- |||||||||| lorazepam / Generic mfg.
Retrospective data, Journal: Lorazepam timing for acute convulsive seizure control (LoTASC). (Pubmed Central) - Jan 5, 2021
Our study suggests that lorazepam administration for acute convulsive seizures not meeting convulsive status epilepticus criteria may lead to iatrogenic vital instability and need for ICU admission.
- |||||||||| Nitredon (nitrazepam) / Remedica
Journal: Incidence of and Characteristics Associated With Long-term Benzodiazepine Use in Finland. (Pubmed Central) - Jan 5, 2021
The findings of this population-based cohort study conducted in Finland suggest that the incidence of subsequent long-term BZDR use in individuals who initiate use of BZDRs is high, especially among older persons, and that the specific BZDR used initially is associated with the development of long-term BZDR use and should be carefully considered when prescribing BZDRs. The observed factors that appear to be associated with development of long-term BZDR use also should be considered in clinical decision-making when starting and monitoring BZDR treatment.
- |||||||||| risperidone / Generic mfg.
Journal: Brief psychotic disorder associated with quarantine and mild COVID-19. (Pubmed Central) - Dec 30, 2020
Anxiety about his health and social isolation appeared the main aetiological factors but an inflammatory component cannot be excluded. The case highlights that first episode psychosis can be associated with mild COVID-19.
- |||||||||| lorazepam / Generic mfg.
[VIRTUAL] Utilization review of the alcohol withdrawal powerplan and benzodiazepine usage in patients with a history of alcohol abuse () - Dec 26, 2020 - Abstract #ASHP2020ASHP_5091;
The following data will be collected: age, sex, date and time of admission, discharge, and initiation of the alcohol withdrawal powerplan, diagnosis or documented history of alcohol use, benzodiazepines ordered and administered including medication name, route, dose, and Clinical Institute Withdrawal Assessment (CIWA) score indication, unit in which the protocol for severe withdrawal was used, and total dose (in milligrams) of lorazepam administered while on the powerplan. The data collected will be used to evaluate the time from admission to the initiation of the alcohol withdrawal powerplan, doses, routes, frequencies, and CIWA score indications of benzodiazepines ordered and administered using the powerplan, symptom control based on the average CIWA score documented for each patient, frequency the protocol for severe withdrawal was used in the intensive care unit (ICU), and total doses of lorazepam administered under the powerplan.
- |||||||||| hydralazine hydrochloride / Generic mfg., lorazepam / Generic mfg., labetalol / Generic mfg.
[VIRTUAL] Timeliness of Antihypertensive Agents for Hypertensive Crisis during Pregnancy () - Dec 26, 2020 - Abstract #ASHP2020ASHP_5069;
Lastly, the timing and method of delivery will be noted if childbirth occurred during the same admission. Therapy will be evaluated for compliance according to the American College of Obstetricians and Gynecologists (ACOG) guidelines.
- |||||||||| lorazepam / Generic mfg.
[VIRTUAL] The utility of the prediction of alcohol withdrawal severity scale (PAWSS) for identifying risk of complicated alcohol withdrawal () - Dec 26, 2020 - Abstract #ASHP2020ASHP_5065;
The following data will be collected: relevant demographics, CIWA-Ar scores, total lorazepam equivalents, PAWSS score, advancement of care (defined as ICU consult, ICU admission, or initiation of mechanical ventilation), incidence of seizure, incidence of delirium tremens, and initiation of GABAergic medication...The primary end point will be the difference in the rate of advancement of care for high-risk individuals as compared to low-risk. Secondary endpoints will be seizure incidence, delirium tremens incidence, initiation of scheduled GABAergic medication, length of stay, and cumulative benzodiazepine dose.
- |||||||||| lorazepam / Generic mfg.
