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1.
Rev. bras. cir. cardiovasc ; 34(3): 311-317, Jun. 2019. tab, graf
Article in English | LILACS | ID: biblio-1013477

ABSTRACT

Abstract Objective: To investigate the effects of preoperative anxiety relieving on electrophysiological changes in patients undergoing off-pump coronary artery bypass surgery. Methods: A total of 61 patients at ASA III risk group in the age range of 18-65 years were enrolled in the present study. Patients were randomly divided into two groups. Group S (Sedation group) was administered 0.04 mg/kg lorazepam per os (PO) twice before the operation. Group C (control group) was not administered with any anxiolytic premedication. State Trait Anxiety Inventory (STAI-I) and Beck Anxiety Inventory (BAI) were used to evaluate the level of anxiety. Electrocardiography (ECG), pulse oximeter and standard monitoring were performed for each patient. QT and P dispersions in each derivation of all ECGs were calculated. Results: Preoperative STAI-I scores were significantly lower in sedation group compared to the controls. Mean values of QT dispersion measured before induction, at the 1st minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.024; P=0.027; P=0.001; P=0.033, respectively). The mean values of P dispersion measured before induction, at the 3rd minute of induction, 30th second of intubation and 4th minute of intubation in sedation group were significantly reduced compared to controls (P=0.001; P=0.020; P=0.023; P=0.005, respectively). Conclusion: Elevated anxiety levels in patients undergoing coronary bypass surgery have a negative effect through prolonged QT and P-wave dispersion times. Anxiolytic treatment before surgery may be useful to prevent ventricular and atrial arrhythmias and associated complications through decreasing the QT and P-wave dispersion duration.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Anxiety/physiopathology , Anxiety/drug therapy , Anti-Anxiety Agents/therapeutic use , Preoperative Care/methods , Coronary Artery Bypass, Off-Pump/psychology , Electrocardiography/psychology , Lorazepam/therapeutic use , Arrhythmias, Cardiac/physiopathology , Arrhythmias, Cardiac/psychology , Reference Values , Time Factors , Reproducibility of Results , Risk Factors , Treatment Outcome , Statistics, Nonparametric , Coronary Artery Bypass, Off-Pump/methods
2.
Porto Alegre; Universidade Federal do Rio Grande do Sul. Telessaúde; 2018. ilus.
Non-conventional in Portuguese | LILACS | ID: biblio-995599

ABSTRACT

A insônia é o mais prevalente dos transtornos do sono. É definida como a insatisfação com a qualidade ou a quantidade de sono, que ocorre a despeito de adequada oportunidade para dormir e que impõe ao indivíduo algum tipo de prejuízo durante o dia. A prevalência da insônia crônica em sociedades industrializadas é de 5 a 10%. Entre pessoas portadoras de doença crônica (psiquiátricas ou não) e idosos, a prevalência é significativamente maior. Trata-se de queixa frequente na Atenção Primária à Saúde (APS). Este material contempla as situações mais comumente associadas a insônia na APS, assim como o manejo inicial desta queixa. Está baseado em extensa revisão das evidências disponíveis na literatura, em boas práticas clínicas e adaptado à realidade brasileira, considerando as intervenções terapêuticas disponíveis. Esta guia apresenta informação que orienta a conduta para casos de avaliação e manejo da insônia no contexto da Atenção Primária à Saúde, incluindo: Avaliação Geral, Avaliação Objetiva, Avaliação e Manejo em situações específicas, Intervenções Não-Farmacológicas, Manejo Farmacológico na APS, Retirada de benzodiazepínico, Preocupações com uso de amitriptilina, Fármacos não recomendados na APS, Avaliação longitudinal da insônia, Fluxograma para avaliação e manejo da insônia.


Subject(s)
Humans , Sleep Initiation and Maintenance Disorders/diagnosis , Sleep Initiation and Maintenance Disorders/drug therapy , Primary Health Care , Trazodone/therapeutic use , /therapeutic use , /therapeutic use , Amitriptyline/therapeutic use , Lorazepam/therapeutic use
3.
Rev. bras. anestesiol ; 66(4): 426-429,
Article in English | LILACS | ID: lil-787613

