Drugs, response alcohol

There is an increased risk for bone marrow suppression when levamisole or hydroxyurea are administered witii other antineoplastic dni. Use of levamisole witii phenytoin increases die risk of phenytoin toxicity. Pegaspargase may alter drug response of the anticoagulants. When procarbazine is administered with other central nervous system (CNS) depressants, such as alcohol, antidepressants, antihistamines, opiates, or the sedatives, an additive CNS effect may be seen. Procarbazine may potentiate hypoglycemia when administered witii insulin or oral antidiabetic dru . ... 

Some of these measures are part of larger, semistructured interviews administered by the therapist. The most commonly used assessments in this category are a family of instruments developed mainly in the Veterans Administration (VA) hospital system. The first instrument in this family is known as the Addiction Severity Index (ASI McLellan et al., 1985). The ASI assesses for a wide variety of biographical data, so it has the advantage of potentially being used as part of an intake interview. The ASI asks about consequences in a wide variety of life domains, and determines recent and lifetime patterns of drug and alcohol use. The ASI also detects recent and lifetime occurrence of problems in these different life domains (e.g., work). Each domain can be scored for the severity of the problems based upon the responses of the client and the clinical judgment of the interviewer. The ASI can be administered by computer to provide for rapid interpretation of answers. 

Marks Ml, Stitzel lA, et al (1985) Time course study of the effects of chronic nicotine infusion on drug response and brain receptors. 1 Pharmacol Exp Ther 235(3) 619-628 Marshall DL, Redfem PH, et al (1997) Presynaptic nicotinic modulation of dopamine release in the three ascending pathways studied by in vivo microdialysis comparison of naive and chronic nicotine-treated rats. 1 Neurochem 68(4) 1511-1519 Martinez D, Gil R, et al (2005) Alcohol dependence is associated with blunted dopamine transmission in the ventral striatum. Biol Psychiatry 58(10) 779-786 McClernon El, Kozink RV, Rose IE (2007) Individual differences in nicotine dependence, withdrawal symptoms, and sex predict transient fMRl-BOLD responses to smoking cues. Neuropsychopharmacology 33(9) 2148-2147... 

Factors, such as smoking, food habits and alcohol intake influence drug responses probably by both intrinsic and extrinsic mechanisms. 

Although genetic influences on the dynamics of drug response have been studied in a wide range of disorders, most of the studies have been carried out in only the past few years. Disorders and behaviors studied include Alzheimer s disease, schizophrenia, depression, suicide, anxiety, obsessive-compulsive disorder (OCD), substance abuse, smoking, and alcoholism. Across these disorders, however, there has been a focus on only a handful of neuroeffector systems. These include apolipoprotein and the cholinergic system (in Alzhei-... 

Before leaving the abuse and addiction area, the exciting work in which animal models are used to map genes for drug abuse, alcoholism, neuroleptic-induced catalepsy, and stimulant response deserves mention (Crabbe et ah, 1994 Kanes et al., 1996 Grisel et al., 1997). The application of powerful quantitative trait loci (QTE) approaches to animal models will almost... 

Posttraumatic stress disorder (PTSD) is another anxiety disorder that can be characterized by attacks of anxiety or panic, but it is notably different from panic disorder or social phobia in that the initial anxiety or panic attack is in response to a real threat (being raped, for example) and subsequent attacks are usually linked to memories, thoughts, or flashbacks of the original trauma. The lifetime incidence of PTSD is about 1%. Patients have disturbed sleep and frequent sleep complaints. Comorbidities with other psychiatric disorders, especially depression and drug and alcohol abuse, are the rule rather than the exception. The DSM-IV diagnostic criteria are given in Table 9—11. 

The personal consequences of nicotine dependence are clearly the potentially life threatening illnesses that tobacco causes. Additional negative consequences become evident as tobacco use becomes less socially acceptable. Unlike the use of other recreational drugs or alcohol, tobacco use does not alter consciousness or cause escape from social responsibility. Therefore, until recently, smoking was regarded as a matter of personal choice. The links between second-hand smoke and disease in nonsmokers altered that view. Smokers often must face isolation and the outdoor elements to avoid exposing family, friends, and coworkers to second-hand smoke. Even then, they may face negative feedback from those around them. 

Many drugs have been associated with corneal and crystalline lens opacities, including phenothiazines, allo-purinol, phenytoin, diuretics, and heavy alcohol consmnp-tion. Over 16 drugs are listed to be associated with epithelial vortex keratopathy alone in a recent review, whereas the stroma is affected much less frequently. A variety of ocular toxicities are well recognized, aside from isolated case reports, and the drugs responsible for these side effects are listed in Table 35-2. 

The first category is the moral model, in which individuals are seen as personally responsible for problems they may incur from their use of drugs and alcohol. That is, the development of a substance-use disorder is seen as the product of a series of personal decisions or choices to use those substances in a way that is harmful. This perspective implies that choices other than to use alcohol and drugs were available to the person but not taken. Depending on the variation of the model, treatment consists of either spiritual or legal intervention. 

Some of those choices may involve substances because drugs and alcohol are part of every growing child s world in the United States today. When children choose their way into any kind of trouble, including that involving alcohol and drugs, the role of the parent is to help them take responsibility for these decisions, face their consequences, choose their way out, and learn from the adversity that was created. 

Evasiveness substance use can offer the boy or girl a way to avoid facing up to hard reality. In response, parents can make it absolutely clear that drug or alcohol use will not be allowed to put off hard issues or make them go away. 

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