical symptoms disappear almost immediately with administration of lorazepam, which acts on GABAA receptors.Using functional magnetic resonance imaging (fMRI) we investigated prefrontal activation patterns during emotion processing in catatonic patients with and without lorazepam in a double-blind study design. For emotional stimulation the International Affective Picture System (IAPS) was used. BOLD-signals were determined using regions of interest (ROI) and were statistically compared between groups.For negative emotional pictures lorazepam induced higher signal decreases in the orbitofrontal cortex (OFC) in catatonic patients than in healthy subjects resulting in ...

Acute Pharmaceutical Toxicity killed Brittany Murphy - Could it be killing millions more?

NaturalNews.com — Mon, 28 Dec 2009 07:00:00 +0100

(NaturalNews) The entire pharmaceutical industry is based on the idea that for whatever's wrong with you, there's a patented chemical pill that can make it better. Feeling some anxiety? There's a pill for that. Have high blood pressure? There's a pill for that, too. Suffering from sleepless nights? There's yet another pill for that, too.Importantly, modern medicine and the pharmaceutical industry both believe there is no limit to how many prescription medications you can simultaneously take. If you have ten health problems, they've got ten different pills for you. And when those pills cause twenty different dangerous side effects, they're ready for twenty more prescriptions for you to dutifully swallow.This idea that health is achieved by taking prescription chemicals is ludicrous from the...

Optimizing Emetic Control in Children Receiving Antineoplastic Therapy: Beyond the Guidelines.

Paediatric Drugs — Sat, 26 Dec 2009 13:08:08 +0100

Authors: Dupuis LL, Nathan PC Existing guidelines for the prevention of antineoplastic chemotherapy-induced nausea and vomiting (CINV) in children are constrained by the lack of robust evidence. Current guidelines recommend the use of a serotonin 5-HT(3) receptor antagonist plus a corticosteroid to prevent acute CINV. Consequently, antiemetic agents that are recommended for use in adult cancer patients do not appear in the current pediatric guidelines. In addition, there is no information to guide the selection of alternative antiemetic agents for children who either cannot receive the recommended agents or who do not respond adequately to the treatment. Possible barriers to adherence to the pediatric antiemetic selection guidelines that are currently available are discussed, and publi...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Enzyme-assisted synthesis and structural characterization of pure benzodiazepine glucuronide epimers.

European Journal of Pharmaceutical Sciences — Thu, 24 Dec 2009 00:00:00 +0100

Authors: Pallmann T, Jonas U, Wagner M, Thevis M, Kaeferstein H, Rothschild MA, Bender K The three hydroxybenzodiazepines oxazepam, temazepam, and lorazepam used for their anxiolytic, sedative, and anticonvulsant properties are metabolized by glucuronidation, which is the predominant pathway in the clearance mechanism of exogenous and endogenous substances during phase II metabolism. The aim of this study was the synthesis of benzodiazepine-O-glucuronides as analytical reference substances. All benzodiazepines are prescribed clinically as racemic formulations. The resulting conjugates from the coupling reactions with glucuronic acid are epimeric pairs of glucuronides. Due to the importance of stereochemical factors in drug disposition it is necessary to separate the diastereomeric form...

Cochrane review: Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children

Evidence-Based Child Health: A Cochrane Review Journal — Wed, 16 Dec 2009 00:00:00 +0100

Tonic-clonic (grand mal) convulsions and convulsive status epilepticus (currently defined as a grand mal convulsion lasting at least 30 minutes) are medical emergencies and demand urgent and appropriate anticonvulsant treatment. Benzodiazepines (midazolam, diazepam, lorazepam), phenobarbitone, phenytoin and paraldehyde may all be regarded as drugs of first choice. This is an update of a Cochrane review first published in 2002 and previously updated in 2005.To review the evidence comparing the efficacy and safety of midazolam, diazepam, lorazepam, phenobarbitone, phenytoin and paraldehyde in treating acute tonic-clonic convulsions and convulsive status epilepticus in children treated in hospital.We searched the Cochrane Epilepsy Group's Specialized Register (1st July 2007), the Cochrane Cen...

Catatonia: Clinical Aspects and Neurobiological Correlates [SPECIAL ARTICLES]

J Neuropsychiatry Clin Neurosci — Tue, 08 Dec 2009 16:47:33 +0100

Catatonia is a neuropsychiatric syndrome that can occur due to medical or psychiatric disorder. This review synthesizes over 20 years of original research and comprehensive review articles with attention to the most recent findings. Though catatonia is common and highly treatable, there have been few research studies investigating the syndrome. Pooled case reports suggest that catatonia due to an underlying general medical condition and catatonia due to a psychiatric illness can be treated similarly and that the catatonic symptoms and the underlying illness must be addressed in both types. Benzodiazepines and ECT continue to be mainstays of treatment. Evidence is mounting for the use of NMDA antagonists in catatonia refractory to lorazepam. (Source: J Neuropsychiatry Clin Neurosci)

Benzodiazepine Withdrawal

About.com Bipolar Disorder — Sun, 06 Dec 2009 00:00:00 +0100

One of our forum members, Bwaisley, posted about the difficulty of discontinuing Ativan, which is a benzodiazepine anti-anxiety medication: "I have been trying for months to get off Ativan. The best I can do is where I am right now on 0.5 mg a night. Whenever I try to reduce by a little bit, I spin into an anxiety attack. I've been on it for months. I even tried titrating off when my pdoc started titrating me onto Depakote ER. That didn't work. To top it off, every Sunday night I have to take 1 mg of Ativan because of the anxiety of starting a new work week. What the hell do I do now? I only want it for emergencies, but it won't let me. I feel trapped with no way out. Yuck!!!! Any suggestions?" I feel for Bwaisley. I went through benzodiazepine withdrawal myself, when I had to go off all...

A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder

Phytomedicine — Fri, 04 Dec 2009 00:00:00 +0100

In conclusion, our results demonstrate that silexan is as effective as lorazepam in adults with GAD. The safety of silexan was also demonstrated. Since lavender oil showed no sedative effects in our study and has no potential for drug abuse, silexan appears to be an effective and well tolerated alternative to benzodiazepines for amelioration of generalised anxiety. (Source: Phytomedicine)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

The toxicological challenges in the European research project DRUID

Forensic Science International Supplement Series — Fri, 27 Nov 2009 16:16:36 +0100

Abstract: Within the epidemiological studies of the integrated European research project DRUID (Driving Under the Influence of Drugs, alcohol and medicines), 13 laboratories from across Europe will analyse whole blood, oral fluid (OF) or urine from the general driving population and injured drivers. To ensure the comparability of toxicological results from the different studies, the collection of samples, analytical methods, target analytes and analytical cut-offs have been standardized for all laboratories involved.Target analytes were selected based on suspected impairing effects and prevalence. Twenty-three drugs are included in the ‘core list’ for which analysis is mandatory: ethanol, amphetamine, MDMA, MDA, MDEA, methamphetamine, cocaine, benzoylecgonine, THC, THC-COOH, 6-acetylmo...

The Homeopathic Preparation Nervoheel N can Offer an Alternative to Lorazepam Therapy for Mild Nervous Disorders

Evidence-based Complementary and Alternative Medicine — Tue, 24 Nov 2009 15:14:55 +0100

In an open-label, prospective non-randomized cohort study, we compared the effectiveness and tolerability profiles of the homeopathic remedy Nervoheel N with those of the benzodiazepine, lorazepam, in 248 patients with insomnia, distress, anxieties, restlessness or burnout and similar nervous conditions (‘mild nervous disorders’). Patients were treated with Nervoheel N or lorazepam at the recommended doses for a maximum of 4 weeks. Dose variations were allowed if in the patient's best interest. Treatment effects were evaluated by the practitioner in a dialogue with the patient at the start of treatment, after 2 weeks and after maximally 4 weeks of treatment. Tolerability data were recorded as adverse events. At baseline, lorazepam patients were on average slightly older and the...

Is This Really Weed?

PediatricEducation.org — Mon, 23 Nov 2009 00:01:36 +0100

Discussion Marijuana (Cannibis sativa) is the most common illicit drug abused in the United States, but is also used in certain circumstances for pain and anxiety control in patients with chronic disease. It is estimated that 102 million Americans (~40%) have used marijuana at some time in their lifetime. Children who use marijuana, especially at a younger age, are more likely to abuse other substances such as cocaine or heroine. Therefore patients using any illicit substance should be evaluated for additional substance abuse. Acute problems caused by marijuana include tachycardia, impaired coordination, increased respiratory illnesses, and problems with learning, memory and social behavior. Chronic abuse has been associated with anxiety, depression, schizophrenia and suicidal ideation. Ma...

Propylene Glycol Accumulation in Critically Ill Patients Receiving Continuous Intravenous Lorazepam Infusions(December).

The Annals of Pharmacotherapy — Tue, 17 Nov 2009 00:00:00 +0100

CONCLUSIONS: The continuous infusion rate and cumulative 24-hour lorazepam dose are strongly associated with and independently predict propylene glycol concentrations. Despite the absence of confirmed propylene glycol-associated adverse effects, clinicians should be aware that propylene glycol accumulation may occur with continuous-infusion lorazepam. PMID: 19920159 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

Mom Flies Over the Cuckoo’s Nest

Psychology Today Food and Diet Center — Sat, 07 Nov 2009 17:33:58 +0100

Several weeks ago my mother, in her eighth or ninth year of Alzheimer’s Disease, and 63rd year of marriage, began wielding knives and trying to stab people, verbally threatening to kill my father, throwing dangerous glass objects and screaming bloody murder at her own image in the mirror—“I DON’T WANT YOU HERE, GET OUT!!!” My brother and I finally intervened and had her temporarily hospitalized in a psychiatric ward, hoping we could buy more time for her at home through stabilizing her on the right meds, and getting Dad more help. We chose a modern, upscale hospital in a New Jersey suburb that came highly recommended, and where we had a personal connection with the presiding geriatric psychiatrist on the unit. My parents are fairly well off and ...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Topiramate overdose: A case report of a patient with extremely high topiramate serum concentrations and nonconvulsive status epilepticus

Epilepsia — Tue, 03 Nov 2009 00:00:00 +0100

We report the case of a 21-year-old man with idiopathic generalized epilepsy who ingested about 8,000 mg of topiramate (TPM) in a suicide attempt. On admission to the hospital he had a nonconvulsive status epilepticus and received 4 mg lorazepam i.v. He recovered rapidly despite an initial TPM concentration of 144.6 [mu]g/ml. To our knowledge, this is the first report of a patient who survived such a high TPM concentration. The case indicates that nonconvulsive status epilepticus could be a manifestation of TPM intoxication. (Source: Epilepsia)

What Evaluation is Appropriate for Complex Febrile Seizures?