ABSTRACT

Abstract Introduction: Psychogenic non-epileptic seizures (PNES or “pseudoseizures”) remain an obscure topic in the peri-operative setting. They are sudden and time-limited motor and cognitive disturbances, which mimic epileptic seizures, but are psychogenically mediated. Pseudoseizures occur more frequently than epilepsy in the peri-operative setting. Early diagnosis and management may prevent iatrogenic injury. Case: 48 year-old female with a history of depression and “seizures” presented for gynecologic surgery. She described her seizure history as “controlled” without anticonvulsant therapy. The patient underwent uneventful general anesthesia and recovered neurologically intact. During the first two postoperative hours, the patient experienced 3 episodes of seizure-like activity with generalized shaking of extremities and pelvic thrusting; her eyes were firmly closed. No tongue biting or incontinence was noted. The episodes lasted approximately 3 min each, one of which resolved spontaneously and the other two following intravenous lorazepam. During these episodes, the patient had stable hemodynamics and adequate ventilation such that endotracheal intubation was deemed unwarranted. Post-ictally, the patient was neurologically intact. Computed axial tomography of the head, metabolic assay, and electroencephalogram showed no abnormalities. A presumptive diagnosis of PNES was made. Discussion: Psychogenic non-epileptic seizures mimic shivering, and should be considered early in the differential diagnosis of postoperative shaking, as they may be more likely than epilepsy in this setting. Pseudoseizure patterns include asynchronous convulsive episodes lasting more than 90 s, forced eye closure with resistance to opening, and retained pupillary responses. Autonomic manifestations such as tachycardia, cyanosis and incontinence are usually absent. A psychiatric background is common. Knowledge and correct diagnosis of pseudoseizures is of great importance for anesthesiologists to prevent morbidity and iatrogenic injury such as respiratory arrest caused by anticonvulsant therapy, in addition to the risks associated with endotracheal intubation and prolonged hospital stays. The diagnosis of pseudoseizures must be thoroughly documented and relayed in transfer of care to avoid misdiagnosis and iatrogenic complications. Treatment recommendations are anecdotal; psychiatric interventions are the hallmark of treatment. Anesthetic recommendations include techniques involving the minimum required short-acting agents, along with high levels of peri-operative psychological support and reassurance.


Resumo Introdução: As convulsões não epilépticas psicogênicas (CNEP ou “pseudoconvulsões”) permanecem como tema obscuro no cenário perioperatório. Trata-se de distúrbios motores e cognitivos súbitos, mas por tempo limitado, que imitam as convulsões epilépticas, mas que são psicogenicamente mediados. Pseudoconvulsões ocorrem com mais frequência do que epilepsia em cenário perioperatório. O diagnóstico e o tratamento precoces podem evitar lesões iatrogênicas. Caso: Paciente do sexo feminino, 48 anos, com história de depressão e “convulsões”, apresentou-se para cirurgia ginecológica. A paciente descreveu sua história de convulsões “controladas” sem o uso de terapia anticonvulsivante. Foi submetida à anestesia geral sem intercorrências e recuperou-se neurologicamente intacta. Durante as duas primeiras horas de pós-operatório, apresentou três episódios semelhantes à convulsão, com tremores generalizados das extremidades e impulso pélvico; seus olhos estavam bem fechados. Não observamos mordedura da língua ou incontinência. Os episódios duraram cerca de três minutos cada; um dos episódios resolveu espontaneamente e os outros dois após a administração de lorazepam por via intravenosa. Durante os episódios, a condição hemodinâmica da paciente era estável e a ventilação adequada, de modo que a intubação traqueal foi considerada injustificável. Após a convulsão, a paciente estava neurologicamente intacta. Tomografia axial da cabeça, teste metabólico e eletroencefalograma não mostraram alterações. O diagnóstico de provável CNEP foi feito. Discussão: As convulsão não epilépticas psicogênicas imitam o tremor e devem ser inicialmente consideradas no diagnóstico diferencial de tremor pós-operatório, pois podem ser mais prováveis do que a epilepsia nesse cenário. Os padrões da pseudoconvulsão incluem episódios convulsivos assíncronos que duram mais de 90 segundos, olhos forçadamente fechados com resistência à abertura e respostas pupilares mantidas. Manifestações autonômicas, como taquicardia, cianose e incontinência, normalmente estão ausentes. Uma história psiquiátrica é comum. O conhecimento e o diagnóstico correto de pseudoconvulsões são muito importantes para os anestesiologistas para a prevenção de morbidade e lesões iatrogênicas, como a parada respiratória causada por terapia anticonvulsivante, além dos riscos associados à intubação orotraqueal e internação prolongada. O diagnóstico de pseudoconvulsões deve ser cuidadosamente documentado e retransmitido nas trocas de equipes médicas para evitar erros de diagnóstico e complicações iatrogênicas. As recomendações de tratamento são anedóticas; intervenções psiquiátricas são o pilar do tratamento. As recomendações anestésicas incluem técnicas que envolvem o uso de agentes de ação curta, juntamente com altos níveis de apoio e amparo psicológico no período perioperatório.


