- |||||||||| lorazepam / Generic mfg.
FULL OF HOT AIR: A RARE COMPLIATION OF COVID-19 (Poster Hall - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_6380;
His early hospital course was complicated by acute alcohol withdrawal requiring lorazepam...Since SARS CoV2 is a new virus, not all its effects are known. However, there have been studies showing COVID-19 infection interacts with the parasympathetic nervous system3 alters neural-hormonal signals4 and autonomic dysfunction correlates to higher morbidity and mortality.5
- |||||||||| DIFFERENCES IN THE EPIDEMIOLOGY, TREATMENT AND OUTCOMES OF BLACK PATIENTS WITH GASTROPARESIS IN A NATIONWIDE ANALYSIS OF ACADEMIC MEDICAL CENTERS (28DE - San Diego Convention Center) - Apr 25, 2022 - Abstract #DDW2022DDW_3622;
Black patients were more likely to be treated with conventional prokinetic medications (metoclopramide, erythromycin, and azithromycin) but less likely to be given domperidone and pyridostigmine...Opioids were prescribed more among Black patients (the opposite for tapentadol), as were the neuromodulators amitryptiline and gabapentin, non-steroidals for pain, and the benzodiazepine Lorazepam (as opposed to alprazolam and clonazepam)...These could reflect differences in the clinical profile (more pain and nausea, less gastro-esophageal reflux), symptom severity or unequal access to healthcare and newer medications. Future research should focus on clarifying the root cause of these important disparities.
- |||||||||| lorazepam / Generic mfg.
Journal: Efficient and ecofriendly cellulose-supported MIL-100(Fe) for wastewater treatment. (Pubmed Central) - Apr 19, 2022
Moreover, the effect of pH, dose of adsorbent, isotherms and the kinetics of this process were studied using UV-vis and HPLC analyses and the adsorbents were fully characterized with PXRD, TGA, BET, SEM, ZP and FT-IR techniques. Our findings demonstrate that this composite is clearly a green, recyclable and efficient adsorbent for the removal of lorazepam and opens our way to further potential applications in the removal of other active pharmaceutical ingredients.
- |||||||||| lorazepam / Generic mfg., escitalopram / Generic mfg.
Preclinical, Journal: Escitalopram and lorazepam differentially affect nesting and open field behaviour in deer mice exposed to an anxiogenic environment. (Pubmed Central) - Apr 13, 2022
We show that LNB behaviour in deer mice is stable, irrespective of the anxiety-related context in which it is assessed, and that LNB mice find an open field arena to be less aversive compared to NNB mice. Escitalopram and lorazepam differentially affect the nesting and open field behaviour of LNB expressing mice, confirming deer mouse LNB as a repetitive behavioural phenotype that is related to a compulsive-like process which is regulated by the serotonergic system.
- |||||||||| lorazepam / Generic mfg.
Impact of an Alcohol Withdrawal Screening and Treatment Protocol for Hospitalized Patients (Great Hall Foyer, Third Floor) - Apr 8, 2022 - Abstract #ASAM2022ASAM_263;
However, these protocols were associated with a significant reduction in both total benzodiazepine dose and progression to delirium tremens in hospitalized patients. Implementing universal screening with validated screening tools, clinical assessments, and standardized treatment protocols is associated with improved clinical care in hospitalized patients at risk for AWS Results From the National Epidemiologic Survey on Alcohol and Related Conditions III.
- |||||||||| Clinical Guide to Phenibut: Systematic Review of Intoxication, Withdrawal, and Management (Great Hall Foyer, Third Floor) - Apr 8, 2022 - Abstract #ASAM2022ASAM_243;
These patients have a relatively high LOS likely reflecting the seriousness of toxicity and withdrawal, but also maybe provider unfamiliarity with these syndromes and the absence of a standardized treatment protocol. Perhaps most important is the gravity of phenibut overdose, which in several cases resulted in unresponsiveness, severe agitation necessitating sedation and intubation, and death.
- |||||||||| lorazepam / Generic mfg.
Retrospective data, Journal: Pre-hospital and emergency department treatment of convulsive status epilepticus in adults: an evidence synthesis. (Pubmed Central) - Apr 7, 2022
Both intravenous lorazepam and intravenous diazepam administered by paramedics are more effective than a placebo in the treatments of adults with convulsive status epilepticus, and intramuscular midazolam is non-inferior to intravenous lorazepam. Large well-designed clinical trials are needed to establish which benzodiazepines are more effective and preferable in the pre-hospital setting.