PediatricEducation.org — Mon, 02 Nov 2009 00:23:48 +0100

Discussion Febrile seizures are the most common type of seizures in children. They affect about 2-5% of all children. Febrile seizures are characterized into two groups: simple febrile seizures and complex febrile seizures. Basically, if the child does not meet the criteria for a simple febrile seizure it is called a complex febrile seizure. The main characteristics are outlined below: Simple Febrile Seizure Complex Febrile Seizure Age 6-60 months < 6 months or > 60 months Duration < 15 minutes > 15 minutes Type Generalized Focal seizures tonic-clonic Tonic and/or clonic Partial seizure with/without generalization Head or eye deviation to one side Unilateral transient paralysis after seizure Loss of musc...

Lorazepam: Delirium and difficulty separating from the ventilator: case report

Reactions — Sat, 31 Oct 2009 14:02:00 +0100

(Source: Reactions)

The effects of lorazepam on extrastriatal dopamine D2/3-receptors—A double-blind randomized placebo-controlled PET study

Psychiatry Research: Neuroimaging — Fri, 30 Oct 2009 16:25:02 +0100

In conclusion, lorazepam decreased [11C]FLB 457 binding in frontal and temporal cortex, suggesting that cortical GABA–dopamine interaction may be involved in the central actions of lorazepam in healthy volunteers. The correlation between lorazepam-induced sedation and D2/D3 receptor binding potential (BP) change further supports this hypothesis. (Source: Psychiatry Research: Neuroimaging)

Caring for the Elderly in an Inpatient Setting: Managing Insomnia and Polypharmacy

Journal of Pharmacy Practice — Wed, 21 Oct 2009 00:17:20 +0100

This article addresses these concerns by highlighting key points from the available literature. Insomnia may be a problem in the elderly because of their increased sensitivity to changes in environment among other factors. First, obtain a sleep history and a comprehensive medical and medication history to identify the cause. Next, treat the underlying cause with nonpharmacological interventions to restore restful and qualitative sleep. When nonpharmacological interventions are not successful, pharmacological means are indicated. Remember to start low, go slow, and treat for a short duration of time (less than 4 weeks) to avoid withdrawal or rebound insomnia. First-line agents are trazodone, triazolam, temazepam, and lorazepam followed by zaleplon and zolpidem. As people age, it is common f...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Effects of Lorazepam and citalopram on human defensive reactions: ethopharmacological differentiation of fear and anxiety. - Perkins AM, Ettinger U, Davis R, Foster R, Williams SC, Corr PJ.

SafetyLit: All (Unduplicated) — Sun, 18 Oct 2009 14:10:10 +0100

Drugs that are clinically effective against generalized anxiety disorder preferentially alter rodent risk assessment behavior, whereas drugs that are clinically effective against panic disorder preferentially alter rodent flight behavior. The theoretical p... (Source: SafetyLit: All (Unduplicated))

Epilepsia partialis continua responsive to intravenous levetiracetam

Seizure: European Journal of Epilepsy — Fri, 16 Oct 2009 00:00:00 +0100

We report on a case of epilepsia partialis continua with rapid response to intravenous bolus administration of levetiracetam. A 60-year-old woman presented with continuous jerking of the right foot and hallux persisting for more than two days. She had a 9-year history of epilepsy due to a left temporoparietal oligodendroglioma with occasional focal seizures clinically presenting as speech arrest, which was treated with levetiracetam and oxcarbazepine administered orally. After hospital admission, the twitching of the foot and toe was refractory to add-on treatment with lorazepam and diazepam but stopped within 15min after intravenous bolus administration of 2000mg levetiracetam. This observation suggests that intravenous bolus administration of levetiracetam may be an effective therapeutic...

ATIVAN (Lorazepam) Injection, Solution [Baxter Healthcare Corporation]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Wed, 14 Oct 2009 05:00:00 +0100

Updated Date: Oct 14, 2009 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Review article: Convulsive and non-convulsive status epilepticus: An emergency medicine perspective

Emergency Medicine Australasia — Mon, 12 Oct 2009 23:00:00 +0100

Status epilepticus (SE) is divided into convulsive and non-convulsive types; both are associated with significant morbidity and mortality. Although convulsive SE is easily recognized, non-convulsive SE remains an elusive diagnosis as physical signs are varied and subtle. Successful management depends on a comprehensive approach that involves diagnostic testing and pharmacological interventions while ensuring cerebral oxygenation and perfusion at all times. There are a limited number of well-designed studies to support the development of evidence-based recommendations for the management of SE, especially for the management of non-convulsive status. Benzodiazepines, specifically lorazepam, continue to be the most commonly recommended first-line therapy; best treatment for refractory status c...

The Brown University Psychopharmacology Update — Mon, 05 Oct 2009 19:00:47 +0100

Study Examines Impact of Treatment on Prodromal Symptom Progression in YouthTargeted Naltrexone Reduces Alcohol Use Among Male Problem DrinkersRhabdomyolysis After Clozapine and Lithium TreatmentMetabolic Assessment of Adjunctive Aripiprazole in MDDCognitive Effects of Lorazepam in APOE [epsiv]4 CarriersProdromal Treatment StudiesElevated Rate of Adverse Events With QuetiapineA Case of Myopathy Associated With Valproic AcidNew Approvals: Saphris (Asenapine) for Schizophrenia, Bipolar DisorderNew Approval: Intuniv (Guanfacine) for ADHD (Source: The Brown University Psychopharmacology Update)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Lorazepam/olanzapine: Hypotension and unconsciousness: case report

Reactions — Wed, 30 Sep 2009 16:32:33 +0100

(Source: Reactions)

Translocator Protein Blockade Reduces Prostate Tumor Growth.

Clinical Cancer Research — Mon, 28 Sep 2009 23:00:00 +0100

CONCLUSION: These data suggest that blocking TSPO function in tumor cells induces cell death and denotes a survival role for TSPO in prostate cancer and provides the first evidence for the use of benzodiazepines in prostate cancer therapeutics. (Clin Cancer Res 2009;15(19):6177-84). PMID: 19789311 [PubMed - as supplied by publisher] (Source: Clinical Cancer Research)

Alcohol and drugs in suspected impaired drivers in Ontario from 2001 to 2005

Journal of Forensic and Legal Medicine — Fri, 25 Sep 2009 18:05:15 +0100

Conclusion: However, these data demonstrate that ‘‘drugged driving” does occur and that further, comprehensive investigation is needed to determine the frequency and type of drug use by Ontario drivers. (Source: Journal of Forensic and Legal Medicine)

Addiction is treatable

Psychology Today Addiction Center — Fri, 18 Sep 2009 20:16:20 +0100

Here we are deep in the middle of Recovery Month. As I’ve stated during the last couple of weeks, the whole purpose of Recovery Month is to focus on the fact that alcohol and drug addiction exists, and yet, it is very treatable. I think of Recovery Month as a time to showcase all of the great advances and treatments that have been discovered by scientific research over the last two decades. Why are these research findings important to promote? Because these scientific breakthroughs create a great deal of hope for the patients and families that this life-threatening disease affects. Just to make sure that you are aware of all of the Recovery Month activities in your area, here is the website that you can browse for activities both nationally and in your area (searchable ...

A clinical, radiological and outcome study of status epilepticus from India

Journal of Neurology — Wed, 16 Sep 2009 19:09:08 +0100

The objective of this study is to evaluate the clinical and radiological characteristics and the outcome of status epilepticus (SE). 117 consecutive patients with SE were evaluated including their demographics, history of epilepsy, antiepileptic drug (AED) default, comorbidities, SE type and duration. The study included 22 children, 77 adults and 18 elderly patients with SE. Blood counts, serum chemistry, ECG, cranial MRI, cerebrospinal fluid and EEG were done. Patients were treated with IV phenytoin, valproate, lorazepam or diazepam as per a fixed protocol and responses to first and second drugs were noted. Death during hospital was recorded. The etiology of SE was infection in 53.8%, drug default in 7.9%, metabolic in 14.5%, stroke in 12.8% and miscellaneous in 11% of patients. 92....

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Successful Use of Dexmedetomidine for Sedation in a 24-Week Gestational Age Neonate (October).

The Annals of Pharmacotherapy — Mon, 14 Sep 2009 23:00:00 +0100

CONCLUSIONS: Dexmedetomidine was an effective sedative and analgesic in a 24-week gestational age neonate treated for refractory agitation while on mechanical ventilation. Based on its documented efficacy for pain and sedation and its favorable adverse effect profile, dexmedetomidine warrants further study as first-line or adjunct therapy with narcotics for sedation in ventilated newborns. PMID: 19755621 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

Ativan (lorazepam) Injection - Revised SPC

NeLM - SPC Changes — Sun, 13 Sep 2009 23:00:00 +0100

Source: Manufacturer notification Area: Other Library Updates > SPC Changes Section 4.5 (interactions) has been updated. The following information is now included: Concomitant administration of lorazepam with valproate may result in increased plasma concentrations and reduced clearance of lorazepam. Lorazepam dosage should be reduced to approximately 50% when co-administered with valproate. Concurrent administration of lorazepam with probenecid may result in a more rapid onset or prolonged effect of lorazepam due to increased half lifee and decreased total clearance. Lorazepam dosage needs to be reduced by approximately 50% when co-administered with probenecid. Concomitant use of clozapine and lorazepam may produce marked sedation, excessive salivation and ataxia. Administration o...

Pharmacotherapy in pediatric critical illness: a prospective observational study.

Paediatric Drugs — Fri, 04 Sep 2009 16:22:02 +0100

Authors: McDonnell C, Hum S, Frndova H, Parshuram CS Pharmacotherapy is an under-evaluated element of critical care medicine. In order to better understand pharmacotherapy in pediatric critical illness, we evaluated a cohort of emergency admissions to a university-affiliated pediatric intensive care unit (PICU). A prospective, observational study was performed. Eligible patients were admitted to this medical-surgical ICU for at least 24 hours. The primary outcomes were the number of drug orders written, the number of different medications ordered, and the number of drug administrations. Multiple regression analyses were used to identify factors independently associated with each primary outcome. We studied 100 patients with a median age of 40 months (interquartile range [IQR] 9-82), wh...

Ativan - Lorazepam

About.com Bipolar Disorder — Tue, 01 Sep 2009 23:00:00 +0100

This article covers what Ativan is used for, warnings associated with the drug, major side effects, drug interactions, pregnancy and nursing, and withdrawal symptoms. (Source: About.com Bipolar Disorder)

[Haloperidol plus promethazine for agitated patients - a systematic review.]

