Download or read book Benzodiaz pines et modalit s de sevrage written by Christopher Debuys and published by . This book was released on 2013 with total page 202 pages. Available in PDF, EPUB and Kindle. Book excerpt: Les benzodiazépines font partie de notre panorama thérapeutique depuis maintenant plus de 50 ans et leur intérêt -sous réserve d'une prescription appropriée- n'est pas remis en cause. Cependant, plusieurs décennies après leur mise sur le marché, les cas d'abus et de dépendance aux benzodiazépines en cas d'exposition chronique se sont multipliés ; d'autres effets indésirables sur la vigilance sont depuis longtemps décrits. Parallèlement et malgré ces effets délétères au long cours, leur utilisation n'a cessé de croître en France, dans un contexte de banalisation des traitements psychotropes. La consommation de benzodiazépines dans l'Hexagone est désormais l'une des plus importantes d'Europe. Depuis maintenant plusieurs années, les pouvoirs publics ont pris en compte cette problématique, essayant d'y apporter une réponse adaptée. D'une part, la notion d'une durée de traitement limitée est clairement abordée et des protocoles d'arrêt du traitement sont parfois proposés ; d'autre part, la règlementation relative aux benzodiazépines évolue et les conditions de prescription et de délivrance ont été modifiées. Concernant les modalités pratiques d'arrêt de traitement par benzodiazépines, il n'existe pas un protocole de sevrage consensuel au niveau international. Nous avons ainsi pu identifier plusieurs protocoles émis par les autorités de santé et/ou des associations référentes. Après un rappel sur les aspects pharmacologie/toxicologie/potentiel d'abus des benzodiazépines et les données de consommation les concernant, nous présenterons les modalités de sevrage telles que proposées en France et dans plusieurs autres pays, anglo-saxons notamment. Nous comparerons les outils à disposition pour évaluer la dépendance à la benzodiazépine concernée ainsi que les prises en charge complémentaires dont peut bénéficier le patient. Si quelques distinctions existent entre ces protocoles, tous sont unanimes sur la nécessité d'informer de façon précoce le patient sur les risques d'une consommation au long cours, d'un arrêt très progressif du traitement et d'un suivi rapproché du patient ensuite. Nous discuterons enfin des rôles respectifs des différents acteurs impliqués : patients, prescripteurs, dispensateurs et autorités sanitaires. Chacun peut en effet contribuer à améliorer la situation et réduire le niveau de consommation des benzodiazépines et apparentés
Download or read book Conditions de prescription des benzodiaz pines en soins premiers dans le cadre du sevrage des consommations probl matiques de boissons alcoolis es dans le Nord et le Pas de Calais written by Victor Ledoue and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introduction : Les personnes consommant de manière importante et chronique de l'alcool peuvent présenter, dans les 24 heures suivant l'arrêt de la consommation, un syndrome de sevrage. Depuis la conférence de consensus de 1999 {61}, il a été recommandé, afin de protéger le patient de ces symptômes lors d'un sevrage alcoolique, d'utiliser les benzodiazépines. Mais ces molécules ne sont pas dénuées d'effets indésirables. La question de recherche était d'identifier les modalités de prescription de ces médicaments dans le cadre du sevrage alcoolique dans le Nord et le Pas de Calais. Méthode : Il a été réalisé une étude descriptive, transversale, par questionnaires anonymes, adressés à 100 médecins généralistes maîtres de stage universitaire, tirés au sort, en soins premiers, dans des zones citadines, semi-rurales et rurales, dans les départements du Nord et du Pas de Calais. Résultats : En moyenne, les répondants prenaient en charge 23 patients par an pour des troubles de consommation en boissons alcoolisées, dans la moitié des cas sans intervention d'autres spécialistes. La majorité des répondants prescrivait des benzodiazépines dans le cadre du sevrage alcoolique afin d'éviter les signes de sevrage pour 92% (75), le delirium tremens pour 67% (55) ou les convulsions pour 53% (43). Les répondants débutaient pour 27% (22) d'entre eux un traitement par benzodiazépine lors d'un sevrage alcoolique, en fonction de la quantité d'alcool bue déclarée, et ce en moyenne à partir de 9 verres doses quotidiens. En adéquation avec les recommandations actuelles, les répondants prescrivaient en majorité du Diazépam pour 84% (69) et de l'Oxazépam pour 57% (47). Les mises en garde principales données aux patients vis-à-vis du traitement étaient les risques avec la conduite automobile pour 55% (42), la somnolence pour 40% (31), les risques de dépendance pour 30% (23) et la nécessité de s'abstenir de consommer de l'alcool pendant le traitement pour 20% (15). Les posologies et durées de traitement prescrites n'étaient pas identiques aux recommandations actuelles ; les répondants prescrivaient en moyenne 32.3mg/j de Diazépam ou 80.4mg/j d'Oxazépam, et ce pendant 49 jours en moyenne. Les répondants réévaluaient en moyenne après 9 jours de traitement leurs patients en étant attentif à leur consommation d'alcool et leur prise du traitement pour 94% (77), aux signes de manque pour 88% (72) et de sevrage alcoolique pour 85% (70), à la tolérance clinique du traitement pour 81% (66), ainsi qu'à la possible émergence d'une comorbidité psychiatrique pour 55% (45). Conclusion : Il y avait des différences entre les recommandations actuelles concernant la prescription de benzodiazépines dans le cadre du sevrage alcoolique et les pratiques proposées par les répondants. Néanmoins, les recommandations actuelles ne prenaient pas nécessairement en compte l'adaptation du praticien au cas par cas, son isolement professionnel, le manque de formation ou de temps à la réalisation de ce type de prise en charge, ainsi que l'absence d'alternatives thérapeutiques disponibles.