- |||||||||| methylphenidate tablet / Generic mfg., risperidone / Generic mfg., lorazepam / Generic mfg.
Biomarker, Clinical, Journal: Psychotropic prescribing rates and pharmacogenomic testing implications for autism in the Canadian primary care sentinel surveillance network. (Pubmed Central) - Apr 2, 2022
The change in prescription behavior could be motivated by regulatory hassle or by change in attitude towards opioid prescriptions and increased recognition of opioid use disorder. Our findings suggest primary care providers in Canada prescribe a wide range of psychotropics to their patients with autism, some of which may benefit from the integration of pharmacogenomic information into their treatment planning.
- |||||||||| lorazepam / Generic mfg., tramadol hydrochloride / Generic mfg.
Clinical, PK/PD data, Journal: Marked and prolonged serotonin toxicity in a tramadol-poisoned patient with a pharmacokinetic study. (Pubmed Central) - Mar 31, 2022
He was a kidney transplant patient treated with mycophenolate, tacrolimus, prednisone, and paroxetine...Only M2 present in sufficient concentrations up to 48 h could explain the prolonged serotonin toxicity. Marked and prolonged serotonin toxicity was attributed to increased M2 production due to paroxetine- and propranolol-related CYP2D6 inhibition of tramadol metabolism.
- |||||||||| Phase classification, Trial completion date, Trial primary completion date: Multimodal Analgesia Effect on Post Surgical Patient (clinicaltrials.gov) - Mar 28, 2022
P4, N=60, Recruiting,
These data support the use of either approach of the medication taper for seizure provocation in iEEG. Phase classification: P=N/A --> P4 | Trial completion date: Dec 2022 --> Dec 2025 | Trial primary completion date: Nov 2021 --> Dec 2024
- |||||||||| amitriptyline / Generic mfg., lorazepam / Generic mfg., duloxetine / Generic mfg.
SEVERE AORTIC VASOSPASM IN SEROTONIN SYNDROME ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_2551;
Postoperatively, the patient was admitted to the intensive care unit with hypotension, requiring epinephrine and dopamine...Methylene blue infusion was discontinued and intravenous lorazepam administered to no effect...As both pathologies are intimately associated, the plausibility of similar pathogenesis between the two is extremely likely. We describe the first case of serotonin associated aortic vasospasm.
- |||||||||| lorazepam / Generic mfg., midazolam hydrochloride / Generic mfg.
RAPIDLY PROGRESSIVE ANTI-NMDAR ENCEPHALITIS: MANAGEMENT CHALLENGE IN A PATIENT ADMITTED TO THE PICU ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_2082;
She developed hypoxemic respiratory failure, requiring mechanical ventilation, midazolam drip and IV antibiotic/acyclovir prophylaxis without improvement of movements...Once infection ruled out, Solu-medrol was started...This case is uncommon, our patient developed acute respiratory failure, AKI, and bullous lesions over the first 48hrs of admission. Prompt immunosuppressive therapy and high index of suspicion for paraneoplastic mass as etiology of her autoimmune encephalitis, helped control refractory focal movements, skin lesions and frail state in a timely manner.
- |||||||||| lorazepam / Generic mfg.
PHENOBARBITAL PROTOCOL FOR ALCOHOL WITHDRAWAL IN THE ICU ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1984;
Use of an IV phenobarbital loading dose with an oral phenobarbital taper had a lower ICU length of stay in patients admitted to a medical ICU with alcohol withdrawal symptoms, compared to patients treated with a symptom triggered protocol based on CIWA-Ar scores. . The phenobarbital protocol used in this facility has the benefit of a single IV loading dose of phenobarbital, with a two-day taper of oral phenobarbital.
- |||||||||| lorazepam / Generic mfg.
EVALUATION OF GUANFACINE USE, SAFETY, AND EFFICACY FOR MANAGEMENT OF AGITATION ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1974;
These findings of this quality improvement project support continuing unrestricted use of guanfacine for agitation but identified opportunities for education related to hemodynamic monitoring and hold parameters. Prospective studies are needed to solidify the role of guanfacine for this indication.