Revista Brasileira de Psiquiatria — Mon, 31 Aug 2009 23:00:00 +0100

CONCLUSION: All treatments evaluated are effective, but this review provides compelling evidence as to clear advantages of the haloperidol plus promethazine combination. PMID: 19784494 [PubMed - in process] (Source: Revista Brasileira de Psiquiatria)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Jackson Autopsy Fingers Propofol, Lorazepam as Cause of Death

MedPage Today Product Alert — Fri, 28 Aug 2009 22:30:16 +0100

The Los Angeles County coroner's office has officially determined that pop music legend Michael Jackson died of an overdose involving multiple drugs, specifically propofol and lorazepam. (Source: MedPage Today Product Alert)

Propofol Plus Sedative Killed Michael Jackson

WebMD Health — Fri, 28 Aug 2009 22:10:30 +0100

Acute intoxication with the anesthetic propofol, coupled with the effect of the sedative drug Ativan, killed pop star Michael Jackson on June 25, the Los Angeles County Coroner's Office has announced. (Source: WebMD Health)

Propofol Plus Sedative Killed Michael Jackson

WebMD Health — Fri, 28 Aug 2009 05:00:00 +0100

Differential effects of lorazepam on sleep and activity in C57BL/6J and BALB/cJ strain mice.

Journal of Sleep Research — Thu, 27 Aug 2009 11:08:05 +0100

We examined the effects of two doses of lorazepam (0.5 and 1.5 mg kg(-1)) or saline alone (0.2 mL) on sleep and activity in C57BL/6 (n = 8) and BALB/c (n = 7) mice. Compared to saline, both doses of lorazepam significantly increased non-rapid eye movement (NREM) and reduced activity in both strains. In C57BL/6 mice, rapid eye movement (REM) was increased at both doses. In BALB/c mice, the 0.5 mg kg(-1) dose had no significant influence on REM, whereas REM was reduced significantly after the 1.5 mg kg(-1) dose. The results demonstrate significant differences between C57BL/6 and BALB/c mice in the effects of lorazepam on REM, whereas the effects on NREM and activity were similar. Strain differences in the number of BZ receptors in the amygdala, but not other brain regions, suggests possible ...

From Diseased towards Human Ease

Homoeopathic Links — Wed, 26 Aug 2009 11:54:57 +0100

Homoeopathic Links 2009; 22: 149-155DOI: 10.1055/s-0029-1185962SummaryA long-term difficult case involving multiple disease layers demonstrating clearly the need for a comprehensive case management approach and the use of more than one remedy. Treating episodic acute illness within the framework of chronic disease involves addressing the underlying miasmic influence. Different case management techniques and remedies illustrated, analyzed and compared. Appropriate usage of hand-triturated, high-potency (C 4, C 5) remedies. The treatment of addiction via the patient's trituration of the addictive substance (tautopathy). Following the sensation, the patient and the energy of the case to bring about a curative response. Remedies used include Falco-p, Merc, Ativan, Calc-p, Lac-h, an...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Jackson pleaded with doctor for powerful anesthetic, records show

Los Angeles Times - Science — Tue, 25 Aug 2009 07:00:00 +0100

The mixture of the sedatives Valium, lorazepam and midazolam, combined with propofol, was enough to kill the singer, a warrant affidavit unsealed Monday in Houston shows. A sleepless Michael Jackson spent his last hours pleading for a dose of a powerful anesthetic, his doctor told police, according to court records unsealed Monday. (Source: Los Angeles Times - Science)

New to forum, 3rd day on suboxone...

Suboxone Forum — Wed, 12 Aug 2009 23:22:00 +0100

Author: jamez70 Posted: Thu Aug 13, 2009 12:22 am Diary, I have had SEVERE SEVERE anxiety in my life. Let me try to describe it. Suddenly, out of nowhere, I have a severe panic attack without any real reason (no phobia). I try to go on.. That night, I have another one. I then become afraid to sleep in my bed, because I associate it with the panic attack. Then about 8 hours later, I have another one. Then I wonder "whats wrong with me? Do I have a tumor? Did I have a stroke?".. Then they keep coming and coming. Eventually, I enter a constant state of severe anxiety.. I sleep very little, and I stop eating. I get afraid to leave the house. Usually by that time, I seek out a psychiatrist, and I'm on the waiting list. TH...

Catatonic syndrome associated with lead intoxication: a case report

Cases Journal — Mon, 10 Aug 2009 23:00:00 +0100

Conclusion: Possibly, lead intoxication results in changes in neurotransmitter system that leads to catatonia. Lorazepam improves patient's condition through changes in this system. (Source: Cases Journal)

Lorazepam/temazepam: Sleep apnoea syndrome and respiratory insufficiency: case report

Reactions — Mon, 10 Aug 2009 10:20:04 +0100

(Source: Reactions)

Successful treatment for refractory convulsive status epilepticus by parenteral lacosamide

Epilepsia — Fri, 07 Aug 2009 23:00:00 +0100

We report a case of refractory convulsive status epilepticus (CSE) that was successfully controlled with lacosamide. The 38-year-old male patient was admitted for a series of complex partial seizures with secondary generalization leading to refractory CSE. During the transport to the hospital the patient was given 22.5 mg diazepam, 12.5 mg etomidate, and 5 mg midazolam without success. An additional dose of 4 mg lorazepam and a dose of 1,500 mg levetiracetam after admission were yet without clinical effect. A further treatment with lacosamide (300 mg via percutaneous gastric fistula) resulted in complete clinical remission of the epileptic activity within 30 min. The application of lacosamide resulted in cessation of CSE and was well tolerated. To our knowledge, this is the first case of s...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Major issue, plz help!

Suboxone Forum — Fri, 31 Jul 2009 00:18:00 +0100

Author: MACKENZY3376 Posted: Fri Jul 31, 2009 1:18 am DUDE!!! u cant do this alone all by urself. from my experience if i had been alone i would have killed myself. pleeease if nothing else-cant you go to a hospital or something? im not familiar with where you are or how in general the healthcare is and this might sound childish but if nothing else i would go to a hospital and tell them if they dont help you that you think you might commit suicide. you need help and i always try to put myself in the others shoes and if i didnt have the help from my parents or anyone else, i think i would have to go to that extreme. i can hardly imagine being in a foreign country and feeling that desperate, helpless and alone but i have no idea what ...

Evaluation of Adult Outpatient Magnetic Resonance Imaging Sedation Practices: Are Patients Being Sedated Optimally?

Canadian Association of Radiologists Journal — Thu, 30 Jul 2009 23:00:00 +0100

Conclusions: Many outpatients in MRI centres may be scanned before the peak effect of anxiolytics prescribed. A standard sedation protocol in such centres is associated with a more appropriate drug choice, as well as optimized monitoring and postprocedure care.Abrégé: But: Examiner l'utilisation d'anxiolytiques chez les patients adultes externes de centres d'imagerie par résonance magnétique afin de déterminer s'ils sont administrés de façon optimale eu égard à l'action des médicaments, au prescripteur des médicaments ainsi qu'au type de suivi postadministration.Matériel et méthodes: Les données sur l'utilisation, par les radiologistes, d'agents anxiolytiques sur des patients adultes externes devant subir des examens d'IRM ont été extraites de questionnaires en version papi...

Gabapentin Therapy for Pain and Irritability in a Neurologically Impaired Infant

Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy — Mon, 27 Jul 2009 23:00:00 +0100

We describe a 39-week gestational age, male infant with hypotonicity, functional short gut, and microduplication of chromosome 22 who was treated with gabapentin to control pain and irritability. During his hospitalization, the infant experienced multiple complications including respiratory distress, persistent pulmonary hypertension of the newborn, hypocalcemia, hypoglycemia, hyperbilirubinemia, gastroesophageal reflux, necrotizing enterocolitis, and cholestatic jaundice. Pain associated with related invasive procedures and surgeries was treated with intermittent and scheduled morphine. In addition to postoperative and procedural pain, the infant continued to experience pain and irritability attributed to neurologic impairment, presumably secondary to his chromosomal abnormality. Trials o...

Magnitude of potentially inappropriate prescribing in Germany among older patients with generalized anxiety disorder

BMC Geriatrics — Sun, 26 Jul 2009 23:00:00 +0100

Conclusions: GPs in Germany often prescribe medications that have been designated as potentially inappropriate to their elderly patients with GAD--especially those with comorbid depressive disorders. Further research is needed to ascertain whether there are specific subgoups of elderly patients with GAD for whom the benefits of these medications outweigh their risks. (Source: BMC Geriatrics)

Ativan (lorazepam) injection - Revised SPC

NeLM - SPC Changes — Sun, 26 Jul 2009 23:00:00 +0100

Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Section 4.4 (special warnings and precautions for use) had been updated with the following information: The use of benzodiazepines, including lorazepam, may lead to physical and psychological dependence. Severe anaphylactic/anaphylactoid reactions have been reported with the use of benzodiazepines. Cases of angioedema involving the tongue, glottis or larynx have been reported in patients after taking the first or subsequent doses of benzodiazepines. Some patients taking benzodiazepines have had additional symptoms such as dyspnoea, throat closing, or nausea and vomiting. Some patients have required medical therapy in the emergency department. If angioedema involves the tongue, glottis or larynx, ai...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Going off Meds, Part 1

About.com Bipolar Disorder — Fri, 24 Jul 2009 23:00:00 +0100

From June to late August of 2005 I tapered off all of my bipolar disorder medications - Zyprexa, Topamax, Trazodone, Prozac / Celexa, Ativan, Gabitril and Wellbutrin. This is the first of three articles telling why I decided to do this and how the process unfolded through an episode of agitated depression coupled with serious back pain. (Source: About.com Bipolar Disorder)

The pharmacokinetic and pharmacodynamic effects of SL65.1498, a GABA-A 2,3 selective agonist, in comparison with lorazepam in healthy volunteers

Journal of Psychopharmacology — Tue, 21 Jul 2009 23:00:00 +0100

This study was a double-blind, five-way cross-over study to investigate the effects of three doses of SL65.1498 in comparison with placebo and lorazepam 2 mg in healthy volunteers. The objective was to select a dose level (expected to be therapeutically active), free of any significant deleterious effect. Psychomotor and cognitive effects were measured using a validated battery of measurements, including eye movements, body sway, memory tests, reaction-time assessments, and visual analogue scales. The highest dose of SL65.1498 showed slight effects on saccadic peak velocity and smooth pursuit performance, although to a much lesser extent than lorazepam. In contrast to lorazepam, none of the SL65.1498 doses affected body sway, visual analogue scale alertness, attention, or memory tests. Thi...

