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https://www.readbyqxmd.com/read/28106623/symptom-presentation-and-prescription-of-sleep-medications-for-veterans-with-posttraumatic-stress-disorder
#1
Mark A Greenbaum, Thomas C Neylan, Craig S Rosen
This study tested whether sleep medications prescribed to veterans diagnosed with posttraumatic stress disorder (PTSD) are being targeted to patients who report more severe insomnia or nightmares. Secondary analysis of survey and pharmacy data was conducted in samples of veterans from two periods: from 2006 to 2008 and from 2009 to 2013. Logistic regression tested associations between self-reported insomnia and nightmare severity, and being prescribed trazodone, prazosin, zolpidem, and benzodiazepines, controlling for PTSD severity and other covariates...
January 18, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28105500/-discontinuation-of-benzodiazepines-in-old-age-when-and-if-so-how
#2
Dirk K Wolter
Although viewed critically in geriatrics, benzodiazepine use is still common among old people. Before reducing the dosage the following questions must be considered: 1. Are there indications for benzodiazepine treatment and will discontinuation cause relevant rebound symptoms of the initial disorder treated? 2. To what extent do the patient and other key persons consider discontinuation to be reasonable and will they support discontinuation? 3. Is the target complete withdrawal, a dose reduction or shift to another benzodiazepine drug which is more suitable in old age for pharmacokinetic reasons? This article provides assistance in answering these questions and some guidelines for the practical management of discontinuation...
January 19, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28104560/metabolite-characterization-of-a-novel-sedative-drug-remimazolam-in-human-plasma-and-urine-using-ultra-high-performance-liquid-chromatography-coupled-with-synapt-high-definition-mass-spectrometry
#3
Ying Zhou, Pei Hu, Ji Jiang
Remimazolam is a new chemical entity belonging to the benzodiazepine class of sedative drugs, which shows faster-acting onset and recovery than currently available short-acting sedatives. In the present study, ultra high performance liquid chromatography with synapt high-definition mass spectrometry method combined with MassLynx software was established to characterize metabolites of remimazolam in human plasma and urine. In total, 5 human metabolites were detected, including 3 phase I and 2 phase II metabolites...
January 12, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/28101764/diazepam-in-the-treatment-of-moderate-to-severe-alcohol-withdrawal
#4
Steven J Weintraub
Benzodiazepines ameliorate or prevent the symptoms and complications of moderate to severe alcohol withdrawal, which can include autonomic hyperactivity, agitation, combativeness, hallucinations, seizures, delirium, and death. The benzodiazepines most commonly used for this purpose are lorazepam, chlordiazepoxide, oxazepam, and diazepam. It is widely asserted that no member of this group is superior to the others for treatment of alcohol withdrawal. However, of these, diazepam has the shortest time to peak effect, which facilitates both rapid control of symptoms and accurate titration to avoid over-sedation...
January 18, 2017: CNS Drugs
https://www.readbyqxmd.com/read/28098590/analgesia-and-sedation-requirements-in-mechanically-ventilated-trauma-patients-with-acute-preinjury-use-of-cocaine-and-or-amphetamines
#5
Bridgette Kram, Shawn J Kram, Michelle L Sharpe, Michael L James, Maragatha Kuchibhatla, Mark L Shapiro
BACKGROUND: The purpose of this study was to determine whether mechanically ventilated trauma patients with a positive urine drug screen (UDS) for cocaine and/or amphetamines have different opioid analgesic and sedative requirements compared with similar patients with a negative drug screen for these stimulants. METHODS: This retrospective, single-center cohort study at a tertiary care, academic medical and level 1 trauma center in the United States included patients ≥16 years of age who were admitted to an adult intensive care unit with a diagnosis of trauma between 2009 and 2013 with a UDS documented within 24 hours of admission, and were mechanically ventilated for >24 hours...
January 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28097536/prevalence-and-correlates-of-adhd-in-individuals-with-substance-use-disorder-in-nigeria
#6
Musa U Umar, Auwal S Salihu, Shakirat D Owolabi
Substance use disorder (SUD) is associated with ADHD. ADHD increases the severity of SUD and has negative influence on the prognosis of the disorder. The aim of the study was to determine the prevalence and correlates of ADHD in individuals with SUD. During 2013-2015, a cross-sectional descriptive study of 233 drug treatment-seeking individuals was assessed. Diagnosis of ADHD was done using DSM-IV criteria with the Diagnostic Interview for ADHD in Adults (DIVA 2.0), while Semi-structured Assessment for Drug Dependence and Alcoholism (SSADDA 6...
January 17, 2017: Attention Deficit and Hyperactivity Disorders
https://www.readbyqxmd.com/read/28097532/medication-overuse-in-chronic-pain
#7
REVIEW
Eric S Hsu
PURPOSE OF REVIEW: Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? RECENT FINDINGS: Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28096989/successful-treatment-of-severe-baclofen-toxicosis-initially-refractory-to-conventional-treatment
#8
Christine M Fox, Meredith L Daly
After ingesting a dose of baclofen thought to be lethal, a patient with severe neurologic signs was successfully managed despite initially being refractory to treatment. Patients with persistent neurologic abnormalities may still have an excellent prognosis despite lack of initial response. Additionally, we present a potential case of benzodiazepine withdrawal.