- |||||||||| lorazepam / Generic mfg., paracetamol / Generic mfg.
“COMMON THINGS ARE COMMON”: RED HERRINGS IN THE DIAGNOSIS OF ACETAMINOPHEN AND SALICYLATE OVERDOSE ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1878;
These included acetaminophen, aspirin, quetiapine and zolpidem...With a toxicology screen in process, the patient was treated with intravenous lorazepam for suspected serotonin syndrome and a bicarbonate drip for possible salicylate toxicity...Salicylate intoxication often has a delayed presentation and therefore it is crucial to look for subtle clinical findings in any patient with a suspected overdose and an elevated anion gap. While toxic ingestion of these medications can have devastating, possibly fatal adverse effects, a high index of suspicion and knowledge of common OTC medications can lead to early diagnosis with appropriate management having a high chance of clinical success.
- |||||||||| lorazepam / Generic mfg.
NATIONAL SURVEY OF CRITICAL CARE PRACTICES FOR ALCOHOL WITHDRAWAL SYNDROME IN THE ICU SETTING ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1795;
A total of 137 (97%) reported use of benzodiazepines, with lorazepam (n=134, 98%) as the preferred first-line treatment. Practice nationally varies; however, most pharmacists use symptom-triggered benzodiazepines first line for AWS in the ICU, followed by use of propofol intubated patients and dexmedetomidine and/or phenobarbital for refractory cases.
- |||||||||| dexamethasone / Generic mfg., lorazepam / Generic mfg., tianeptine / Generic mfg.
COMPLEX PARTIAL STATUS EPILEPTICUS PRECIPITATED BY SEROTONIN SYNDROME ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1790;
She was initiated on broad spectrum antibiotics, acyclovir and dexamethasone...She was treated with lorazepam and levetiracetam...After initiation of appropriate treatment, in the next 24 hours her mental status returned to baseline; on further questioning she admitted to taking tianeptine over-the-counter for insomnia, along with venlafaxine...Imbalance of glutamate excess and inadequate gamma aminobutyric acid as a result of SS provokes seizures. SS can be prevented by educating patients on potential drug interactions.
- |||||||||| lorazepam / Generic mfg.
CATATONIA AS AN ETIOLOGY OF PERSISTENT ALTERED MENTAL STATUS IN A CRITICALLY ILL PEDIATRIC PATIENT ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1772;
Olanzapine was started for hypoactive delirium on day 43...On day 50, a lorazepam challenge to evaluate for malignant catatonia was performed, and within 2 minutes of administration he opened his eyes, moved spontaneously, and followed commands before again becoming obtunded...Malignant catatonia includes features of hyperthermia and autonomic instability and is associated with morbidity and mortality. Catatonia should be considered when AMS is prolonged and not responding to typical interventions.
- |||||||||| lorazepam / Generic mfg.
LATE-ONSET MAPLE SYRUP URINE DISEASE TRIGGERED BY HHV-6-MEDIATED TOXIC-METABOLIC ENCEPHALOPATHY ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1758;
Metabolic crisis should always be on the differential diagnosis of a toddler presenting with focal neurologic signs and refractory ketoacidosis. Though MSUD diagnosis is incredibly rare beyond the neonatal period, prompt recognition and treatment can be life-saving and lead to good outcomes.
- |||||||||| lorazepam / Generic mfg., midazolam hydrochloride / Generic mfg.
MORBIDITY ASSOCIATED WITH TREATMENT DEVIATION FROM PEDIATRIC STATUS EPILEPTICUS GUIDELINES ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1757;
Interventions that increase physician adherence to guidelines of SE treatment in children will likely reduce excessive benzodiazepine administration and the need for intubation. Improving accurate weight measurement for our youngest patients may also improve dosing accuracy.
- |||||||||| DELIRIUM, DYSAUTONOMIA, AND HYPERTHERMIA: AN INCREDIBLY RARE CASE OF IDIOPATHIC VENTRICULITIS ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1746;
Ceftriaxone, vancomycin, and ampicillin were started empirically for pneumonia and meningitis...Serotonin syndrome was considered, and midazolam and acetaminophen were given with symptom improvement...Symptoms resolved with cooling blanket, lorazepam, and acetaminophen...MRI is ideal to show the characteristic dependent ventricular debris. Our case is 1 of less than 15 found in literature describing idiopathic ventriculitis, a diagnosis which should be considered in atypical presentations consistent with CNS infection despite inconsistent CSF findings.