Subject(s)
Male , Female , Seizures/complications , Anesthesia Recovery Period , Depressive Disorder/complications , Anesthesia, General , Seizures/drug therapy , Diagnosis, Differential , Lorazepam/therapeutic use , Middle Aged , Anticonvulsants/therapeutic use
5.
Indian J Med Sci ; 2009 Nov; 63(11) 512-516
Article in English | IMSEAR | ID: sea-145464

ABSTRACT

Opisthotonus 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.


Subject(s)
Adult , Catatonia/complications , Catatonia/diagnosis , Catatonia/drug therapy , Catatonia/therapy , Diagnosis, Differential , Dystonia/diagnosis , Dystonia/drug therapy , Dystonia/etiology , Dystonia/therapy , Electroconvulsive Therapy , GABA Modulators/therapeutic use , Humans , Lorazepam/therapeutic use , Male , Muscle Spasticity , Recurrence , Risk Factors
6.
Rev. bras. psiquiatr ; 31(3): 265-270, Sept. 2009. tab
Article in Portuguese | LILACS | ID: lil-526266

ABSTRACT

OBJETIVO: A tranquilização farmacológica rápida e segura de episódios de agitação/agressividade é muitas vezes inevitável. Esta revisão investiga a efetividade da combinação haloperidol e prometazina intramuscular, muito utilizada no Brasil. MÉTODO: Através de busca nos registros do Cochrane Schizophrenia Group, foram incluídos todos os ensaios clínicos nos quais a combinação haloperidol e prometazina foi avaliada em pacientes agressivos com psicose. Todos os estudos relevantes foram avaliados quanto à qualidade e tiveram seus dados extraídos de forma confiável. RESULTADOS: Foram identificados quatro estudos relevantes de alta qualidade. A combinação haloperidol e prometazina foi comparada com midazolam, lorazepam, haloperidol isolado e olanzapina, todos administrados por via intramuscular. No Brasil, a combinação foi efetiva, com mais de 2/3 dos pacientes tranquilos em 30 minutos, mas midazolam foi mais rápido. Na Índia, comparado a lorazepam, a combinação haloperidol e prometazina foi mais efetiva. Após as primeiras horas, as diferenças foram negligenciáveis. O uso de haloperidol isolado acarretou maior incidência de efeitos adversos. Olanzapina promove tranquilização tão rapidamente quanto a combinação, mas não tem efeito tão duradouro e mais pessoas necessitaram medicação adicional nas quatro horas subseqüentes. CONCLUSÃO: Todos os medicamentos avaliados são eficazes, mas esta revisão demonstra vantagens no uso da combinação haloperidol e prometazina.


OBJECTIVE: Rapid and safe tranquillisation is sometimes unavoidable. We conducted this systematic review to determine the value of the combination haloperidol plus promethazine, frequently used in Brazil. METHOD: We searched the Cochrane Schizophrenia Group's Register and included all randomised clinical trials involving aggressive people with psychosis for which haloperidol plus promethazine was being used. We reliably selected, quality assessed and extracted data from all relevant studies. RESULTS: We identified four relevant high quality studies. The combination haloperidol plus promethazine mix was compared with midazolam, lorazepam, haloperidol alone and olanzapine Intramuscular. In Brazil, haloperidol plus promethazine was effective with over 2/3 of people being tranquil by 30 minutes, but midazolam was more swift and in India, compared with lorazepam, the combination was more effective. Over the next few hours reported differences are negligible. Haloperidol given without promethazine in this situation causes frequent serious adverse effects. Olanzapine is as rapidly tranquillising as haloperidol plus promethazine, but did not have an enduring effect and more people needed additional drugs within 4 hours. CONCLUSION: All treatments evaluated are effective, but this review provides compelling evidence as to clear advantages of the haloperidol plus promethazine combination.