January 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28096176/reduced-all-cause-mortality-with-antipsychotics-and-antidepressants-compared-to-increased-all-cause-mortality-with-benzodiazepines-in-patients-with-schizophrenia-observed-in-naturalistic-treatment-settings
#9
https://www.readbyqxmd.com/read/28094153/development-and-validation-of-a-fast-ionic-liquid-based-dispersive-liquid-liquid-microextraction-procedure-combined-with-lc-ms-ms-analysis-for-the-quantification-of-benzodiazepines-and-benzodiazepine-like-hypnotics-in-whole-blood
#10
Marieke De Boeck, Sophie Missotten, Wim Dehaen, Jan Tytgat, Eva Cuypers
To date, thorough clean-up of complex biological samples remains an essential part of the analytical process. The solid phase extraction (SPE) technique is the well-known standard, however, its main weaknesses are the labor-intensive and time-consuming protocols. In this respect, dispersive liquid-liquid microextractions (DLLME) seem to offer less complex and more efficient extraction procedures. Furthermore, ionic liquids (ILs) - liquid salts - are emerging as new promising extraction solvents, thanks to their non-flammable nature, negligible vapor pressure and easily adaptable physiochemical properties...
December 26, 2016: Forensic Science International
https://www.readbyqxmd.com/read/28093640/polypharmacy-and-potentially-inappropriate-medications-a-cross-sectional-analysis-among-451-nursing-homes-in-france
#11
Marie Herr, Helene Grondin, Stéphane Sanchez, Didier Armaingaud, Caroline Blochet, Antoine Vial, Philippe Denormandie, Joël Ankri
PURPOSE: The quality of drug therapy is an important issue for nursing homes. This study aimed to assess the prevalence of polypharmacy and potentially inappropriate medications (PIMs) in a large sample of nursing home residents by using the data recorded during the preparation of pill dispensers. METHODS: This is a cross-sectional study that included 451 nursing homes across France. Information about the medications received by the 30,702 residents (73.8% women) living in these nursing homes was extracted from the system that assists in the preparation of pill dispensers in pharmacies...
January 16, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28093373/improved-arousal-and-motor-function-using-zolpidem-in-a-patient-with-space-occupying-intracranial-lesions-a-case-report
#12
Martin Nicholas Bomalaski, Sean Robinson Smith
Patients with disorders of consciousness (DOC) have profound functional limitations with few treatment options for improving arousal and quality of life. Zolpidem is a non-benzodiazepine hypnotic used to treat insomnia that has also been observed to paradoxically improve arousal in those with DOC, such as the vegetative or minimally conscious states (MCS). There is little information on its use in DOC patients with intracranial space occupying lesions. We present a case of a 24year old man in a MCS due to CNS lymphoma who was observed to have increased arousal and improved motor function following administration of zolpidem...
January 13, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28092324/long-term-use-of-opioids-for-nonmalignant-pain-among-community-dwelling-persons-with-and-without-alzheimer-disease-in-finland-a-nationwide-register-based-study
#13
Aleksi Hamina, Heidi Taipale, Antti Tanskanen, Anna-Maija Tolppanen, Niina Karttunen, Liisa Pylkkänen, Jari Tiihonen, Sirpa Hartikainen
Persons with Alzheimer disease (AD) commonly present with chronic nonmalignant pain, but long-term use of opioids among this population has not been studied previously. Our aim was to investigate the prevalence of long-term (≥180 days) use of opioids for nonmalignant pain and associated factors among community-dwelling persons with AD and to compare the prevalence with a matched cohort without AD. The Medication use and Alzheimer's disease (MEDALZ) cohort was used for this study, comprising all community-dwelling persons diagnosed with AD in Finland during 2005 to 2011 and their matched comparison persons without AD...
February 2017: Pain
https://www.readbyqxmd.com/read/28091881/identifying-metabolites-of-meclonazepam-by-high-resolution-mass-spectrometry-using-human-liver-microsomes-hepatocytes-a-mouse-model-and-authentic-urine-samples
#14
Svante Vikingsson, Ariane Wohlfarth, Mikael Andersson, Henrik Gréen, Markus Roman, Martin Josefsson, Fredrik C Kugelberg, Robert Kronstrand
Meclonazepam is a benzodiazepine patented in 1977 to treat parasitic worms, which recently appeared as a designer benzodiazepine and drug of abuse. The aim of this study was to identify metabolites suitable as biomarkers of drug intake in urine using high-resolution mass spectrometry, authentic urine samples, and different model systems including human liver microsomes, cryopreserved hepatocytes, and a mice model. The main metabolites of meclonazepam found in human urine were amino-meclonazepam and acetamido-meclonazepam; also, minor peaks for meclonazepam were observed in three of four urine samples...
