Alcohol infection therapy

Maintenance When clinical symptoms have subsided and the blood picture has normalized, use the dosage below. Never give less than 0.1 mg/day. Keep patients under close supervision and adjust maintenance dose if relapse appears imminent. In the presence of alcoholism, hemolytic anemia, anticonvulsant therapy, or chronic infection, the maintenance level may need to be increased. 

The book concludes with Chapter 13 and Chapter 14 on disorders that require separate consideration. The first group includes Panic, Obsessive-Compulsive, Post-Traumatic Stress, Somatoform, and Dissociative disorders. Although traditionally these are classified as anxiety disorders, their symptoms and varied treatment responsivity require a separate series of discussions. Finally, certain groups of patients are considered in light of their specialized needs when contemplating psychotropic drug therapy. They include the pregnant patient, children and adolescents, the elderly, the personality disordered, as well as patients whose conditions are complicated by medical problems (e.g., the alcoholic patient the HIV-infected patient). 

HIV infection in humans is now pandemic. As of January 2006, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) estimate that AIDS has killed more than 25 million people since it was first recognized on December 1, 1981, making it one of the most destructive pandemics in recorded history. Antiretroviral treatment reduces both the mortality and the morbidity of HIV infection, but routine access to antiretroviral medication is not available in all countries. An alternative therapy to circumvent this problem is the use of polyanionic substances, which demonstrated a number of promising features as potential anti-HIV drug candidates. In this respect, various SPs (e.g., heparin, DS, dextrin sulfate, cyclo dextrin sulfate, curdlan sulfate, pentosan polysulfate, mannan sulfate, sulfoevernan, and fucoidan) and derivatives thereof (e.g., O-acylated heparin, polyacetal polysulfate, polyvinyl alcohol sulfate, and modified cyclo dextrin sulfates) have been found to inhibit HIV replication in vitro at concentrations that are up to 10 000-fold lower than the cytotoxic concentration [2,71]. 

Cautions Anticoagulant therapy, history of liver disease, substantial alcohol consumption, major surgery, severe acute infection, trauma, hypotension, severe metabolic, endocrine, or electrolyte disorders, uncontrolled seizures... 

Interpretation In normal subjects, serum cortisol concentration is suppressed to 2 pg/dL or less after administration of 1 mg of dexamethasone. Most patients with Cushing s syndrome do not show adequate suppression, and 0800 hours cortisol concentrations are usually >10pg/dL. Serum cortisol >2pg/dL may also be seen in cases of stress, obesity, infection, acute or chronic illness, alcohol abuse, severe depression, oral contraceptive use, pregnancy, estrogen therapy, failure to take the dexamethasone, or treatment with phenytoin or phenobarbital (enhancement of dexamethasone metabolism). 

Elevated liver enzymes may occur in up to 15% of patients cirrhosis is rare. Liver function tests, aspartate aminotransferase (AST) or alanine aminotransferase (ALT), should be performed periodically. Methotrexate should be discontinued if these test values show sustained results greater than twice the upper limits of normal. Serum albumin levels also should be checked periodically, as signs of liver toxicity in some patients may not have liver inflammation manifested by AST or ALT elevation. Liver biopsy is now recommended before beginning methotrexate therapy only for patients with a history of excessive alcohol use, ongoing hepatitis B or C infection, or recurring elevation of AST. Biopsies during methotrexate therapy are recommended only for patients who develop consistently abnormal liver function tests. ... 

Root extracts of P. kurroa have been used to treat liver disorders, caused by the ever increasing environmental pollution, exposure to industrial toxicants, food adulteration, malnutrition, injudicious use of drugs, excessive consumption of alcohol and certain infections. Such disorders pose a major challenge in the health care programmes of any country. Presently, however, no effective therapy is available for the treatment of various liver ailments [5,6],... 

Fatty infiltration of the liver (FFl) is a common asymptomatic condition reported to be present in as much as 10% of the adult population and is usually associated with a variety of clinical situations, of which alcoholism, diabetes and obesity are the most common in the developed countries (el-Hassan et al. 1992). There are many other reported causes that include inborn metabolic errors, drug toxicity, glucocorticoid therapy, and infections (Alpers et al. 1993). Kammen et al. (2001) described an overall incidence of focal fatty liver in as many as 9% of children and... 

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