[Epileptic seizures in critically ill patients]

Medicina (Kaunas) — Sun, 19 Jul 2009 00:36:02 +0100

Authors: Stasiukyniene V, Pilvinis V, Reingardiene D, Janauskaite L THE AIM OF THIS ARTICLE: To review the causes, clinical signs, pathophysiology, consequences, and treatment of seizures and status epilepticus in critically ill patients. Only 25% of people, who have seizures and status epilepticus, have epilepsy as well. In the intensive care settings, seizures and status epilepticus are a common neurologic complication, which is attributable to primary neurologic pathology (stroke, hemorrhage, tumor, central nervous system infection, head trauma) or secondary to critical illness (anoxic brain damage, intoxications, metabolic abnormalities) and clinical management. There are three main subtypes of status epilepticus in intensive care units: generalized convulsive status epilepticus, f...

The Mothers Act Disease Mongering Campaign - Part I

NaturalNews.com — Thu, 16 Jul 2009 07:00:00 +0100

(NaturalNews) The Mothers Act represents the ultimate example of disease mongering at its worst because the eight-year attempt to pass this federal legislation has evolved into profiteering never before exhibited so conspicuously.Disease mongering "is the selling of sickness that widens the boundaries of illness and grows the markets for those who sell and deliver treatments," according to Ray Moyniahan and David Henry in the April 11, 2006 paper in PLoS Med, titled, "The Fight against Disease Mongering." "It is exemplified most explicitly by many pharmaceutical industry -- funded disease-awareness campaigns -- more often designed to sell drugs than to illuminate or to inform or educate about the prevention of illness or the maintenance of health," the authors explain. "Drug companies are ...

Plasma tryptophan and tyrosine levels are independent risk factors for delirium in critically ill patients

Intensive Care Medicine — Thu, 09 Jul 2009 12:34:02 +0100

Conclusions In this pilot study, plasma tryptophan/LNAA and tyrosine/LNAA ratios were associated with transition to delirium in MV patients, suggesting that alterations of amino acids may be important in the pathogenesis of ICU delirium. Future studies evaluating the role of amino acid precursors of neurotransmitters are warranted in critically ill patients. Content Type Journal ArticleCategory OriginalDOI 10.1007/s00134-009-1573-6Authors P. P. Pandharipande, Vanderbilt Medical Center Division of Critical Care Medicine, Department of Anesthesiology 526 MAB, 1211 21st Avenue South Nashville TN 37212 USAA. Morandi, Vanderbilt Medical Center Center for Health Services Research Nashville TN USAJ. R. Adams, Vanderbilt University School of Medicine Nashville TN USAT. D. Gir...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

My journey to sobriety

Suboxone Forum — Wed, 08 Jul 2009 23:38:00 +0100

Author: Unsponsored Posted: Thu Jul 09, 2009 12:38 am Hello, I'm 23 years old and discovered oc , and binged for 8 months : 160mg- 320 mg OC a day. I believed that I could quit cold turkey in January but it was too hard with work and school.. So I decided to go on suboxone, which I have been taking for about 6 months. I am tapering off pretty quickly actually and it has been working out nicely. week 1 - 1.5 mg -> 1mg, gradual reduction (each pill slightly smaller than the other) week 2 - 1 mg - stabilize week 3 - 0.75 - >0.5 mg gradual reduction(each pill slightly smaller than the other) week 4 - 0.5 for 3 days, 0.25 - 5 days (Currently at this step) Week 5 - Stop 7/10 The most of my withdrawal symptoms have been malaise, ...

Altering Intensive Care Sedation Paradigms to Improve Patient Outcomes

Critical Care Clinics — Tue, 30 Jun 2009 23:00:00 +0100

Providing sedation and comfort for intensive care patients has evolved in the last few years. New approaches to improving outcomes for intensive care unit (ICU) patients include providing analgesia before adding sedation and recognizing dangerous adverse effects associated with sedative medications, such as prolonged effects of midazolam, propylene glycol toxicity with lorazepam, propofol infusion syndrome, the deliriogenic effects of benzodiazepines and propofol, and bradycardia with dexmedetomidine. There are now reliable and valid ways to monitor pain and delirium in ICU patients. Dexmedetomidine reduces the incidence of delirium, reduces the duration of mechanical ventilation, and appears to be cost effective. (Source: Critical Care Clinics)

Chronic gamma-hydroxybutyric-acid use followed by gamma-hydroxybutyric-acid withdrawal mimic schizophrenia: a case report

Cases Journal — Tue, 30 Jun 2009 23:00:00 +0100

Conclusions: In our opinion, this original case illustrates the importance of considering gammahydroxybutyric- acid withdrawal delirium in the differential diagnosis of a first-break psychosis. In this case, the effects of chronic GHB use were incorrectly identified as the negative symptoms of schizophrenia prodrome. Likewise, severe gamma-hydroxybutyric-acid withdrawal syndrome was initially mistaken for acute positive symptoms of schizophrenia, until autonomic dysfunction manifested itself more clearly. (Source: Cases Journal)

Catatonia: a syndrome appears, disappears, and is rediscovered.

Canadian Journal of Psychiatry — Tue, 30 Jun 2009 23:00:00 +0100

Authors: Fink M Catatonia is the psychiatric syndrome of disturbed motor functions amid disturbances in mood and thought first described in 1874. It was quickly found in 10% to 38% of psychiatric populations. After it was tied to schizophrenia as a type in the psychiatric classification, its recognition became increasingly limited and by the 1980s questions were asked as to where the catatonics had gone. The decline is largely owing to the change in venue for psychiatric practice from asylum to office, the rejection of physical examination, and the dependence on item rating scales for diagnosis. In the 1970s, broad surveys again showed that catatonia was as common as before among patients with mania and depression, and as a toxic response to neuroleptic drugs. The latter recognition, t...

A Case of Alcohol Withdrawal Requiring 1,600 mg of Lorazepam in 24 Hours.

CNS Spectrums — Tue, 30 Jun 2009 23:00:00 +0100

Authors: Kahn DR, Barnhorst AV, Bourgeois JA Alcohol withdrawal continues to present significant morbidity and mortality in hospitalized medical/surgical patients. The authors present a case of a patient with delirium tremens requiring up to 1,600 mg/day of lorazepam and discuss alternative treatments for alcohol withdrawal. PMID: 19773714 [PubMed - in process] (Source: CNS Spectrums)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

[CASE REPORTS] Recurring Episodes of Bell's Mania After Cerebrovascular Accident

Psychosomatics — Mon, 29 Jun 2009 23:00:00 +0100

DISCUSSION: Failure to recognize this patient’s syndrome as a form of catatonia could have had severe, even life-threatening, consequences. The use of neuroleptic medications in cases of delirium/mania with catatonic signs may result in marked clinical deterioration, whereas high-dose lorazepam can ameliorate catatonic signs. (Source: Psychosomatics)

From Diseased towards Human Ease

Homoeopathic Links — Thu, 25 Jun 2009 07:29:11 +0100

Homoeopathic Links 2009; 22: 86-92DOI: 10.1055/s-0029-1185585SummaryLong-term difficult case involving multiple disease layers demonstrating clearly the need for a comprehensive case management approach and the use of more than one remedy. Treating episodic acute illness within the framework of chronic disease involves addressing the underlying miasmic influence. Different case management techniques and remedies illustrated, analyzed and compared. Appropriate usage of hand-triturated, high-potency (C4, C5) remedies. The treatment of addiction via the patient's trituration of the addictive substance (tautopathy). Following the sensation, the patient, and the energy of the case to bring about a curative response. Remedies used include Falco-p, Merc, Ativan, Calc-p, Lac-h, and Umbilical cord....

Digest

Progress in Neurology and Psychiatry — Tue, 23 Jun 2009 23:00:00 +0100

Safety of ramelteonThere is great interest in the role of melatonin agonists as treatments for insomnia. Ramelteon is already available in the USA, where it is used to reduce sleep latency associated with primary insomnia. Licensing in Europe has been delayed after the European Medicines Agency questioned its efficacy. Two studies now report on the safety of ramelteon over one year.The first study enrolled 1213 adults taking ramelteon 16mg (18-64 year age group) or 8mg (over-65 years) and were considered compliant if they took it at least three nights per week (J Clin Psychiatry 2009; pii:ej07m03834). In the younger group taking 16mg, 51 per cent discontinued treatment within six months and 62 per cent within 48 weeks; in the older group taking 8mg, the figures were 49 per cent and 58 per ...

Role of Intravenous Levetiracetam in Acute Seizure Management of Children

Pediatric Neurology — Wed, 17 Jun 2009 03:33:10 +0100

Status epilepticus is defined as a seizure lasting beyond 30minutes. Children with intractable epilepsy undergo frequent hospital admissions secondary to status epilepticus or because of acute exacerbation of seizures. Intravenous levetiracetam became available in August 2006 for use in patients aged above 16 years. There are insufficient data about the efficacy and safety of intravenous levetiracetam in children. We retrospectively analyzed data from children treated with intravenous levetiracetam for status epilepticus and acute exacerbation of seizures. We acquired data from our institution's electronic medical records concerning patients with status epilepticus and acute exacerbation of seizures who received intravenous levetiracetam. Thirty-two patients (age range, 2 months to 18 year...

Concomitant treatment with voriconazole and benzodiazepines like temazepam and lorazepam may lead to decreased serum voriconazole concentrations

Reactions — Tue, 02 Jun 2009 22:36:40 +0100

(Source: Reactions)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest

Neurology — Mon, 01 Jun 2009 04:00:00 +0100

Conclusions: EEG monitoring in children undergoing therapeutic hypothermia after cardiac arrest is safe and feasible. Electrographic seizures and status epilepticus are common in this setting but are often not detectable by clinical observation alone. The EEG background often evolves over time, with milder abnormalities improving and more severe abnormalities worsening. BS = burst suppression; CA = cardiac arrest; CPR = cardiopulmonary resuscitation; DD = developmental delay; FEN = fentanyl; FOS = fosphenytoin; HIE = hypoxic ischemic encephalopathy; LEV = levetiracetam; LZP = lorazepam; MDZ = midazolam; NCS = nonconvulsive seizures; NCSE = nonconvulsive status epilepticus; NPV = negative predictive value; PB = phenobarbital; PED = periodic epileptiform discharge; PICU = pediatric intensive...

Selection of My Twitter Favorites, Edition 64

Clinical Cases and Images — Sun, 31 May 2009 11:04:00 +0100

Twitter is a microblogging service where people answer the question "What are you doing?" via 140-character messages from their cellphone, laptop or desktop. You can select the messages (called "tweets") that you find interesting, useful, amusing, or disagreeable. Here is the 64th edition of My Twitter Favorites (the oldest post is at the bottom, the newest at the top): Micro-blogging on Twitter is easy, fun and can be very useful and educational if you follow/subscribe to interesting people. You can read more here: A Doctor's Opinion: Why I Started Microblogging on Twitter and visit my account at Twitter/AllergyNotes.bencasnocha Reading blogs/ RSS is a better use of time than reading Twitter. In gen'l the most interesting thinkers are blogging more than twittering. 5:43 PM May 26th from T...