January 13, 2017: AAPS Journal
https://www.readbyqxmd.com/read/28090727/italian-patients-with-more-recent-onset-of-major-depressive-disorder-have-a-shorter-duration-of-untreated-illness
#15
Bernardo Dell'Osso, Laura Cremaschi, Benedetta Grancini, Francesca De Cagna, Beatrice Benatti, Giulia Camuri, Chiara Arici, Cristina Dobrea, Lucio Oldani, Maria Carlotta Palazzo, Matteo Vismara, A Carlo Altamura
BACKGROUND: Previous investigation on the duration of untreated illness (DUI) in patients with Major Depressive Disorder (MDD) revealed a different latency to first antidepressant treatment, with adverse consequences in terms of outcome for individuals with a longer DUI. Recent reports, moreover, documented a reduced DUI, as observed with the passage of time, in patients with different psychiatric disorders. Hence, the present study was aimed to assess DUI and related variables in a sample of Italian patients with MDD as well as to investigate potential differences in subjects with onset before and after 2000...
January 15, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28090524/the-samukeppra-study-in-prehospital-status-epilepticus-lessons-for-future-study
#16
COMMENT
Andrew C Schomer, Jaideep Kapur
In the Lancet Neurology article "Prehospital treatment with levetiracetam plus clonazepam or placebo plus clonazepam in status epilepticus (SAMUKeppra): a randomised, double-blind, phase 3 trial" the authors conducted a prehospital, randomized controlled study to determine which treatment is more effective for status epilepticus (SE): benzodiazepine alone, or in combination with levetiracetam (LEV). Although the study had negative results, several aspects of the trial design likely masked any added effect that LEV may have had in controlling SE, including: higher doses of benzodiazepines, lower thresholds for determining cessation of SE, and a smaller sample size...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28080146/perceptions-vs-evidence-therapeutic-substitutes-for-antipsychotics-in-patients-with-dementia-in-long-term-care
#17
Brianne L Olivieri-Mui, John W Devlin, Aileen Ochoa, Danielle Schenck, Becky Briesacher
OBJECTIVE: To compare differences between clinician perceptions of therapeutic substitutes for antipsychotics prescribed to patients with dementia in long term care (LTC) and published evidence. METHODS: A mixed-methods approach that included a drug information search, online survey of 55 LTC clinicians and a comprehensive literature review was used. For 41 pharmacologic antipsychotic substitute candidates identified, LTC clinicians rated the likelihood they would substitute each for patients with dementia and identified non-pharmacologic antipsychotic substitutes...
January 12, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/28079605/delirium-in-critically-ill-children-an-international-point-prevalence-study
#18
Chani Traube, Gabrielle Silver, Ron W Reeder, Hannah Doyle, Emily Hegel, Heather A Wolfe, Christopher Schneller, Melissa G Chung, Leslie A Dervan, Jane L DiGennaro, Sandra D W Buttram, Sapna R Kudchadkar, Kate Madden, Mary E Hartman, Mary L deAlmeida, Karen Walson, Erwin Ista, Manuel A Baarslag, Rosanne Salonia, John Beca, Debbie Long, Yu Kawai, Ira M Cheifetz, Javier Gelvez, Edward J Truemper, Rebecca L Smith, Megan E Peters, A M Iqbal O'Meara, Sarah Murphy, Abdulmohsen Bokhary, Bruce M Greenwald, Michael J Bell
OBJECTIVES: To determine prevalence of delirium in critically ill children and explore associated risk factors. DESIGN: Multi-institutional point prevalence study. SETTING: Twenty-five pediatric critical care units in the United States, the Netherlands, New Zealand, Australia, and Saudi Arabia. PATIENTS: All children admitted to the pediatric critical care units on designated study days (n = 994). INTERVENTION: Children were screened for delirium using the Cornell Assessment of Pediatric Delirium by the bedside nurse...
January 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28079530/can-intoxication-status-be-used-as-a-prediction-tool-for-manner-of-death-a-comparison-of-the-intoxication-status-in-violent-suicides-and-homicides
#19
D Kimberley Molina, Veronica M Hargrove
Determining the manner of death in medicolegal death investigations can be difficult. The investigator relies on many facets of death investigation, including the circumstances of death and autopsy examination. A study was designed to analyze whether the intoxication status of the decedent could be used as another tool in death investigations. The intoxication status of violent (nonoverdose or poisoning) suicides and homicides was retrospectively reviewed and compared. A total of 625 deaths were identified, including 366 suicides and 259 homicides...
January 10, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28078633/benzodiazepine-use-and-risk-of-developing-alzheimer-s-disease-a-case-control-study-based-on-swiss-claims-data
#20
Fabienne A Biétry, Alena M Pfeil, Oliver Reich, Matthias Schwenkglenks, Christoph R Meier
BACKGROUND: A possible association between benzodiazepine use and Alzheimer's disease (AD) has been hypothesized in previous studies. OBJECTIVES: Using claims data from the Helsana Group, a large Swiss health insurance provider, we examined the association between previous benzodiazepine use and the risk of AD. METHODS: We conducted a matched case-control study and identified 1438 incident AD cases between 2013 and 2014 based on recorded first-time use of drugs used to treat AD [i...
January 11, 2017: CNS Drugs
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