Download or read book GABA and Sleep written by Jaime M. Monti and published by Springer Science & Business Media. This book was released on 2010-09-28 with total page 501 pages. Available in PDF, EPUB and Kindle. Book excerpt: GABA (gamma-aminobutyric acid) is the main neurotransmitter regulating sleep. The majority of drugs presently in use for the treatment of sleep disorders act by enhancing GABAergic neuronal inhibition. The GABA system is, therefore, of prime clinical relevance for the therapy of insomnia. The focus of this volume is on the neuropsychopharmacology and the clinical impact of the GABA system in regulating sleep and wakefulness. It presents molecular, neuropharmacological, systems-biological and clinical approaches to the understanding of the mechanism of action of GABA and GABAergic drugs. It also explores the role of GABA in the basic drives that affect sleep, and the influences that adapt sleep and wakefulness to external events.
Download or read book Current Medical Research and Opinion written by and published by . This book was released on 2004 with total page 808 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Handbook of Psychiatry in Palliative Medicine written by Harvey Max Chochinov and published by . This book was released on 2009 with total page 591 pages. Available in PDF, EPUB and Kindle. Book excerpt: Psychiatric, or psychosocial, palliative care has transformed palliative medicine. Palliation that neglects psychosocial dimensions of patient and family experience fails to meet contemporary standards of comprehensive palliative care. While a focus on somatic issues has sometimes overshadowed attention to psychological, existential, and spiritual end-of-life challenges, the past decade has seen an all encompassing, multi-disciplinary approach to care for the dying take hold. Written by internationally known psychiatry and palliative care experts, the Handbook of Psychiatry in Palliative Medicine is an essential reference for all providers of palliative care, including psychiatrists, psychologists, mental health counselors, oncologists, hospice workers, and social workers.
Download or read book Madness and Democracy written by Marcel Gauchet and published by Princeton University Press. This book was released on 2012-05-05 with total page 352 pages. Available in PDF, EPUB and Kindle. Book excerpt: How the insane asylum became a laboratory of democracy is revealed in this provocative look at the treatment of the mentally ill in nineteenth-century France. Political thinkers reasoned that if government was to rest in the hands of individuals, then measures should be taken to understand the deepest reaches of the self, including the state of madness. Marcel Gauchet and Gladys Swain maintain that the asylum originally embodied the revolutionary hope of curing all the insane by saving the glimmer of sanity left in them. Their analysis of why this utopian vision failed ultimately constitutes both a powerful argument for liberalism and a direct challenge to Michel Foucault's indictment of liberal institutions. The creation of an artificial environment was meant to encourage the mentally ill to live as social beings, in conditions that resembled as much as possible those prevailing in real life. The asylum was therefore the first instance of a modern utopian community in which a scientifically designed environment was supposed to achieve complete control over the minds of a whole category of human beings. Gauchet and Swain argue that the social domination of the inner self, far from being the hidden truth of emancipation, represented the failure of its overly optimistic beginnings. Madness and Democracy combines rich details of nineteenth-century asylum life with reflections on the crucial role of subjectivity and difference within modernism. Its final achievement is to show that the lessons learned from the failure of the asylum led to the rise of psychoanalysis, an endeavor focused on individual care and on the cooperation between psychiatrist and patient. By linking the rise of liberalism to a chapter in the history of psychiatry, Gauchet and Swain offer a fascinating reassessment of political modernity.
Download or read book Monitoring in Neurocritical Care written by Peter D. Le Roux and published by Saunders. This book was released on 2013 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ideal for neurosurgeons, neurologists, neuroanesthesiologists, and intensivists, Monitoring in Neurocritical Care helps you use the latest technology to more successfully detect deteriorations in neurological status in the ICU. This neurosurgery reference offers in-depth coverage of state-of-the-art management strategies and techniques so you can effectively monitor your patients and ensure the best outcomes. Understand the scientific basis and rationale of particular monitoring techniques and how they can be used to assess neuro-ICU patients. Make optimal use of the most advanced technology, including transcranial Doppler sonography, transcranial color-coded sonography, measurements of jugular venous oxygen saturation, near-infrared spectroscopy, brain electrical monitoring techniques, and intracerebral microdialysis and techniques based on imaging. Apply multimodal monitoring for a more accurate view of brain function, and utilize the latest computer systems to integrate data at the bedside. Access practical information on basic principles, such as quality assurance, ethics, and ICU design. Seamlessly search the full text of Monitoring in Neurocritical Care online at www.expertconsult.com.