Subject(s)
Humans , Antipsychotic Agents/therapeutic use , Haloperidol/therapeutic use , Promethazine/therapeutic use , Psychomotor Agitation/drug therapy , Anti-Anxiety Agents/therapeutic use , Benzodiazepines/therapeutic use , Drug Therapy, Combination , Lorazepam/therapeutic use , Midazolam/therapeutic use , Randomized Controlled Trials as Topic
7.
Indian Pediatr ; 2009 Aug; 46(8): 681-698
Article in English | IMSEAR | ID: sea-144150

ABSTRACT

Justification: Seizures constitute the most common neurological problem in children and the majority of epilepsy has its onset in childhood. Appropriate diagnosis and management of childhood epilepsy is essential to improve quality of life in these children. Evidence-based clinical practice guidelines, modified to the Indian setting by a panel of experts, are not available. Process: The Indian Academy of Pediatrics organized a consensus meeting on the diagnosis and management of childhood epilepsy on 22-23 of July 2006 at Mumbai. An expert committee was formed consisting of pediatricians, pediatric epileptologists, pediatric and adult neurologists, electrophysiologists, neuroradiologists, neurosurgeons and intensivists. A consensus was reached during the discussion that followed presentation by each of these experts. The process of updating these recommendations and arriving at consensus continued till 2009. Objectives: To develop practice guidelines for diagnosis and management of childhood epilepsy. Recommendations: Recommendations for diagnosis and management of following childhood seizures and epilepsies are given: neonatal seizures, acute symptomatic seizures, neurocysticercosis, febrile seizures, idiopathic partial and generalized epilepsies, first unprovoked seizure, newly diagnosed epilepsy, catastrophic epilepsies of infancy, refractory epilepsies of older children and adolescents, epilepsy with cognitive deterioration and status epilepticus.


Subject(s)
Algorithms , Anticonvulsants/therapeutic use , Child , Child, Preschool , Diazepam/therapeutic use , Electroencephalography , Epilepsy/diagnosis , Epilepsy/drug therapy , Humans , India , Infant , Infant, Newborn , Lorazepam/therapeutic use , Midazolam/therapeutic use , Pediatrics/methods , Phenytoin/therapeutic use , Pyridoxine/therapeutic use
10.
Article in English | IMSEAR | ID: sea-158020

ABSTRACT

This prospective semi structured study evaluated the relations of symptomatology and outcome of bipolar manic patients with personality vulnerability. Methods: 52 patients of bipolar (mania) disorder, out of total 430 admitted patients in psychiatry ward, from January 10, to July 9, 2005 were included in the study. The patients with organic diseases or on any drugs for last two weeks were excluded from the study. All the patients were diagnosed as per ICD-10 diagnostic criteria. Patients of bipolar mania were administered Young Mania Rating Scale (YMRS) to assess the severity of mania. The personality traits and disorders were assessed by the help of ICD-10 module of International Personality Disorder Examination (IPDE). The stress in preceding one month was evaluated by using 41 items Presumptive Stressful Life Event Scale. Initial response to lorazepam was monitored to determine outcome categories. Results: The clinical and demographic variables of the study sample were analyzed with initial response to IV lorazepam as quick responder (grade-I), moderate and poor responders (grade II, III). Sociodemographic variables like marital status (x2 = 1.62, df = 2, NS) and education status (X2 = 4.57, df = 2, NS) did not approach to statistical significance in outcome. However, the outcome of the low income group patients was significantly better ( X2 = 16.84, df = 2, p < 0.001). Out of 14 (26.92%) patients of first manic episode, only 3 patients showed good response to initial lorazepam treatment (Grade I) and 9 and 2 patients assigned outcome category II and III respectively. Patients with history of multiple episodes had shown better response (X2=11.59, df=1, p<0.001, highly significant). Presence of stressful life events was positively correlated with better response to lorazepam treatment (x2==6.73, df=1, p<0.01 significant). Anxious (avoidant) or dependent traits alone or in combination with emotionally unstable personality traits in manic patients significantly determined better episode recovery with lorazepam at one hand proneness for relapses on the other hand.


