- |||||||||| Successful Use Of Electroconvulsive Therapy For Severe Medically Refractory Status Epilepticus (Hall C) - Aug 15, 2022 - Abstract #ASA2022ASA_4910;
Intubated for airway protection and transferred to our hospital for further management and admitted to Neuro ICU. She was burst suppressed with Phenytoin, Pentobarbital, Valproate, Propofol, Ketamine, and underwent multiple sessions of electroconvulsive therapy with multidisciplinary input from Anesthesia Critical Care, Neurology, and Psychiatry, with success in aborting status epilepticus.
- |||||||||| lithium carbonate ER / Generic mfg., lorazepam / Generic mfg.
Differentiating Etomidate Induced Myoclonus From Seizure In A Patient Scheduled For Electroconvulsive Therapy (Hall C) - Aug 15, 2022 - Abstract #ASA2022ASA_984;
Resolution was achieved with a total of 6 mg Ativan given intravenously...Follow-up EEG was negative for epileptiform activity suggesting against seizure. This case highlights the difficulty in distinguishing clinical signs and symptoms of etomidate induced myoclonus and seizure activity in patients undergoing ECT.
- |||||||||| Diabetes Insipidus Related To Sedation In The Intensive Care Unit: A Review Of The Literature (Virtual - Mobile App) - Aug 15, 2022 - Abstract #ASA2022ASA_212;
In particular, sevoflurane and dexmedetomidine appear to be implicated more frequently. While our study implicated sevoflurane as the causative agent in the highest percentage of ICU cases, a recent study of DI cases from anesthetics used intraoperatively found sevoflurane was responsible for the second highest percentage of cases after dexmedetomidine, despite the ubiquitous use of sevoflurane in anesthesia.
- |||||||||| morphine sulphate / Generic mfg., lorazepam / Generic mfg.
Journal: Hospitalisations related to benzodiazepine, Z-drug, and opioid treatment in Italy: a claim on the risks associated with inappropriate use. (Pubmed Central) - Aug 14, 2022
While our study implicated sevoflurane as the causative agent in the highest percentage of ICU cases, a recent study of DI cases from anesthetics used intraoperatively found sevoflurane was responsible for the second highest percentage of cases after dexmedetomidine, despite the ubiquitous use of sevoflurane in anesthesia. These results indicate that, in Italy, the inappropriate use of BZD/ZD is a relevant heath issue, often leading to serious AEs requiring patients' ED visits and hospitalisation, especially in young women and patients with a history of substance abuse.
- |||||||||| lorazepam / Generic mfg.
Observational data, Retrospective data, Journal: Pharmacist involvement with antiepileptic therapy for status epilepticus in the emergency department. (Pubmed Central) - Aug 11, 2022
Pharmacist presence during status epilepticus patient management was associated with a clinically significant reduction in time to administration of AEDs. Medication doses were more guideline adherent and more patients received a lorazepam dose of at least 4 mg compared to when a pharmacist was not present.
- |||||||||| lorazepam / Generic mfg.
Two-step flow synthesis of propofol (W176c (McCormick Place Convention Center)) - Aug 9, 2022 - Abstract #ACSFall2022ACS_Fall_11541;
It has mostly replaced sodium thiopental and is more effective than lorazepam at a lower cost...The two-step synthetic strategy relies on a double Friedel-Crafts followed by high-temperature decarboxylation in which the reaction concentration is maximized to obtain an optimal output. The use of inexpensive, and readily available reagents affords an industrially viable process of this widely employed active pharmaceutical ingredient.
- |||||||||| Seizalam (midazolam intramuscular) / Pfizer
Retrospective data, Review, Journal: Termination of seizures in the pediatric age group, best benzodiazepine, and route of administration. A Network Meta-analysis. (Pubmed Central) - Aug 5, 2022
Buccal Midazolam showed the lowest mean with a value of 0.106(0.084) for rate of recurrence. Although there was no significant difference between the treatment but based on the rank probability IVL shows more promising results for patients who already have an established intra-venous line, but patients presenting in the ER without an intravenous line, the first line of treatment should be INM as it shows the highest rank probability in total time with second-highest successful cessation rate.
- |||||||||| lorazepam / Generic mfg.