Concomitant treatment with voriconazole and benzodiazepines like temazepam and lorazepam may lead to decreased serum voriconazole concentrations,.

Reactions Weekly — Sat, 30 May 2009 15:31:34 +0100

Page: 3 (Source: Reactions Weekly)

Neonatal allopregnanolone increases novelty-directed locomotion and disrupts behavioural responses to GABA(A) receptor modulators in adulthood.

International Journal of Developmental Neuroscience — Tue, 26 May 2009 23:00:00 +0100

Authors: Darbra S, Pallarès M Recent findings indicate that neurosteroids could act as important modulators during brain development. The aim of the present work is to screen whether developmentally altered AlloP levels may have long-lasting effects on behaviour and influence the emotional response to several GABA(A) receptor modulating drugs in adulthood. Acute allopregnanolone administration (10mg/kg) in the fifth postnatal day: (1) provoked long-term effects, as an increase of the novelty-directed locomotor activity and a decrease of its habituation in the open field in adult rats; (2) altered GABA(A) receptor response in adulthood, as reflected by the disruption of the effects of midazolam (1mg/kg) and flumazenil (10mg/kg) on the locomotor habituation in adulthood. Whereas the...

A Double-Blind Trial of Gabapentin Versus Lorazepam in the Treatment of Alcohol Withdrawal

Alcoholism: Clinical and Experimental Research — Tue, 26 May 2009 04:00:00 +0100

Conclusions: Gabapentin was well tolerated and effectively diminished the symptoms of alcohol withdrawal in our population especially at the higher target dose (1200 mg) used in this study. Gabapentin reduced the probability of drinking during alcohol withdrawal and in the immediate postwithdrawal week compared to lorazepam. (Source: Alcoholism: Clinical and Experimental Research)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

A Double-Blind Trial of Gabapentin Versus Lorazepam in the Treatment of Alcohol Withdrawal.

Alcoholism, Clinical and Experimental Research — Mon, 25 May 2009 23:00:00 +0100

Conclusions: Gabapentin was well tolerated and effectively diminished the symptoms of alcohol withdrawal in our population especially at the higher target dose (1200 mg) used in this study. Gabapentin reduced the probability of drinking during alcohol withdrawal and in the immediate postwithdrawal week compared to lorazepam. PMID: 19485969 [PubMed - as supplied by publisher] (Source: Alcoholism, Clinical and Experimental Research)

When Your Toilet is Your Best Friend...

About.com Cervical Cancer — Fri, 22 May 2009 04:00:00 +0100

How Ativan can help reduce chemo related nausea and vomiting If you are going through chemotherapy and are nauseas and vomiting, you have my sympathy! It is miserable when you feel... (Source: About.com Cervical Cancer)

Oral administration of analgesia and anxiolysis for pain associated with bone marrow biopsy

Supportive Care in Cancer — Wed, 20 May 2009 06:21:09 +0100

Conclusions An oral administration of prophylactic regimen of analgesia and anxiolysis, at the above-mentioned doses, produced a statistically significant reduction of the perception of pain in patients undergoing BMAB, but its effect did not seem to provide a major and clinically significant reduction of pain level. Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s00520-009-0652-0Authors Giampaolo Talamo, Penn State Milton S. Hershey Cancer Institute 500 University Dr Hershey PA 17033 USAJason Liao, Penn State Milton S. Hershey Cancer Institute 500 University Dr Hershey PA 17033 USAMichael G. Bayerl, Penn State Milton S. Hershey Medical Center Department of Pathology 500 University Drive Hershey PA 17033 USADavid F. Claxton, Penn State Milton S. Hers...

Interactions of Valeriana officinalis L. and Passiflora incarnata L. in a patient treated with lorazepam

Phytotherapy Research — Wed, 13 May 2009 04:00:00 +0100

There is an increasing interest in the health risks related to the use of herbal remedies. Although most consumers think that phytomedicines are safe and without side effects, interactions between complementary alternative and conventional medicines are being described. The aim of this clinical case report is to highlight the importance of the safe use of herbal remedies by providing a clinical interaction study between pharmaceutical medicines and herbal medicinal products. The case of a patient self-medicated with Valeriana officinalis L. and Passiflora incarnata L. while he was on lorazepam treatment is described. Handshaking, dizziness, throbbing and muscular fatigue were reported within the 32 h before clinical diagnosis. The analysis of family medical history ruled out essential trem...

Palliative cancer care - nausea and vomiting - Nausea and vomiting - management

Mon, 11 May 2009 12:03:55 +0100

Published 18th Oct 2007. This record contains the following: * Clinical summary: Nausea and vomiting - management o What simple measures may help nausea and vomiting in palliative care? o How should I manage nausea and vomiting of known cause? o How should I manage nausea and vomiting of unknown cause? o What should I do if a first-line anti-emetic has not worked? * Prescriptions o Cyclizine (oral or parenteral) o Haloperidol (oral or parenteral) o Metoclopramide or domperidone (oral, rectal, or parenteral) o Levomepromazine (oral or parenteral) o Dexamethasone (oral): IF raised intracranial pressure o Anti-secretory: hyoscine butylbromide (parenteral) o Lorazepam to relieve anxiety (Source: Gastroenterology and Liver Diseases Sp...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Treatment of catatonic schizophrenia with lorazepam and aripiprazole

Schizophrenia Research — Sun, 03 May 2009 23:00:00 +0100

The catatonic subtype of schizophrenia affects approximately 10% of patients with schizophrenia () and is classically characterized by extreme negative symptoms such as mutism, immobility or posturing, and stupor. Published works to date demonstrate variable successes with benzodiazepines (), clozapine, ECT, and NMDA antagonists (). Typically, use of antipsychotics leads to worsening of catatonia, likely due to the dopaminergic blockade exerted, making the partial dopamine agonist aripiprazole a treatment strategy of interest, especially in patients with prominent negativistic catatonia. (Source: Schizophrenia Research)

Variation in glucuronidation of lamotrigine in human liver microsomes.

Xenobiotica — Thu, 30 Apr 2009 23:00:00 +0100

Authors: Argikar UA, Remmel RP Lamotrigine (LTG), a diaminotriazine anti-epileptic, is principally metabolized at the 2-position of the triazine ring to form a quaternary ammonium glucuronide (LTGG) by uridine glucuronosyl transferease (UGT) 1A3 and UGT1A4. It has been hypothesized that glucuronidation of anti-epileptic drugs is spared with age, despite a known decrease in liver mass, based on older studies with benzodiazepines such as lorazepam. To examine this, the formation rates of LTGG formation were measured by liquid chromatography-mass spectrometry (LC-MS) in a bank of human liver microsomes (HLMs) obtained from younger and elderly donors at therapeutic concentrations. The formation rate of LTGG was not significantly different in HLMs obtained from younger and elderly subjects....

Going Off Meds - Part 3

About.com Bipolar Disorder — Sun, 26 Apr 2009 04:00:00 +0100

I had just 3 medications left to get out of my system - Wellbutrin, Gabitril and Ativan - generic name Lorazepam. So far the process hadn't been too difficult, but when I cut my Ativan dose down, it was like being run over by a truck. (Source: About.com Bipolar Disorder)

Solubility of Chlordiazepoxide, Diazepam, and Lorazepam in Ethanol + Water Mixtures at 303.2 K

Journal of Chemical and Engineering Data — Wed, 22 Apr 2009 13:05:48 +0100

Journal of Chemical & Engineering Data, Volume 0, Issue 0, Articles ASAP (As Soon As Publishable). (Source: Journal of Chemical and Engineering Data)

Judge: Excess Policy Requires Reimbursement Of Defense Costs For Drug Claims

LexisNexis® Mealey's™ Emerging Drugs & Devices Legal News — Sat, 18 Apr 2009 04:59:20 +0100

NEW YORK - A New York federal magistrate judge ruled March 31 that an excess insurer has a duty to reimburse defense costs associated with foreign lawsuits relating to the manufacture and sale of Wyeth's Ativan anxiety drug (Allstate Insurance Co. v. American Home Products Corp., No. 01 Civ. 10715, S.D. N.Y.). Full story on lexis.com (Source: LexisNexis® Mealey's™ Emerging Drugs & Devices Legal News)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Intranasal Delivery of Antiepileptic Medications for Treatment of Seizures

Neurotherapeutics — Wed, 01 Apr 2009 04:00:00 +0100

Summary: Acute isolated seizure, repetitive or recurrent seizures, and status epilepticus are all deemed medical emergencies. Mortality and worse neurologic outcome are directly associated with the duration of seizure activity. A number of recent reviews have described consensus statements regarding the pharmacologic treatment protocols for seizures when patients are in pre-hospital, institutional, and home-bound settings. Benzodiazepines, such as lorazepam, diazepam, midazolam, and clonazepam are considered to be medications of first choice. The rapidity by which a medication can be delivered to the systemic circulation and then to the brain plays a significant role in reducing the time needed to treat seizures and reduce opportunity for damage to the CNS. Speed of delivery, particularly ...

191: Metabolic Acidosis, Hyperosmolaity, and Acute Kidney Injury Associated With Propylene Glycol Toxicity Secondary to Lorazepam Infusion

American Journal of Kidney Diseases — Sat, 28 Mar 2009 04:08:17 +0100

(Source: American Journal of Kidney Diseases)

Neuroleptic Malignant Syndrome Secondary to Quetiapine (April).

The Annals of Pharmacotherapy — Wed, 18 Mar 2009 04:00:00 +0100

CONCLUSIONS: NMS with associated EPS has been previously associated with quetiapine. Clinicians should be aware that NMS with EPS can occur with quetiapine at steady state doses without recent dosage adjustments or titration. PMID: 19299325 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

Lorazepam versus diazepam-phenytoin combination in the treatment of convulsive status epilepticus in children: A randomized controlled trial.