- |||||||||| lorazepam / Generic mfg.
TODD PARALYSIS: MASKING OF SEIZURES DUE TO ANESTHESIA AND SEDATION ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1714;
He was given antibiotics, methylprednisolone, and lorazepam in the ED and was then intubated due to severe agitation...A fast-acting benzodiazepine for symptomatic treatment and an EEG to confirm seizures would have been sufficient. The presence of seizures and Todd’s paralysis was unmasked following the weaning of sedative medications.
- |||||||||| Rituxan (rituximab) / Biogen, Zenyaku Kogyo, Roche
POST-COVID-19 SUPER-REFRACTORY STATUS EPILEPTICUS SUCCESSFULLY TREATED WITH INTRATHECAL RITUXIMAB ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1133;
Patient had 2 seizures and received lorazepam...Seizures continued despite max doses of midazolam, propofol and ketamine infusions, which were then switched for pentobarbital...Patient completed high-dose steroids, 5 doses of plasmapheresis, rituximab and anakinra without seizure resolution...Our patient was discharged, decannulated and returned to work. We want to bring attention to this treatment modality that can help resolve seizures in post COVID-19 status epilepticus and contribute to a promising neurologic recovery.
- |||||||||| lorazepam / Generic mfg.
RARE POST-COVID-19 SEQUELAE: A CASE SERIES ON NEW-ONSET TEMPORAL LOBE SEIZURES IN HEALTHY ADULTS ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1132;
Underlying mechanisms for COVID-19 related seizures include neurotropism, entry of inflammatory cytokines into the nervous system & post-infectious immune mediated cerebritis. Hence long-term follow-up is needed to investigate the increased risk of developing epilepsy as a delayed manifestation of COVID-19.
- |||||||||| ceftriaxone / Generic mfg., lorazepam / Generic mfg., enoxaparin sodium / Generic mfg.
POLYCYTHEMIC COVID-19 WITH CEREBRAL VENOUS THROMBOSIS AS INITIAL PRESENTATION: CAUSE OR COINCIDENCE? ([VIRTUAL]) - Mar 23, 2022 - Abstract #SCCM2022SCCM_1109;
On hospital day 2, CT venogram confirmed extensive CVT and therapeutic enoxaparin was initiated...He was discharged on hospital day 8 on apixaban...Hypercoagulable states found with COVID-19 infections have been previously linked to CVT in young adults, however these are more often complicated by anemia. Our patient’s unique presentation of CVT underlined by polycythemia was found to be treatable with phlebotomy, leading to complete resolution of acute encephalopathy.
- |||||||||| nifedipine immediate release / Generic mfg., lorazepam / Generic mfg.
Journal: Drugs in Pregnancy and Lactation - Medications used in Swiss Obstetrics. (Pubmed Central) - Mar 9, 2022
Official authorisation for frequently or consistently used active substances is urgently needed. With this study, a first important step towards national harmonisation has been taken.
- |||||||||| lorazepam / Generic mfg., gabapentin / Generic mfg.
Retrospective data, Journal: Outcomes After Implementation of a Benzodiazepine-Sparing Alcohol Withdrawal Order Set in an Integrated Health Care System. (Pubmed Central) - Mar 9, 2022
To evaluate changes in outcomes after implementation of a benzodiazepine-sparing AWS inpatient order set that included adjunctive therapies (eg, gabapentin, valproic acid, clonidine, and dexmedetomidine)...Among hospitalizations with order set use, any benzodiazepine use decreased after implementation from 6431 hospitalizations (78.1%) to 2823 hospitalizations (60.7%) (P < .001), with concomitant decreases in the mean (SD) total dosage of lorazepam before vs after implementation (19.7 [38.3] mg vs 6.0 [9.1] mg; P < .001)...This study found that implementation of a benzodiazepine-sparing AWS order set was associated with decreased use of benzodiazepines and favorable trends in outcomes. These findings suggest that further prospective research is needed to identify the most effective treatments regimens for patients hospitalized with alcohol withdrawal.
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