Journal: Valid or not: A critique of Graver and Green. (Pubmed Central) - Jul 23, 2022
As identified by a Nature Methods editorial entitled "The Power of Disagreement" (2016), disagreements bring attention to best practices so that differences in interpretation do not result from inferior data sets or confirmation bias, "prompting researchers to take a second look at evidence that is not in agreement with their hypothesis, rather than dismiss it as artifacts." Graver and Green published reasons why they disagree with a recent clinical case report and a decades old randomized control trial characterizing the effect of an acute 2 mg dosing of lorazepam on the Word Memory Test...These two opposing views provide an excellent learning opportunity, particularly for students, demonstrating the importance of careful articulation of the rationale behind certain conclusions from different perspectives. We encourage careful review of the original articles being discussed so the neuropsychologists can read both positions and decide which interpretation of the findings they consider most sound.
- |||||||||| risperidone / Generic mfg., lorazepam / Generic mfg.
Review, Journal: Antipsychotics for schizophrenia spectrum disorders with catatonic symptoms. (Pubmed Central) - Jul 20, 2022
The lack of consensus on the psychopathology of catatonia remains a barrier to defining treatments for people with schizophrenia. Better understanding of the efficacy and safety of antipsychotics may clarify treatment for this unique subtype of schizophrenia.
- |||||||||| Activase (alteplase) / Roche, Boehringer Ingelheim, Kyowa Kirin, Mitsubishi Tanabe
Journal: Case Report: Possible Serotonin Syndrome in a Patient Taking Kratom and Multiple Serotonergic Agents. (Pubmed Central) - Jul 17, 2022
Better understanding of the efficacy and safety of antipsychotics may clarify treatment for this unique subtype of schizophrenia. Because substances contained in kratom can inhibit metabolism of prescription serotonergic medications, clinicians must be aware of potential development of serotonin syndrome.
- |||||||||| Review, Journal: ECT-resistant Catatonia: Case Report and Literature Review. (Pubmed Central) - Jul 17, 2022
Because substances contained in kratom can inhibit metabolism of prescription serotonergic medications, clinicians must be aware of potential development of serotonin syndrome. The literature review and new case suggest reconsideration of catatonia diagnosis, optimizing ECT treatments, cautious use of antipsychotics, consideration of lorazepam augmentation to ECT treatments and/or use of N-methyl-D-aspartate (NMDA) receptor antagonists.
- |||||||||| Aptiom (eslicarbazepine) / Sumitomo Dainippon, BIAL
Journal: Effects of central nervous system drugs on androgen, estrogen α, glucocorticoid, and thyroid receptors. (Pubmed Central) - Jul 16, 2022
In the hERα-HeLa-9903 cells, estrogen receptor α agonistic activities were shown for fluoxetine, paroxetine, and sertraline (at 10 μM and 25 μM), and in the GH3.TRE-Luc cells, the same three CNS drugs showed antithyroid activities (ICs, 11.6, 11.9, 2.7 μM, respectively)...Little to no effects were seen toward any of these nuclear receptors for paliperidone and risperidone...These data elucidate the potential for adverse endocrine effects for some of these CNS drugs, which should therefore contribute to informed choice when prescribing them. However, long-term exposure to therapeutic concentrations of CNS drugs that have activities on the endocrine system should be explored further also in vivo.
- |||||||||| Quviviq (daridorexant) / Idorsia, Mochida, Syneos Health
Journal: Daridorexant (Quviviq) for insomnia. (Pubmed Central) - Jul 16, 2022
While this case does not alter the standard care of ethanol dependence, it does alert clinicians that our treatment approach may not be fully benign. No abstract available
- |||||||||| diphenhydramine / Generic mfg., lorazepam / Generic mfg., Neulasta (pegfilgrastim) / Amgen, Kyowa Kirin, Roche
Huh. I was so premeded before each infusion. Ativan injection, dex injection, 2 antiemitics, and a benadryl injection. Before they even finished injecting the benadryl, I was fighting sleep, so I'd just nap hard. My neulasta shot after treatments sucked. (Twitter) - Jul 10, 2022
- |||||||||| tramadol hydrochloride / Generic mfg.
Clinical, Journal: A Case Report of Hypoglycemia Following a Tramadol Overdose in a Non-Diabetic Patient. (Pubmed Central) - Jul 8, 2022
This case illustrates that hypoglycemia can be a presenting symptom in patients with an acute overdose of tramadol with no previous history of glycemic dysregulation. Upon presentation it is important to closely monitor serum glucose concentrations to identify hypoglycemia early in order to initiate necessary hypoglycemia protocols.
- |||||||||| lorazepam / Generic mfg.