Download or read book Public Health Service Publication written by and published by . This book was released on with total page 712 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Guidelines for the Treatment of Alcohol Problems written by Paul S. Haber and published by Specialty of Addiction Medicine, Faculty of Medicine and Health, The University of Sydney. This book was released on 2021-04-01 with total page 408 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Australian Guidelines for the Treatment of Alcohol Problems have been periodically developed over the past 25 years. In 1993, the first version of these guidelines, titled: ‘An outline for the management of alcohol problems: Quality assurance in the treatment of drug dependence project’ was published (Mattick & Jarvis 1993). The Australian Government commissioned an update a decade later (Shand et al. 2003) and a further edition in 2009 to integrate the Guidelines with the Australian Guidelines to Reduce Health Risks from Drinking Alcohol (National Health and Medical Research Council, NHMRC 2009; Haber et al., 2009). The present version of the Guidelines was also commissioned by the Commonwealth of Australia to remain current and integrated with the updated NHMRC consumption guidelines (2020). In order to ensure that guidelines remain relevant, the next set of guidelines should be updated in 2025, consistent with NHMRC recommendation that guidelines be updated every five years. These guidelines aim to provide up-to-date, evidence-based information to clinicians on available treatments for people with alcohol problems and are largely directed towards individual clinicians in practice, such as primary care physicians (general practitioners, nursing staff), specialist medical practitioners, psychologists and other counsellors, and other health professionals. Some chapters highlight service or system level issues that impact on clinicians and their patients. These include recommendations concerning Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse groups, stigma, and discrimination. Elsewhere, organisation capacity is implied, such as medical resources for withdrawal management where recommendations indicate use of medications. As all forms of treatment will not be readily available or suitable for all populations or settings, these guidelines may require interpretation and adaptation.
Download or read book Public Health Bibliography Series written by United States. Public Health Service and published by . This book was released on 1951 with total page 422 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Circadian Rhythm Sleep Wake Disorders written by R. Robert Auger and published by Springer Nature. This book was released on 2020-05-26 with total page 251 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book resolves to bridge the communication gap between research and clinical practice for circadian rhythm sleep-wake disorders. Beginning with a scientific background on biological timekeeping, opening chapters describe the crucial nature of maintaining delicate temporal organization of physiological and molecular events within the body. Following this are discussions on circadian physiology and methods of circadian assessments. Subsequent chapters then relay comprehensive information regarding the International Classification of Sleep Disorders-defined circadian rhythm sleep-wake disorders (CRSWDs), specifically discussing etiology and epidemiology, but focusing on evidence-based treatment data. Concluding discussions provide guidance for the application of light therapy and discuss future roles for optimized lighting environments. Nuanced and market-demanded, Circadian Rhythm Sleep-Wake Disorders: An Evidence-Based Guide for Clinicians and Investigators is an invaluable resource for Sleep Medicine clinicians, circadian researchers, and other interested parties.
Download or read book Prediction of Percutaneous Penetration written by R. C. Scott and published by . This book was released on 1991 with total page 666 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Smokeless Tobacco Or Health written by and published by . This book was released on 1992 with total page 422 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence written by World Health Organization. Department of Mental Health and Substance Abuse and published by World Health Organization. This book was released on 2009 with total page 133 pages. Available in PDF, EPUB and Kindle. Book excerpt: "These guidelines were produced by the World Health Organization (WHO), Department of Mental Health and Substance Abuse, in collaboration with the United Nations Office on Drugs and Crime (UNODC) a Guidelines Development Group of technical experts, and in consultation with the International Narcotics Control Board (INCB) secretariat and other WHO departments. WHO also wishes to acknowledge the financial contribution of UNODC and the Joint United Nations Programme on HIV/AIDS (UNAIDS) to this project. " - p. iv
Download or read book Women and Addiction written by Kathleen T. Brady and published by Guilford Press. This book was released on 2009-04-02 with total page 526 pages. Available in PDF, EPUB and Kindle. Book excerpt: For many years, addiction research focused almost exclusively on men. Yet scientific awareness of sex and gender differences in substance use disorders has grown tremendously in recent decades. This volume brings together leading authorities to review the state of the science and identify key directions for research and clinical practice. Concise, focused chapters illuminate how biological and psychosocial factors influence the etiology and epidemiology of substance use disorders in women; their clinical presentation, course, and psychiatric comorbidities; treatment access; and treatment effectiveness. Prevalent substances of abuse are examined, as are issues facing special populations.
Download or read book Pain Relief in Advanced Cancer written by Robert G. Twycross and published by . This book was released on 1994 with total page 596 pages. Available in PDF, EPUB and Kindle. Book excerpt: It is six years since publication of 'Therapeutics in Terminal Cancer'. This is the new, second edition of this successful book which is pitched at just the right level for quick reference and practical advice. It covers the full range of cancer symptoms in all types of the disease. It describes the mechanisms and types of pain, and defines the many approaches and their capabilities now available for the relief of pain.