Subject(s)
Bipolar Disorder/drug therapy , Bipolar Disorder/etiology , Bipolar Disorder/psychology , Bipolar Disorder/statistics & numerical data , Humans , Lorazepam/therapeutic use , Personality , Psychiatric Status Rating Scales , Stress, Psychological , Treatment Outcome
11.
Neurol India ; 2001 Sep; 49(3): 317-9
Article in English | IMSEAR | ID: sea-120555

ABSTRACT

Photosensitive epilepsy is a type of reflex epilepsy. Five percent of epileptics are photosensitive, i.e. they show photoconvulsive response (PCR) during intermittent photic stimulation. Patients with photogenic or photosensitive epilepsy have seizures with flickering light. They also exhibit heliotaxis. Sodium valproate and ethosuximide are the common drugs used. Even though benzodiazepines are useful, the specific effect of lorazepam is not mentioned. We report 5 cases of photosensitive epilepsy with inadequate response to usual antiepileptic drugs who had complete or near complete remission with lorazepam.


Subject(s)
Adolescent , Anticonvulsants/therapeutic use , Child , Epilepsy, Reflex/drug therapy , Female , Humans , Lorazepam/therapeutic use , Male , Middle Aged , Sunlight
12.
Article in English | IMSEAR | ID: sea-40440

ABSTRACT

The antiemetic effect of ondansetron-dexamethasone-lorazepam versus those of metoclopramide-dexamethasone-lorazepam were evaluated in 30 ovarian cancer patients undergoing treatment with the same chemotherapeutic regimen (cisplatin 60 mg/m2 and cyclophosphamide 700 mg/m2). Patients were randomly selected to receive either the ondansetron arm or the metoclopramide arm in their first cycle of chemotherapy, but were given an alternative combination in the second cycle. In the ondansetron arm, ondansetron was given 8 mg intravenously (i.v.) plus dexamethasone 20 mg i.v. and lorazepam 0.5 mg oral. For the metoclopramide arm, metoclopramide 10 mg was given i.v. plus dexamethasone 20 mg i.v. and lorazepam 0.5 mg oral. All antiemetics were given twice; 30 minutes before and 6 hours after chemotherapy. In the metoclopramide arm, metoclopramide 40 mg continuous infusion was also administered. During the acute phase, the ondansetron combination was significantly superior to the metoclopramide combination for all evaluation parameters. Complete control of emesis was 90 per cent vs 36.7 per cent, complete protection from nausea was 80 per cent vs 43.3 per cent, and complete protection from both nausea and vomiting was 73.3 per cent vs 30.0 per cent. Forty per cent of patients in the ondansetron arm did not complain of any adverse reaction compared to 13.4 per cent in the metoclopramide arm. It can be concluded, therefore, that a combination of ondansetron, dexamethasone and lorazepam appears to provide a significantly better emetic control with less adverse reaction than the metoclopramide combination in the acute nausea-vomiting phase after receiving cisplatin.


Subject(s)
Adult , Aged , Antiemetics/therapeutic use , Antineoplastic Agents/adverse effects , Chi-Square Distribution , Cisplatin/adverse effects , Dexamethasone/therapeutic use , Drug Therapy, Combination , Female , Humans , Lorazepam/therapeutic use , Metoclopramide/therapeutic use , Middle Aged , Ondansetron/therapeutic use , Ovarian Neoplasms/drug therapy , Treatment Outcome , Vomiting/chemically induced
14.
Rev. bras. mastologia ; 8(4): 196-203, dez. 1998. tab
Article in Portuguese | LILACS | ID: lil-247187

ABSTRACT

A náusea é um dos efeitos colaterais mais temidos pelos pacientes que se submetem à quimioterapia (QT) antineoplásica. O controle inadequado desta complicaçäo confere significativa morbidade aos pacientes tratados com QT. Com o advento dos antagonistas dos receptores 5-HT, a incidência de náusea e vômito relacionados à quimioterapia (NVQT) diminuiu significativamente. Isso permitiu a administraçäo de regimes altamente emetizantes em nível ambulatorial para a maioria dos pacientes com câncer, melhorando sua qualidade de vida. O uso dessas drogas, entretanto, aumentou sobremaneira os custos do tratamento. Nesta revisäo, abordaremos sumariamente os mecanismos fisiopatológicos da emese, para entäo podermos compreender como atuam as drogas antieméticas atualmente utilizadas na prática oncológica. Discutiremos também os novos rumos da pesquisa clínica nesta área, incluindo estratégias para minimizar o custo desse tratamento