Journal: The risks of tanning with the Barbie drug (Pubmed Central) - Jun 30, 2022
Early introduction of enteral lorazepam was associated with reduced duration of hospital stay. This case reports underlines self-administration of Melanotan II is not without potential side effects, although Melanotan II is easily available on the internet and in gyms.
- |||||||||| clonazepam / Generic mfg., lorazepam / Generic mfg., diazepam / Generic mfg.
Journal: Management and outcomes of catatonia: A prospective study in urban South Africa. (Pubmed Central) - Jun 28, 2022
The length of hospital stay of patients with catatonia was similar to that of patients without catatonia. Treatment guidelines for catatonia need to include the role and timing of electroconvulsive therapy to augment current treatment protocols for the use of lorazepam.
- |||||||||| Seizalam (midazolam intramuscular) / Pfizer
Review, Journal: Management of the first stage of convulsive status epilepticus in adults: a systematic review of current randomised evidence. (Pubmed Central) - Jun 25, 2022
Head-to-head trials comparing buccal versus intranasal midazolam versus rectal diazepam would provide useful information to inform the management of the first stage of convulsive status epilepticus in adults, especially when intravenous or intramuscular access is not feasible. Approaches to improve adherence to clinical guidelines on the use of currently available benzodiazepines for the first-line treatment of convulsive status epilepticus should also be considered.
- |||||||||| lorazepam / Generic mfg.
Retrospective data, Journal: New persistent opioid use among adolescents and young adults with sarcoma. (Pubmed Central) - Jun 24, 2022
In this cohort of AYAs treated for sarcoma, 64% of the patients received opioid prescriptions during treatment, and 23% of these patients became new persistent users. Because of the risks associated with persistent opioid use, studies of novel pain management strategies along with age-appropriate education and anticipatory guidance are urgently needed.
- |||||||||| Major depressive disorder (MDD), antidepressants and uncontrolled hypertension: a report of intraoperative autonomic dysregulation along with a literature review (Virtual Platform - Poster section) - Jun 17, 2022 - Abstract #Euroanaesthesia2022Euroanaesthesia_463;
Following the start of the operation, unexplained tachycardia and an hypertensive spike, resistant to aggressive intravenous treatment with opioids, glygeryl nitrate and clonidine appeared...Our patient’s treatment with quetiapine could be correlated with the appearance of malignant neuroleptic syndrome...The fact that the only antihypertensive that controlled the crisis was phentolamine (a known non selective a – adrenergic antagonist that halts sympathetic over-reactivity), strengthens the hypothesis of a catecholamine excess on the patient.Learning points: Our case highlights a hidden dysregulation in MDD treated with SNRI’s which can be unmasked intraoperatively . Anesthesiologists need to be aware of a possible latent autonomic dysfunction in such patients, that during stressful events, like major surgery, can be expressed as a resistant hypertensive crisis.Author, YearFindingBarton et al, 2007A subset of patients with MDD present extraordinarily high sympathetic activityKoschke et al, 2009shift of autonomic balance toward sympathetic predominance,decrease in parasympathetic parameters and baroreflex sensitivity, autonomic dysfunction, is exacerbated by SNRI and to a lesser degree by SSRI treatmentMeng et al, 2012Depression as an independent risk factor of hypertensionScalco et al 2005increased prevalence of hypertension in depressed patients, possible underlying mechanism is aν hyperreactivity of the sympathetic nervous system, the use ofantidepressive agents can interfere with blood pressure control of patients with hypertensionLight et al 2009the use of certain antidepressants is associated with hypertensionAlvares et al , 2016Reductions in HRV (heart rate variability) across psychiatric disordersAbosi et al, 2019antipsychotics, mood stabilizers, and some antidepressants, have been independently associated with increases in blood pressure through inhibition of norepinephrine reuptake
- |||||||||| lorazepam / Generic mfg.