[VIRTUAL] Phenobarbital in the setting of acute alcohol withdrawal syndrome () - Dec 26, 2020 - Abstract #ASHP2020ASHP_4979;
Compared to lorazepam, phenobarbital has a longer half-life and better suited mechanism of action...Patients involved in this study include: adults aged 18 years or older presenting to the emergency department with acute AWS warranting admission. Those meeting the following criteria will be excluded: age < 18 years; currently pregnant or breastfeeding; patients with severe acute hepatitis or liver failure; admission to trauma service; those with a brain mass, intracranial bleed, or abnormal cell count/gram stain on lumbar puncture; strong clinical suspicion of recent co-ingestion of depressant drugs; history of allergy to phenobarbital; those leaving against medical advice; anyone with an active outpatient prescription for an anti epileptic drug, anticoagulant medication, antiviral for HIV, or a monoamine oxidase inhibitor.
- |||||||||| lorazepam / Generic mfg.
[VIRTUAL] Evaluating the safety of dexmedetomidine on non-ICU units for alcohol withdrawal and delirium () - Dec 26, 2020 - Abstract #ASHP2020ASHP_4555;
Secondary endpoints include if the set protocol was followed (maximum rate of 0.7 mcg/kg/hour), average benzodiazepine use in lorazepam equivalents, average dexmeditomidine rate, average duration of dexmeditomidine administration, and estimated cost savings from the ability to keep patients out of the ICU. The study hopes to confirm the safety of dexmeditomidine use on non-ICU floors to allow patients to remain out of the ICU or to transfer out of the ICU earlier if otherwise clinically stable.
- |||||||||| lorazepam / Generic mfg., diazepam / Generic mfg.
[VIRTUAL] Phenobarbital versus benzodiazepines for alcohol withdrawal in the inpatient setting () - Dec 26, 2020 - Abstract #ASHP2020ASHP_4181;
The primary outcome evaluated will be incidence of mechanical ventilation. Secondary outcomes will include length of mechanical ventilation, hospital length of stay, incidence of ICU admission, ICU length of stay, incidence of seizure, incidence of hallucinations, incidence of delirium, incidence of ventilator-associated pneumonia, 30-day hospital mortality, and 30-day readmission rate.
- |||||||||| lorazepam / Generic mfg., dexmedetomidine / Generic mfg.
[VIRTUAL] Medication use evaluation of dexmedetomidine in critically ill patients with alcohol withdrawal symptoms at a community teaching hospital () - Dec 26, 2020 - Abstract #ASHP2020ASHP_4120;
Purpose: Dexmedetomidine is an intravenous, centrally-acting alpha-2 adrenergic agonist currently recommended by the American Society of Addiction Medicine guidelines as an adjunct to benzodiazepine therapy in the critically ill patient population to control autonomic hyperactivity and anxiety or for resistant alcohol withdrawal...Appropriate initiation of dexmedetomidine will be defined with the following criteria: continued presence of alcohol withdrawal symptoms as evidenced by a Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) score greater than or equal to 15 despite total benzodiazepine equivalent use of greater than 10 mg lorazepam equivalents in 1 hour or greater than 40 mg lorazepam equivalents in 4 hours and continued use of benzodiazepine symptom-triggered therapy as needed per provider-specified CIWA-Ar score criteria...Reviewers will determine if dexmedetomidine initiation was appropriate for each patient using pre-specified criteria. Univariate descriptive statistics will be performed to describe the patient population and the outcomes identified in this protocol.
- |||||||||| lorazepam / Generic mfg.
[VIRTUAL] Analysis of phenobarbital taper and its effects on dexmedetomidine use in alcohol withdrawal patients () - Dec 26, 2020 - Abstract #ASHP2020ASHP_3625;
This study seeks to evaluate efficacy and safety of phenobarbital taper compared to lorazepam for preventing dexmedetomidine use...Data analysis plans include descriptive (frequency, percentage, mean, standard of deviation) and inferential statistics (chi-squared analysis, two tailed t-test, fisher’s exact). Statistical significance will be determined at p < 0.05 for all inferential tests.