European Journal of Paediatric Neurology — Mon, 16 Mar 2009 04:00:00 +0100

CONCLUSION: Lorazepam is as efficacious and safe as diazepam-phenytoin combination. We recommend use of lorazepam as a single drug to replace the two drug combination of diazepam-phenytoin combination to control the initial seizure in pediatric convulsive status epilepticus. PMID: 19297221 [PubMed - as supplied by publisher] (Source: European Journal of Paediatric Neurology)

“Stat” Medication Administration Predicts Hospital Discharge

Psychiatric Quarterly — Sat, 14 Mar 2009 12:13:25 +0100

Conclusions “Stat” medications are commonly used. The use of “agitation stat” medications can be used as a proxy for clinical stability and may prove to be a useful outcome measure for future pharmacoepidemiologic studies of comparative medication effectiveness. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s11126-009-9097-3Authors Ari Jaffe, Nathan S Kline Institute for Psychiatric Research 140 Old Orangeburg Road Orangeburg NY 10962 USAJerome Levine, Nathan S Kline Institute for Psychiatric Research 140 Old Orangeburg Road Orangeburg NY 10962 USALeslie Citrome, Nathan S Kline Institute for Psychiatric Research 140 Old Orangeburg Road Orangeburg NY 10962 USA Journal Psychiatric QuarterlyOnline ISSN 1573-6709Print ISSN 0033-2720 (Source: Psychiatric Qu...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Anxiety Medications

About.com Mental Health — Sat, 14 Mar 2009 04:00:00 +0100

Antianxiety medications help to calm and relax the anxious person and remove the troubling symptoms. There are a number of antianxiety medications currently available. The preferred medications for most anxiety disorders are the benzodiazepines such as Valium, Xanax/Zanex, and Ativan. (Source: About.com Mental Health)

Medications for Anxiety

About.com Mental Health — Sat, 14 Mar 2009 04:00:00 +0100

Medications for anxiety benzodiazepines clonazepam Klonopin alprazolam Xanax diazepam Valium lorazepam Ativan buspirone buspar propranolol Inderal Inderide (Source: About.com Mental Health)

Conventional intramuscular sedatives versus ziprasidone for severe agitation in adolescents: case-control study

Child and Adolescent Psychiatry and Mental Health — Thu, 12 Mar 2009 04:00:00 +0100

Conclusion: In this study, IM ziprasidone appeared effective, well tolerated, and similar in clinical profile to combined conventional IM medications for treating severe agitation in adolescents. Given the reportedly favorable acute side effect profile of parenteral atypical agents, they may provide an alternative to conventional antipsychotics for treating acute agitation in both adult and adolescent populations. Future randomized, controlled studies are needed. (Source: Child and Adolescent Psychiatry and Mental Health)

Expression levels of the alpha4 subunit of the GABA(A) receptor in differentiated neuroblastoma cells are correlated with GABA-gated current.

Neuropharmacology — Tue, 10 Mar 2009 04:00:00 +0100

Authors: Zhou X, Smith SS The alpha4 subunit of the GABA(A) receptor (GABAR) is capable of rapid plasticity, increased by chronic exposure to positive GABA modulators, such as the neurosteroid 3alpha-OH-5alpha[beta]-pregnan-20-one (THP). Here, we show that 48 h exposure of differentiated neuroblastoma cells (IMR-32) to 100 nM THP increases alpha4 expression, without changing the current density or the concentration-response curve. Increased expression of alpha4-containing GABAR was verified by a relative insensitivity of GABA (EC(20))-gated current to modulation by the benzodiazepine (BZ) lorazepam (0.01 - 100 muM), and potentiation of current by flumazenil and RO15-4513, characteristic of alpha4betagamma2 pharmacology. In contrast to THP, compounds which decrease GABA-gated current, s...

Ativan Information

About.com Cervical Cancer — Sat, 07 Mar 2009 05:00:00 +0100

If you are experiencing nausea and vomiting during chemotherapy sessions, your doctor may prescribe Ativan, a anti-anxiety medication that also helps with nausea/vomiting. (Source: About.com Cervical Cancer)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Lorazepam

About.com Breast Cancer — Sat, 07 Mar 2009 05:00:00 +0100

Ativan (lorazepam) is an anti-anxiety medication sometimes used to control nausea and vomiting. (Source: About.com Breast Cancer)

Ativan Side Effects

About.com Bipolar Disorder — Sat, 07 Mar 2009 05:00:00 +0100

Catalogue of side effects for the medication Ativan - generic Lorazepam - which is an antianxiety medication and also a mild tranquilizer and sedative. This prescription drug may be used in the treatment of bipolar disorder. (Source: About.com Bipolar Disorder)

A Review of Alcohol Withdrawal Seizures.

Epilepsy and Behaviour — Wed, 25 Feb 2009 05:00:00 +0100

Authors: Hughes JR The topic of the alcohol withdrawal syndrome (AWS) is reviewed and includes delirium tremens (DTs) and especially seizures. From mice and rat studies, both N-methyl-D-aspartate (NMDA) and gamma amino-butyric acid (GABA) receptors are involved in the AWS. During alcohol intoxication chronic adaptations of NMDA and GABA receptors occur and during alcohol withdrawal a hyperexcitable state develops. In human studies during intoxication the NMDA receptors are activated and mediate tonic inhibition. In withdrawal, a rebound activation of these receptors occurs. Both GABA-A and GABA-B receptors are also likely involved, especially the alpha 2 subunit of the GABA-A receptors. Homocysteine (HC) increases with active drinking and in withdrawal excitotoxicity likely is induced ...

Clinical Evaluation of the Daily Assessment of Symptoms-Anxiety (DAS-A): A New Instrument to Assess the Onset of Symptomatic Improvement in Generalized Anxiety Disorder.

CNS Neuroscience and Therapeutics — Sun, 22 Feb 2009 21:17:29 +0100

Conclusions: These data indicate that the DAS-A can detect symptomatic improvement in GAD patients treated with lorazepam during the first week of treatment, and, in a secondary analysis, as early as 24 h. PMID: 19228175 [PubMed - in process] (Source: CNS Neuroscience and Therapeutics)

Simultaneous determination of multibenzodiazepines by HPLC/UV: Investigation of liquid-liquid and solid-phase extractions in human plasma.

Talanta — Fri, 30 Jan 2009 10:54:03 +0100

Authors: Borges KB, Freire EF, Martins I, de Siqueira ME A method for simultaneous determination of seven benzodiazepines (BZPs) (flunitrazepam, clonazepam, oxazepam, lorazepam, chlordiazepoxide, nordiazepam and diazepam using N-desalkylflurazepam as internal standard) in human plasma using liquid-liquid and solid-phase extractions followed by high-performance liquid chromatography (HPLC) is described. The analytes were separated employing a LC-18 DB column (250mmx4.6mm, 5mum) at 35 degrees C under isocratic conditions using 5mM KH(2)PO(4) buffer solution pH 6.0:methanol:diethyl ether (55:40:5, v/v/v) as mobile phase at a flow rate of 0.8mLmin(-1). UV detection was carried out at 245nm. Employing LLE, the best conditions were achieved with double extraction of 0.5mL plasma using ethyl ...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Oral Compared With Intravenous Sedation for First-Trimester Surgical Abortion: A Randomized Controlled Trial.

Obstetrics and Gynecology — Fri, 23 Jan 2009 10:59:02 +0100

CONCLUSION:: Oral sedation, as studied, is not equivalent to intravenous sedation for pain control during first-trimester surgical abortion. CLINICAL TRIAL REGISTRATION:: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00337792 LEVEL OF EVIDENCE:: I. PMID: 19155895 [PubMed - as supplied by publisher] (Source: Obstetrics and Gynecology)

A failed case of weaning from a mechanical ventilator with lorazepam successfully accomplished by ziprasidone

General Hospital Psychiatry — Wed, 14 Jan 2009 00:00:00 +0100

We present a case of a 52-year-old female with COPD exacerbation requiring intubation who failed extubation multiple times while concurrently being treated with lorazepam, for agitation. Based on the evidence for increased carbon dioxide retention associated with benzodiazepine use, we weaned the patient off the lorazepam which in turn allowed the patient to be successfully weaned off the ventilator. (Source: General Hospital Psychiatry)

LETTERS TO THE EDITOR: Concomitant Use of Lorazepam With Tamoxifen in Bipolar Mania Clinical Trials

Archives of General Psychiatry — Mon, 05 Jan 2009 05:00:00 +0100

(Source: Archives of General Psychiatry)

LETTERS TO THE EDITOR: Concomitant Use of Lorazepam With Tamoxifen in Bipolar Mania Clinical Trials--Reply

Archives of General Psychiatry — Mon, 05 Jan 2009 05:00:00 +0100

(Source: Archives of General Psychiatry)

Catatonia and systemic lupus erythematosus: a clinical study of three cases.

General Hospital Psychiatry — Thu, 01 Jan 2009 05:00:00 +0100

We report three cases here of patients who presented with catatonia during a lupus relapse, in whom treatment with lorazepam improved the catatonic symptomatology, thus allowing the associated condition to be treated. We touch on several points about the diagnosis, etiology and treatment of catatonia, when it is associated with SLE. PMID: 19134515 [PubMed - in process] (Source: General Hospital Psychiatry)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

The Lollipop with Strawberry Aroma May Be Promising in Reduction of Infusion-Related Nausea and Vomiting during the Infusion of Cryopreserved Peripheral Blood Stem Cells.

Biology of Blood and Marrow Transplantation — Mon, 01 Dec 2008 05:00:00 +0100

Authors: Ozdemir E, Akgedik K, Akdogan S, Kansu E Nausea and vomiting during the infusion of cryopreserved peripheral blood stem cells (PBSC) are common. The aim of this study was to explore the effect of lollipop with strawberry aroma on the infusion-related nausea and vomiting of cryopreserved autologous PBSCs. We compared 2 groups of adult patients receiving lollipop with strawberry aroma during cryopreserved PBSC infusions or not to assess the incidences of nausea and vomiting occurring during infusions. All patients received granisetron 3 mg i.v. twice a day, and lorazepam 1 mg every 4 hours orally for prophylaxis of the nausea and vomiting during conditioning phase and infusion day. Before infusion, all patients were premedicated with pheniramine maleate 45.5 mg i.v. and paraceta...

Influence of antiepileptic drugs on amplitude-integrated electroencephalography.

Pediatric Neurology — Thu, 27 Nov 2008 14:42:41 +0100

Authors: Shany E, Benzaquen O, Friger M, Richardson J, Golan A Amplitude-integrated electroencephalography monitors different aspects of cerebral function in neonatal intensive care units. To examine the influence of various antiepileptic drugs on the background patterns and voltage of amplitude-integrated electroencephalography recordings, we screened 191 tracing segments originating from 77 newborns treated with antiepileptic drugs. The influences of lorazepam, diazepam, and phenobarbital given as bolus doses, and midazolam and lidocaine given in continuous infusion, were examined. Voltages and patterns before and after drug administration were assessed. Time taken to return to previous voltage was assessed in clinically significant cases. Chi-square and Wilcoxon tests were used for ...