Subject(s)
Humans , Antineoplastic Agents/adverse effects , Dexamethasone/administration & dosage , Dexamethasone/therapeutic use , Dimenhydrinate/administration & dosage , Dimenhydrinate/therapeutic use , Drug Therapy/adverse effects , Granisetron/administration & dosage , Granisetron/therapeutic use , Haloperidol/administration & dosage , Haloperidol/therapeutic use , Lorazepam/administration & dosage , Lorazepam/therapeutic use , Metoclopramide/administration & dosage , Metoclopramide/therapeutic use , Nausea/drug therapy , Nausea/etiology , Ondansetron/administration & dosage , Ondansetron/therapeutic use , Serotonin Antagonists/therapeutic use , Antiemetics/therapeutic use , Vomiting/drug therapy , Vomiting/etiology
15.
Pediatría (Santiago de Chile) ; 36(3/4): 135-40, jul.-dic. 1993. tab
Article in Spanish | LILACS | ID: lil-138061

ABSTRACT

Una encuesta a neurólogos infantiles y pediatras realizada en la ciudad de Santiago de Chile, sobre el manejo de convulsiones febriles, reveló los siguientes hechos: 1) existe uniformidad de criterio en el manejo de convulsiones febriles complejas (tratamiento con anticonvulsivantes a largo plazo) y primera convulsión febril simple (no tratar), 2) en caso de recurrencia de convulsiones febriles simples, los neurólogos infantiles indican con mayor frecuencia, terapia con anticonvulsivantes a largo plazo (85 por ciento) en relación a pediatras (35 por ciento), 3) el fenobarbital usado por dos años o menos, es el tratamiento de elección, 4) si bien la mayoría de los neurólogos infantiles (75 por ciento) admiten conocer los potenciales efectos indeseables de los barbitúricos, el fenobarbital sigue siendo el medicamento de elección en el manejo profiláctico de convulsiones febriles, 5) sólo una minoría de pediatras y neurólogos infantiles se inclinan por la terapia de diazepan oral o rectal


Subject(s)
Infant , Child, Preschool , Anticonvulsants/therapeutic use , Seizures, Febrile/therapy , Valproic Acid/therapeutic use , Data Collection , Diazepam/therapeutic use , Lorazepam/therapeutic use , Neurology/statistics & numerical data , Pediatrics/statistics & numerical data , Phenobarbital/therapeutic use
16.
West Indian med. j ; 41(1): 19-22, Mar. 1992.
Article in English | LILACS | ID: lil-107512

ABSTRACT

In this retrospective study, experience in status epilepticus (SE) over an 18-month period at the Port-of-Spain General Hospital is reported. Sixty-three episodes in 41 patients were studied. Fifty-one per cent of patients were under 10 years of age. Fifty-one per cent of patients were classified as remote symptomatic, 29 per cent idiopathic, 15 per cent acute symptomatic and 5 per cent febrile. Bolus doses of diazepam were used in 62 of 63 episodes, phenytoin in 18, diazepam infusion in 9, paraldehyde in 12 and phenobarbitone in 9. Seizures were controlled within half-hour of starting treatment in 55 episodes (87 per cent). In 3 episodes in 2 patients (5 per cent), control was poor and exceeded 18 hours. No deaths were recorded. Two neurological deficits and 8 other morbid events were recorded. Mean hospital stay was 2.9 days. No patient was ventilated or admitted to the Intensive Care Unit. Current drug therapy is highly effective in SE even in institutions where modern intensive care technology is limited. Prognosis is excellent in patients whom the underlying aetiology is benign.


Subject(s)
Status Epilepticus , Diazepam/therapeutic use , Lorazepam/therapeutic use , Phenytoin/therapeutic use , Prognosis , Retrospective Studies , Status Epilepticus/drug therapy , Status Epilepticus/etiology
17.
Arq. bras. med ; 65(6): 625-9, nov.-dez. 1991. ilus, tab
Article in Portuguese | LILACS | ID: lil-113025

ABSTRACT

Säo analisados os resultados oriundos de 13 ensaios clínicos, realizados no Brasil, com o cloridrato de buspirona, lorazepam, bromazepam e diazepam, envolvendo 1.904 pacientes, no período de 1987 a 1990, no tratamento da ansiedade näo ocasional. Os resultados analisados, quanto a sua especialidade clínica e eficácia terapêutica, demonstram ser a buspirona uma alternativa válida para o manuseio terapêutico da ansiedade patológica. Säo também analisadas as vantagens dos dois grupos de medicamentos utilizados, concluindo-se ser a buspirona a primeira escolha em diversas condiçöes clínicas