- |||||||||| Flagyl (metronidazole) / SLA
[VIRTUAL] Refractory seizures secondary to neurocysticercosis () - Dec 26, 2020 - Abstract #ASHP2020ASHP_2914;
In ED, she had two more GTCS which required lorazepam for the first episode and repeat of lorazepam with an increase in propofol for the second episode...She was started on ceftriaxone and metronidazole for empiric treatment of post-partum endometritis...The patient was started on albendazole and dexamethasone...This case represents a rare status epilepticus refractory to neurocysticercosis with a patient that was in remission for ten years. It is important to consider neurocysticercosis on the differential in any patient presenting with status epilepticus.
- |||||||||| [VIRTUAL] Quetiapine- induced akathisia: case report () - Dec 26, 2020 - Abstract #ASHP2020ASHP_2909;
Memantine 5 mg nightly was initiated to treat akathisia and continued at discharge...The case demonstrates that several treatment options are available for akathisia in patients intolerant to first-line treatment. Pharmacists can advocate the optimal treatment plan for debilitating akathisia in patients who are intolerant of first-line agents.
- |||||||||| Silenor (doxepin) / Currax, Humira (adalimumab) / Eisai, AbbVie
[VIRTUAL] Potential drug-drug interaction between terbinafine and aripiprazole: two cases () - Dec 26, 2020 - Abstract #ASHP2020ASHP_2896;
Medications at time of admission included: albuterol inhaler as needed, aripiprazole 15 mg daily, aspirin 81 mg daily, cholecalciferol 2000 units daily, ferrous sulfate 325 mg daily, fluticasone-umeclidinium-vilanterol 100-62.5-25 mcg/puff daily, lisinopril 10 mg nightly, lorazepam 1 mg every eight hours as needed for anxiety or insomnia, metoprolol tartrate 25 mg twice daily, pantoprazole 40 mg before breakfast, and terbinafine 250 mg daily...Medications at time of admission included: adalimumab 40 mg every week, aripiprazole 15 mg daily, clonazepam 2 mg twice daily as needed for anxiety or panic, diclofenac 75 mg twice daily, doxepin 6 mg nightly, dulaglutide 0.75 mg every week, ergocalciferol 50,000 units twice a week, escitalopram 20 mg daily, fexofenadine 60 mg twice daily, fluticasone propionate/salmeterol inhaler (250-50 mcg/dose) twice daily, glipizide 10 mg daily, lisinopril 10 mg daily, omeprazole 20 mg daily, pramipexole 0.125 mg nightly, and terbinafine 250 mg daily...We compare our patients’ aripiprazole C/D ratios against populations who have undergone pharmacogenetic testing and other control groups in the absence of CYP 2D6 or 3A4 inhibiting medications. Through the use of therapeutic drug monitoring, pharmacogenetic data, other clinical data, and a tool to determine drug-drug interactions, we suggest terbinafine probably does not increase aripiprazole concentrations to a clinically relevant degree.
- |||||||||| [VIRTUAL] Community hospital pharmacy evaluation of the barcode scanning administration (BCMA) process within the system () - Dec 26, 2020 - Abstract #ASHP2020ASHP_2536;
Though the community hospital being studied has a BCMA process in place with an average medication scanning adherence rate of 96.71 percent, there are still high volumes of frequently used medications that are failing to meet the goal adherence rate. The identified primary source of error was nursing noncompliance and was addressed by pharmacy delivering nursing education specific to the frequently missed medications.
- |||||||||| ketamine / Generic mfg.
[VIRTUAL] Phenobarbital loading dose in patients with severe alcohol withdrawal in the emergency department () - Dec 26, 2020 - Abstract #ASHP2020ASHP_2312;
Baseline information including age, sex, height, weight, CIWA-Ar score prior to first treatment medication dose, history of AWS, history of withdrawal seizures, history of delirium tremens, pertinent comorbidities, and blood alcohol level will be collected. Outcomes will be analyzed using the Chi-squared test and Wilcoxon rank-sum test.
- |||||||||| lorazepam / Generic mfg.