Optimal Prevention of Seizures Induced by High-Dose Busulfan

Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy — Mon, 24 Nov 2008 05:00:00 +0100

Pharmacotherapy 28(12): 1502-1510 Abstract High-dose busulfan is frequently used in a variety of conditioning regimens for hematopoietic cell transplantation. In this setting, busulfan has marked neurotoxicity, specifically causing seizures that generally are tonic-clonic in character. Phenytoin has been the preferred drug to treat busulfan-induced seizures, but this practice should be reexamined in light of newer antiepileptic drugs being preferentially used by neurologists. Characteristics of ideal seizure prophylaxis include lack of overlapping toxicity with the conditioning regimen, lack of interference with engraftment of donor cells, and minimal potential for pharmacokinetic drug interactions. Based on these criteria, phenytoin is suboptimal due to possible toxicities and is especial...

Propylene Glycol Accumulation During Continuous-infusion Lorazepam in Critically Ill Patients

Journal of Intensive Care Medicine — Wed, 19 Nov 2008 05:00:00 +0100

(Source: Journal of Intensive Care Medicine)

Propylene Glycol Accumulation During Continuous-infusion Lorazepam in Critically Ill Patients

Journal of Intensive Care Medicine — Wed, 19 Nov 2008 05:00:00 +0100

(Source: Journal of Intensive Care Medicine)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

CADASIL presenting as status migrainosus and persisting aura without infarction

The Journal of Headache and Pain — Sat, 25 Oct 2008 08:39:02 +0100

We describe a novel migrainous manifestation of CADASIL consisting in status migrainosus and persistent aura without infarction. The symptoms resolved after i.v. treatment with lorazepam and mannitol. Content Type Journal ArticleCategory Brief ReportDOI 10.1007/s10194-008-0079-xAuthors Simona Sacco, University of L’Aquila Department of Neurology, The Regional Headache Referral Center Piazzale Salvatore Tommasi 1 67010 L’Aquila ItalyMaurizia Rasura, University of Roma Department of Neurology La Sapienza Rome ItalyMarina Cao, University of Roma Department of Neurology La Sapienza Rome ItalyAlessandro Bozzao, University of Roma Department of Neuroradiology La Sapienza Rome ItalyAntonio Carolei, University of L’Aquila Department of Neurology, The Regional Headache Referral Center P...

Short-term physical compatibility of intramuscular aripiprazole with intramuscular lorazepam.

American Journal of Health-System Pharmacy : AJHP — Fri, 24 Oct 2008 17:06:44 +0100

Authors: Kovalick LJ, Pikalov AA, Ni N, Naringrekar VH, McQuade RD PMID: 18945855 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)

Remifentanil-propofol analgo-sedation shortens duration of ventilation and length of ICU stay compared to a conventional regimen: a centre randomised, cross-over, open-label study in the Netherlands

Intensive Care Medicine — Fri, 24 Oct 2008 06:51:04 +0100

Conclusions In patients with an expected short-term duration of MV, remifentanil significantly improves sedation and agitation levels and reduces weaning time. This contributes to a shorter duration of MV and ICU-LOS. Content Type Journal ArticleCategory OriginalDOI 10.1007/s00134-008-1328-9Authors F. Willem Rozendaal, Jeroen Bosch Hospital ’s-Hertogenbosch The NetherlandsPeter E. Spronk, Gelre Hospitals Apeldoorn The NetherlandsFerdinand F. Snellen, Isala Clinics Zwolle The NetherlandsAdri Schoen, Rivierenland Hospital Tiel The NetherlandsArthur R. H. van Zanten, Gelderse Vallei Hospital Ede The NetherlandsNorbert A. Foudraine, VieCuri Medical Centre North-Limburg Venlo The NetherlandsPaul G. H. Mulder, Erasmus MC University Medical Centre Department of Intensive Ca...

Simultaneous determination of benzodiazepines and their metabolites in human serum by liquid chromatography-tandem mass spectrometry using a high-resolution octadecyl silica column compatible with aqueous compounds.

Biomedical Chromatography : BMC — Mon, 20 Oct 2008 04:00:00 +0100

Authors: Nakamura M, Ohmori T, Itoh Y, Terashita M, Hirano K A liquid chromatography-tandem mass spectrometry (LC-MS/MS) method using a high-resolution octadecyl silica column compatible with aqueous compounds was developed for the simultaneous determination of benzodiazepines and their metabolites in human serum. This method enabled us to determine multiple benzodiazepines, including flurazepam, bromazepam, chlordiazepoxide, nitrazepam, clonazepam, flunitrazepam, estazolam, clobazam, lorazepam, alprazolam, triazolam, brotizolam, fludiazepam, diazepam, quazepam, prazepam and their metabolites such as 7-aminonitrazepam, 7-aminoclonazepam, 7-acetamidonitrazepam, N-desmethylclobazam and N-desmethyldiazepam. The analytes spiked into human serum were subjected to solid-phase extraction foll...

A fatal case of poisoning by lormetazepam

Forensic Toxicology — Thu, 16 Oct 2008 09:58:16 +0100

Abstract Lormetazepam is a benzodiazepine widely used as a hypnotic for management of insomnia. It is considered to be a safe drug when not combined with alcohol or other psychoactive substances. Indeed, we could neither fi nd its toxic nor lethal concentrations in the literature. In the present article, we report a fatal case in which lormetazepam and its metabolite lorazepam were the only drugs found in body fl uids. The concentration measured in blood was more than 100 times higher than the therapeutic one. Therefore, we concluded that the death was due to the drug and that the measured levels could be regarded as lethal. Content Type Journal ArticleCategory Case ReportDOI 10.1007/s11419-008-0053-yAuthors Carmelo Furnari, Tor Vergata University Forensic Toxicology La...

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Pilot Study of Lorazepam and Tiagabine Effects on Sleep, Motor Learning, and Impulsivity in Cocaine Abstinence.

The American Journal of Drug and Alcohol Abuse — Fri, 10 Oct 2008 04:00:00 +0100

Conclusions: These results introduce the possibility of different, sleep-related cognitive effects of mechanistically distinct GABAergic sedative hypnotics. PMID: 18850496 [PubMed - as supplied by publisher] (Source: The American Journal of Drug and Alcohol Abuse)

Treatment of Status Epilepticus

Seminars in Neurology — Thu, 09 Oct 2008 16:38:55 +0100

Semin Neurol 2008; 28: 342-354DOI: 10.1055/s-2008-1079339ABSTRACTStatus epilepticus (SE) is a neurological emergency that requires prompt diagnosis and treatment, as delay is associated with a higher likelihood of poor response to treatment and worse outcome. Lorazepam has been well established as a first-line therapy. Subsequent steps are less established, and there are many reasonable options, including intravenous fosphenytoin, valproate, midazolam, propofol, and phenobarbital. If intravenous access is not immediately available, rectal diazepam or nasal or buccal midazolam should be given; this can also be used as out-of-hospital treatment to prevent or treat SE. For refractory SE, continuous intravenous midazolam and propofol, separately or in combination, are rapidly effective, with p...

Benzodiazepine metabolism: an analytical perspective.

Current Drug Metabolism — Wed, 01 Oct 2008 04:00:00 +0100

Authors: Mandrioli R, Mercolini L, Raggi MA Benzodiazepines are currently among the most frequently prescribed drugs all over the world. They act as anxiolytics, sedatives, hypnotics, amnesics, antiepileptics and muscle relaxants. Despite their common chemical scaffold, these drugs differ in their pharmacokinetic and metabolic properties. In particular, they are biotransformed by different cytochrome P450 isoforms and also by different UDP-glucuronosyltransferase subtypes. The most important studies on the metabolic characteristics of several 1,4-benzodiazepines, carried out from 1998 onwards, are reported and briefly discussed in this review. Moreover, the analytical methods related to these studies are also described and commented upon and their most important characteristics are hig...

Lorazepam: Respiratory insufficiency in an elderly patient: case report

Reactions — Mon, 15 Sep 2008 09:44:54 +0100

(Source: Reactions)

Lorazepam: Respiratory insufficiency in an elderly patient: case report.

Reactions Weekly — Sat, 13 Sep 2008 09:59:08 +0100

Page: 23 (Source: Reactions Weekly)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Dexmedetomidine Infusion as Adjunctive Therapy to Benzodiazepines for Acute Alcohol Withdrawal (November).

The Annals of Pharmacotherapy — Tue, 09 Sep 2008 04:00:00 +0100

CONCLUSIONS: In patients with delirium tremens, dexmedetomidine should be considered as an option for primary treatment. This case illustrates the need for further studies to investigate other potential uses for dexmedetomidine. PMID: 18780809 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

Lorazepam(Lorazepam) Tablet [Ivax Pharmaceuticals Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 04 Sep 2008 05:00:00 +0100

Updated Date: Sep 4, 2008 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

High performance liquid chromatographic analysis of rabeprazole in human plasma and its pharmacokinetic application.

Archives of Pharmacal Research — Mon, 01 Sep 2008 04:00:00 +0100

Authors: Park CW, Rhee YS, Go BW, Kam SH, Lee KH, Lee HS, Park ES A simple and sensitive HPLC method for the analysis of rabeprazole in plasma is described using UV detection in the presence of lorazepam as the internal standard. Rabeprazole and lorazepam were extracted with ethyl ether and quantitated using a reverse-phase C(18) column. The method was specific as there were no interfering peaks in the human plasma eluting at the retention times of rabeprazole and lorazepam. The method was fully validated in human plasma for the concentration range of 20.0-1000.0 ng/ml. The correlation coefficients were greater than 0.999. Extraction recoveries were 72.3% for the drug and 79.1% for the internal standard. The method was simple, reliable, and accurate for the quantitation of rabeprazole ...

Development and Evaluation of Lorazepam Microemulsions for Parenteral Delivery.

AAPS PharmSciTech — Fri, 22 Aug 2008 04:00:00 +0100

The objective of this investigation was to develop lorazepam (LZM) microemulsions as an alternative to the conventional cosolvent based formulation. Solubility of LZM in various oils and Tween 80 was determined. The ternary diagram was plotted to identify area of microemulsion existence and a suitable composition was identified to achieve desired LZM concentration. The LZM microemulsions were evaluated for compatibility with parenteral fluids, globule size, in vitro hemolysis and stability of LZM. Capmul MCM demonstrated highest solubilizing potential for LZM and was used as an oily phase. LZM microemulsions were compatible with parenteral dilution fluids and exhibited mean globule size less than 200 nm. The in vitro hemolysis studies indicated that microemulsions were well tolerated by er...

Propylene Glycol-Induced Lactic Acidosis in a Patient Receiving Continuous Infusion Pentobarbital (October).

The Annals of Pharmacotherapy — Tue, 12 Aug 2008 04:00:00 +0100

CONCLUSIONS: PG toxicity is a potential complication associated with intravenous pentobarbital. Practitioners should be aware of the PG content of pentobarbital and should be familiar with the signs and symptoms associated with PG toxicity. PMID: 18698010 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Lorazepam(Lorazepam) Tablet [Qualitest Pharmaceuticals]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Thu, 07 Aug 2008 05:00:00 +0100

Updated Date: Aug 7, 2008 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Criminal poisoning of commuters in Bangladesh: Prospective and retrospective study.