Subject(s)
Adolescent , Adult , Middle Aged , Humans , Male , Female , Anxiety/drug therapy , Buspirone/therapeutic use , Double-Blind Method , Bromazepam/therapeutic use , Buspirone/adverse effects , Diazepam/therapeutic use , Lorazepam/therapeutic use
18.
J Postgrad Med ; 1991 Jul; 37(3): 168-70
Article in English | IMSEAR | ID: sea-116791

ABSTRACT

An adult schizophrenic patient developed neuroleptic malignant syndrome following treatment with parenteral haloperidol. An early recognition of the syndrome, immediate discontinuation of the offending agent and prompt treatment with bromocriptine and lorazepam produced a good recovery. The various features of the case are discussed in view of the potential lethality of the syndrome.


Subject(s)
Adult , Bromocriptine/therapeutic use , Female , Haloperidol/adverse effects , Humans , Lorazepam/therapeutic use , Neuroleptic Malignant Syndrome/drug therapy
19.
J. bras. psiquiatr ; 39(1): 43-6, jan.-fev. 1990. ilus, tab
Article in Portuguese | LILACS | ID: lil-89312

ABSTRACT

Para Avaliar comparativamente a eficácia e tolerância da buspirona e do lorazepam no tratamento da ansiedade generalizada, foi realizado um estudo duplo-cego, em pacientes ambulatoriais, adultos e de ambos os sexos. Entraram no estudo 37 pacientes; 21 receberam buspirona 5 mg 3x ao dia e 16, lorazepam 1 mg 3x ao dia, por quatro semanas. A eficácia, avaliada através da escala de Hamilton para ansiedade, foi similar para as duas drogas. A tolerância foi boa com ambas as drogas, assim como também elas foram equivalentes nos efeitos colaterais, a näo ser sonolência, presente só no grupo lorazepam. Concluindo, as duas drogas säo igualmente eficazes no controle da ansiedade generalizada, apresentam boa tolerância e equivalência de efeitos colaterais, exceto para sonolência que só esteve presente no grupo tratado com lorazepam


Subject(s)
Adult , Humans , Male , Female , Anxiety/drug therapy , Buspirone/therapeutic use , Lorazepam/therapeutic use , Brazil , Double-Blind Method
20.
J. bras. psiquiatr ; 38(3): 125-8, maio-jun. 1989.
Article in Portuguese | LILACS | ID: lil-74220

ABSTRACT

Os autores consideram os seguintes tópicos: escolha do neuroléptico, vias e esquemas de administraçäo, dose, reaçöes adversas e associaçäo neuroléptico-lítio e neuroléptico-benzoduiazepínico. Tendo em conta experiência pessoal e a revisäo da literatura apresentam as seguintes conclusöes: 1. Para casos de gravidade de moderada a severa o tratamento pode ser iniciado com neuroléptico, que permitiria mais rapidamente o controle motor. 2. O médico deve dar preferência ao neuroléptico com o qual está familiarizado, sem deixar de levar em consideraçäo a resposta do doente aos tratamentos anteriores, utilizando o que proporcionara efeito mais favorável. 3. Dependendo do grau de colaboraçäo, o medicamenteo será empregado por via oral ou intramuscular. 4. Atualmente näo se recomenda o esquema de rápida neuroleptizaçäo e a prescriçäo de dose elevada. Admite-se que a maioria dos pacientes apresentam resposta favorável com dose equivalente a 300-600mg de clorpromazina (5 a 12-15mg de haloperidol). 5. Evita-se a associaçäo lítio-neuroléptico no início do tratamento, pelo fato de que, em pequena proporçäo de casos, pode ocorrer neurotoxicidade. 6. A associaçäo com benzodiazepínico, nos primeiros dias de tratamento auxilia a tranqüilizar mais rápida e intensamente os pacientes. 7. Conseguida a reduçäo da hiperatividade e dos sintomas psicóticos, diminui-se lentamente a dose do neuroléptico e, ao mesmo tempo, introduz-se o lítio cuja dose é aumentada gradualmente. A seguir, muitos pacientes poderäo ser mantidos apenas com lítio, enquanto outros ainda necessitam de pequena dose de neuroléptico


Subject(s)
Humans , Bipolar Disorder/drug therapy , Haloperidol/therapeutic use , Lithium/therapeutic use , Lorazepam/therapeutic use
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