Clinical, Journal: General practitioners' compliance with benzodiazepine discontinuation guidelines in patients treated with long-term lorazepam: A case-vignette cross-sectional survey. (Pubmed Central) - Jun 15, 2022
Anesthesiologists need to be aware of a possible latent autonomic dysfunction in such patients, that during stressful events, like major surgery, can be expressed as a resistant hypertensive crisis.Author, YearFindingBarton et al, 2007A subset of patients with MDD present extraordinarily high sympathetic activityKoschke et al, 2009shift of autonomic balance toward sympathetic predominance,decrease in parasympathetic parameters and baroreflex sensitivity, autonomic dysfunction, is exacerbated by SNRI and to a lesser degree by SSRI treatmentMeng et al, 2012Depression as an independent risk factor of hypertensionScalco et al 2005increased prevalence of hypertension in depressed patients, possible underlying mechanism is aν hyperreactivity of the sympathetic nervous system, the use ofantidepressive agents can interfere with blood pressure control of patients with hypertensionLight et al 2009the use of certain antidepressants is associated with hypertensionAlvares et al , 2016Reductions in HRV (heart rate variability) across psychiatric disordersAbosi et al, 2019antipsychotics, mood stabilizers, and some antidepressants, have been independently associated with increases in blood pressure through inhibition of norepinephrine reuptake GPs largely reported practice compliant with benzodiazepine discontinuation guidelines, although some GPs, mainly older men who overemphasise patient preferences, were more likely to adopt out-of-guidelines practice.
- |||||||||| lorazepam / Generic mfg.
Retrospective data, Journal: A New Strategy for Efficient Retrospective Data Analyses for Designer Benzodiazepines in Large LC-HRMS Datasets. (Pubmed Central) - Jun 14, 2022
The most common tentative and confirmed findings were etizolam (n = 26), phenazepam (n = 13), lorazepam (n = 9), and flualprazolam (n = 8)...When the standard of an emerging DBZD becomes available, all previously acquired DUID data files can be screened in less than 1 min. Being able to perform a fast and accurate retrospective data analysis across previously acquired data files is a major technological advancement in monitoring NPS abuse.
- |||||||||| hydroxychloroquine / Generic mfg., lorazepam / Generic mfg., haloperidol / Generic mfg.
Clinical, Journal: An Unusual Case of COVID-19 Presenting as Acute Psychosis. (Pubmed Central) - Jun 4, 2022
Treatment, as shown in this case report, appears to be supportive and symptom based for the associated psychotic symptoms. Optimal antiviral treatment is still yet to be clearly defined, as research continues on how to best treat the virus itself.
- |||||||||| lorazepam / Generic mfg.
Enrollment change, Trial withdrawal: Lorazepam Effects on Neuroimaging Measures (clinicaltrials.gov) - May 27, 2022
P1, N=0, Withdrawn,
The prevalence of use found is among the highest at international level, justifying the implementation of clinical and public health interventions to improve this situation. N=20 --> 0 | Not yet recruiting --> Withdrawn
- |||||||||| IS POOR SLEEP ASSOCIATED WITH USE OF MULTIPLE BENZODIAZEPINE RECEPTOR AGONISTS IN OLDER VETERANS? (Richardson Ballroom B) - May 20, 2022 - Abstract #SLEEP2022SLEEP_478;
Multi-BZA use was unrelated to duration of sleep complaints, sleep quality or sleep efficiency. Whether the use was simultaneous or staggered, these findings are concerning, given the elimination half-life of most of the BZAs and that polypharmacy, especially within medication class, may increase risk of adverse events (e.g., falls).
- |||||||||| Recentin (cediranib) / AstraZeneca
Trial completion date, Trial primary completion date, Monotherapy, Metastases: Sunitinib or Cediranib for Alveolar Soft Part Sarcoma (clinicaltrials.gov) - May 20, 2022
P2, N=34, Active, not recruiting,
Whether the use was simultaneous or staggered, these findings are concerning, given the elimination half-life of most of the BZAs and that polypharmacy, especially within medication class, may increase risk of adverse events (e.g., falls). Trial completion date: Dec 2022 --> Apr 2023 | Trial primary completion date: Dec 2022 --> Apr 2023
- |||||||||| lorazepam / Generic mfg., alprazolam / Generic mfg.
Journal: Alprazolam and lorazepam overdose and the absence of brainstem reflexes. (Pubmed Central) - May 17, 2022
Her consciousness and brainstem reflexes improved dramatically after 0.25 mg of intravenous flumazenil. The blood for BZDs concentration showed alprazolam 268 ng/mL (20-40 ng/mL), lorazepam 861 ng/mL (20-250 ng/mL) and their metabolites.
- |||||||||| lorazepam / Generic mfg.
Review, Journal: Efficacy of Transcranial Direct-Current Stimulation in Catatonia: A Review and Case Series. (Pubmed Central) - May 17, 2022
The results indicate that tDCS, in addition to symptomatic pharmacotherapies such as lorazepam, seems to effectively reduce catatonic symptoms...However, the specific efficacy of tDCS in catatonia remains to be demonstrated in a randomized controlled trial. The development of therapeutic alternatives in catatonia is of paramount importance.
|