Forensic Science International — Thu, 07 Aug 2008 04:00:00 +0100

Authors: Majumder MM, Basher A, Faiz MA, Kuch U, Pogoda W, Kauert GF, Toennes SW Travel-related poisoning is an emerging social and public health emergency in Bangladesh but its cause and significance have not been determined. To investigate this syndrome we performed a prospective clinical study and retrospective analysis of hospital records in a general medicine unit of a public tertiary care teaching hospital in Dhaka, Bangladesh, using toxicological analysis by fluorescence polarization immunoassay (FPIA) and liquid chromatography coupled to time-of-flight mass spectrometry (LC-TOF MS). The participants of the prospective study were 130 consecutive patients aged 16-80 years who were admitted with central nervous system depression (Glasgow Coma Score 3-14) after using public transpo...

FDA Safety Changes: Ativan, Femara, Invirase

Medscape Medical News Headlines — Thu, 31 Jul 2008 21:00:00 +0100

The FDA has approved revisions to the safety labeling for lorazepam tablets (Ativan), letrozole tablets (Femara), and saquinavir mesylate tablets (Invirase). Medscape Medical News (Source: Medscape Medical News Headlines)

The apolipoprotein E ɛ4 allele and memory performance in HIV-1 seropositive subjects: differences at baseline but not after acute oral lorazepam challenge

Psychopharmacology — Thu, 31 Jul 2008 07:01:04 +0100

Conclusion Future studies should clarify the role of ɛ4 in the modulation of drug-induced cognitive toxicity and baseline performance and their relationship to progressive decline, especially in older individuals with HIV-1 infection, a group at increased risk for dementia. Content Type Journal ArticleCategory Original InvestigationDOI 10.1007/s00213-008-1253-1Authors Nunzio Pomara, Nathan Kline Institute for Psychiatric Research Geriatric Psychiatry Program 140 Old Orangeburg Rd. Bldg.35 Orangeburg NY 10962 USAKenneth D. Belzer, Nathan Kline Institute for Psychiatric Research Geriatric Psychiatry Program 140 Old Orangeburg Rd. Bldg.35 Orangeburg NY 10962 USARaul Silva, Nathan Kline Institute for Psychiatric Research Geriatric Psychiatry Program 140 Old Orangeburg Rd...

Treating bipolar disorder in patients with renal failure having haemodialysis: two case reports

Clinical Practice and Epidemiology in Mental Healt — Sat, 26 Jul 2008 04:00:00 +0100

Conclusion: We discuss the similarities in the two cases and the care plan we used to manage them. (Source: Clinical Practice and Epidemiology in Mental Healt)

MedWorm Message: Get the very latest Swine Flu news via the MedWorm Swine Flu RSS news feed - updated hourly from thousands of authoritative health and news sources.

Ativan(Lorazepam) Tablet [Biovail Pharmaceuticals, Inc.]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Fri, 25 Jul 2008 05:00:00 +0100

Updated Date: Jul 25, 2008 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

Determination of a Lorazepam Dose Threshold for Using the Osmol Gap to Monitor for Propylene Glycol Toxicity

Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy — Fri, 25 Jul 2008 04:00:00 +0100

Conclusion. Screening for propylene glycol toxicity with the osmol gap may be helpful for patients receiving intravenous lorazepam in doses of 1 mg/kg/day or higher. An osmol gap of 10 or greater was predictive of elevated propylene glycol concentrations, and values of 12 or greater were predictive of clinical changes suggestive of propylene glycol toxicity. (Source: Pharmacotherapy: Official Journal of the American College of Clinical Pharmacy)

Early, Aggressive Treatment Warranted in Pediatric Status Epilepticus

Medscape Medical News Headlines — Tue, 22 Jul 2008 20:09:00 +0100

Convulsive status epilepticus in children warrants early, aggressive treatment that includes rapid transport to the emergency department as well as very early prehospital treatment with intravenous lorazepam. Medscape Medical News (Source: Medscape Medical News Headlines)

Lorazepam(Lorazepam) Tablet [Actavis Elizabeth LLC]

DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST) — Wed, 16 Jul 2008 05:00:00 +0100

Updated Date: Jul 16, 2008 EST (Source: DailyMed Drug Label Updates for the last seven days (since May 20, 2007 EST))

MedWorm: Ativan

Anticonvulsants for alcohol withdrawal.

ATIVAN (Lorazepam) Tablet [BTA Pharmaceuticals Inc.]

Phenytoin-induced acute generalized exanthemous pustulosis

Effect of dexmedetomidine versus lorazepam on outcome in patients with sepsis: an a priori-designed analysis of the MENDS randomized controlled trial

Catatonia Is not Schizophrenia: Kraepelin's Error and the Need to Recognize Catatonia as an Independent Syndrome in Medical Nomenclature

ATIVAN (Lorazepam) Tablet [STAT RX USA LLC]

Experimental design for optimization of microwave-assisted extraction of benzodiazepines in human plasma.

Use of EEG Monitoring and Management of Non-Convulsive Seizures in Critically Ill Patients: A Survey of Neurologists

Dexmedetomidine Controls Agitation and Facilitates Reliable, Serial Neurological Examinations in a Non-Intubated Patient with Traumatic Brain Injury

Michael Jackson toxicology report released

Jimsonweed poisoning – Maryland

ECT in the Treatment of a Patient With Catatonia: Consent and Complications [Clinical Case Conference]

ECT in the Treatment of a Patient With Catatonia: Consent and Complications.

A tendency for re-offending in drug-facilitated crime

Treatment of Catatonia With Methylphenidate in an Elderly Patient With Depression [CASE REPORTS]

Severe Lactic Acidosis After an Iatrogenic Propylene Glycol Overdose

Psychotropic PRN use among older people's inpatient mental health services

Memory in humans is unaffected by central H1-antagonism, while objectively and subjectively measured sedation is increased

Efficacy of Sodium Valproate and Haloperidol in the Management of Acute Mania: A Randomized Open-Label Comparative Study.

Benzodiazepines medazepam and midazolam are activators of pregnane X receptor and weak inducers of CYP3A4: Investigation in primary cultures of human hepatocytes and hepatocarcinoma cell lines.

Recurrent opisthotonus in catatonia: An atypical presentation

Rupatadine: pharmacological profile and its use in the treatment of allergic rhinitis

EFNS guideline on the management of status epilepticus in adults

Lorazepam modulates orbitofrontal signal changes during emotional processing in catatonia

Acute Pharmaceutical Toxicity killed Brittany Murphy - Could it be killing millions more?

Optimizing Emetic Control in Children Receiving Antineoplastic Therapy: Beyond the Guidelines.

Enzyme-assisted synthesis and structural characterization of pure benzodiazepine glucuronide epimers.

Cochrane review: Drug management for acute tonic-clonic convulsions including convulsive status epilepticus in children

Catatonia: Clinical Aspects and Neurobiological Correlates [SPECIAL ARTICLES]

Benzodiazepine Withdrawal

A multi-center, double-blind, randomised study of the Lavender oil preparation Silexan in comparison to Lorazepam for generalized anxiety disorder

The toxicological challenges in the European research project DRUID

The Homeopathic Preparation Nervoheel N can Offer an Alternative to Lorazepam Therapy for Mild Nervous Disorders

Is This Really Weed?

Propylene Glycol Accumulation in Critically Ill Patients Receiving Continuous Intravenous Lorazepam Infusions(December).

Mom Flies Over the Cuckoo’s Nest

Topiramate overdose: A case report of a patient with extremely high topiramate serum concentrations and nonconvulsive status epilepticus

What Evaluation is Appropriate for Complex Febrile Seizures?

Lorazepam: Delirium and difficulty separating from the ventilator: case report

The effects of lorazepam on extrastriatal dopamine D2/3-receptors—A double-blind randomized placebo-controlled PET study

Caring for the Elderly in an Inpatient Setting: Managing Insomnia and Polypharmacy

Effects of Lorazepam and citalopram on human defensive reactions: ethopharmacological differentiation of fear and anxiety. - Perkins AM, Ettinger U, Davis R, Foster R, Williams SC, Corr PJ.

Epilepsia partialis continua responsive to intravenous levetiracetam

ATIVAN (Lorazepam) Injection, Solution [Baxter Healthcare Corporation]

Review article: Convulsive and non-convulsive status epilepticus: An emergency medicine perspective

Table of Contents

Lorazepam/olanzapine: Hypotension and unconsciousness: case report

Translocator Protein Blockade Reduces Prostate Tumor Growth.

Alcohol and drugs in suspected impaired drivers in Ontario from 2001 to 2005

Addiction is treatable

A clinical, radiological and outcome study of status epilepticus from India

Successful Use of Dexmedetomidine for Sedation in a 24-Week Gestational Age Neonate (October).

Ativan (lorazepam) Injection - Revised SPC

Pharmacotherapy in pediatric critical illness: a prospective observational study.

Ativan - Lorazepam

[Haloperidol plus promethazine for agitated patients - a systematic review.]

Jackson Autopsy Fingers Propofol, Lorazepam as Cause of Death

Propofol Plus Sedative Killed Michael Jackson

Propofol Plus Sedative Killed Michael Jackson

Differential effects of lorazepam on sleep and activity in C57BL/6J and BALB/cJ strain mice.

From Diseased towards Human Ease

Jackson pleaded with doctor for powerful anesthetic, records show

New to forum, 3rd day on suboxone...

Catatonic syndrome associated with lead intoxication: a case report

Lorazepam/temazepam: Sleep apnoea syndrome and respiratory insufficiency: case report

Successful treatment for refractory convulsive status epilepticus by parenteral lacosamide

Major issue, plz help!

Evaluation of Adult Outpatient Magnetic Resonance Imaging Sedation Practices: Are Patients Being Sedated Optimally?

Gabapentin Therapy for Pain and Irritability in a Neurologically Impaired Infant

Magnitude of potentially inappropriate prescribing in Germany among older patients with generalized anxiety disorder

Ativan (lorazepam) injection - Revised SPC

Going off Meds, Part 1

The pharmacokinetic and pharmacodynamic effects of SL65.1498, a GABA-A 2,3 selective agonist, in comparison with lorazepam in healthy volunteers

[Epileptic seizures in critically ill patients]

The Mothers Act Disease Mongering Campaign - Part I

Plasma tryptophan and tyrosine levels are independent risk factors for delirium in critically ill patients

My journey to sobriety

Altering Intensive Care Sedation Paradigms to Improve Patient Outcomes

Chronic gamma-hydroxybutyric-acid use followed by gamma-hydroxybutyric-acid withdrawal mimic schizophrenia: a case report