[VIRTUAL] Implementation of a phenobarbital protocol for severe alcohol withdrawal in the ICU () - Dec 26, 2020 - Abstract #ASHP2020ASHP_2216;
Adult patients with either Prediction of Alcohol Withdrawal Severity Scale >3, Clinical Institute Withdrawal Assessment >15, or receiving 10mg of lorazepam in 1 hour will be eligible for this study...Patients leaving against medical advice or needing re-admission to the ICU will also be collected. Finally, we’ll record the prevalence of delirium tremens, seizures, hallucinations, and intubations while on this protocol.
- |||||||||| Silenor (doxepin) / Currax
[VIRTUAL] Impact of sleep aid reduction strategies across a multi-hospital health system () - Dec 26, 2020 - Abstract #ASHP2020ASHP_2196;
The electronic medical record system will identify patients prescribed temazepam, alprazolam, lorazepam, zolpidem, diphenhydramine, trazodone, or doxepin (low dose) for insomnia during their admission at South Florida Baptist Hospital between April 2019 and October 2020...This data will be reviewed by clinical pharmacy personnel and health system leadership to determine whether medication-induced fall rates have decreased since initial evaluation one year ago. Results from the analysis will provide future direction to improving the utilization of sleep aid medications for our health system.
- |||||||||| lorazepam / Generic mfg.
[VIRTUAL] Clonidine Use for Withdrawal Prevention in Pediatric Patients Intubated with Dexmedetomidine () - Dec 26, 2020 - Abstract #ASHP2020ASHP_1837;
The primary endpoint of this study will be a clinically significant difference between the clonidine and no clonidine group in the number of as needed sedative use, either midazolam or lorazepam, within the 48 hour period post discontinuation of dexmedetomidine...Additionally, data will be collected to assess total cumulative dose and duration of dexmedetomidine, length of ICU stay, and total cumulative dose and duration of clonidine in those that received clonidine. A t-test will be used to analyze for statistically significant differences in the endpoints between the clonidine and no clonidine groups.
- |||||||||| lorazepam / Generic mfg., escitalopram / Generic mfg.
[VIRTUAL] Catatonia in a young healthy female post-COVID-19 infection: a case study () - Dec 26, 2020 - Abstract #ASHP2020ASHP_1819;
She was initially diagnosed with acute psychosis and was given escitalopram, an antidepressant, and a benzodiazepine as needed...On the night of admission, she had an acute panic attack relieved by lorazepam...While these types of encephalopathies are not a new phenomenon, this case serves to alert providers that a past history of COVID-19 infection could lead to neuropsychiatric symptoms that are not treated by antidepressants alone. This patient is an example of the neurological sequelae of COVID-19 and is a possible addition to the now growing list of short and long-term effects of this mysterious infection.
- |||||||||| lorazepam / Generic mfg.
[VIRTUAL] Assessment of phenobarbital-containing regimens on the resolution of alcohol withdrawal syndrome () - Dec 26, 2020 - Abstract #ASHP2020ASHP_1805;
The primary outcome was the number of days in alcohol withdrawal as defined by CIWA-Ar scores. Secondary outcomes included hospital and ICU length of stay in both treatment groups, incidence of primary intubation or re-intubation, the development of medication related adverse events, development of seizure or delirium tremens, total lorazepam dose equivalents, and the incidence of other adjunctive AWS treatment aside from phenobarbital and benzodiazepines.
- |||||||||| Humira (adalimumab) / Eisai, AbbVie, Trileptal (oxcarbazepine) / Novartis
[VIRTUAL] The clinical use of immunosuppressants and anti-epileptic drug therapies in the treatment of Neuro-Behcet's in a patient with unspecified dementia and epileptic seizure () - Dec 26, 2020 - Abstract #ASHP2020ASHP_1699;
Treatment was initiated with haloperidol, loxapine, lorazepam, phenytoin, levetiracetam, topiramate, lacosamide, adalimumab, hibiclens, and theragran...For ulcers, PD4 inhibitor apremilast is the only FDA approved medication...Anti-epileptic drugs (AED) phenytoin, oxcarbazepine or carbamazepine can control seizures in most patients...Although the combination of dementia, epilepsy and intellectual disabilities seen together in this patient is rare, it is a predictable complication of NBD. Recognition of these symptoms is critical to initiating appropriate therapy.
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