Medication adjunctive

BeckJI, Boothroyd C, Proctor M, et al. Oral anti-oestrogens and medical adjuncts for subfertility associated with anovulation. Cochrane Database Syst Rev. 2005 CD002249. 

Our goal as clinicians in the field of peripheral arterial disease should be to apply the multiple technological advances that we have toward limb salvage and the prevention of amputation. This chapter will discuss the surgical, percutaneous, and medical adjuncts available in this regard. 

Frequendy, the treatment of helminthic diseases requites adjunct medication. Allergic reactions are commonly seen as a result of tissue invasion by worms or as a consequence of anthelmintic therapy. Antihistamines and corticosteroids may be necessary adjuncts to therapy. Anemia, indigestion, and secondary bacterial infections can also occur and may requite concomitant therapy with hematopoietic drugs and appropriate antibiotics. 

Clinical experience suggests that alprazolam can be particularly difficult to taper when lower doses are reached (e.g., tapering from 1 to 0 mg) (Ciraulo et al. 1990). One possible explanation for this is suggested by data from an animal model showing that alprazolam at doses of 0.02—0.05 mg/kg increases benzodiazepine receptor number above baseline (Miller et al. 1987). When difficulty is encountered in tapering the last 1—2 mg of alprazolam, the rate of dose reduction can be decreased to 0.25 mg/week, and/or adjunctive medication may... 

Table 3-2. Adjunctive medications used in the treatment of benzodiazepine withdrawal ...

Kranzler HR, Bauer LO, Hersh D, et al Carbamazepine treatment of cocaine dependence a placebo-controlled trial. Drug Alcohol Depend 38 203-211, 1995 Levin FR, Lehman AF Meta-analysis of desipramine an adjunct in the treatment of cocaine addiction. J Clin Pharmacol 11 374-378, 1991 Lima MS, Reisser AA, Soares BG, et al Antidepressants for cocaine dependence. Cochrane Database Syst Rev 4 CD002950, 2001 Ling W, Shoptaw S, Majewska D Baclofen as a cocaine anti-craving medication a preliminary clinical study 0etter). Neuropsychopharmacology 18 403 04, 1998... 

These studies suggest that behavioral treatment strategies, such as CRA and CM, can be effective alone and as adjuncts to pharmacotherapy. Whether the emphasis is on abstinence, treatment retention, or medication compliance, the results of studies on behavioral approaches are promising. 

To facilitate recovery from addiction it is necessary to utilize a comprehensive biopsychosocial assessment that includes the motivation for change. Pharmacologic treatments are always adjunctive to psychosocial therapy. It is important to remember that mere treatment of withdrawal is not sufficient treatment of DSM-IV-TR dependence (addiction), and that medications are always adjunctive to psychosocial therapy. Comorbid psychiatric... 

Associate Professor of Pharmacy Practice The University of Toledo Adjunct Assistant Professor Department of Medicine Medical University of Ohio Toledo, Ohio... 

Antimicrobial Specialist The Nebraska Medical Center Adjunct Assistant Professor... 

FIGURE 59-1. Pharmacotherapy treatment algorithm. A select population of individuals, based on body mass index (BMI) and waist circumference (WC) together with concurrent risk factors, may benefit from medication therapy as an adjunct to a program of weight loss that includes diet, exercise, and behavioral modification. (CHD, coronary heart disease DM, diabetes mellitus, HTN, hypertension INC WC, >40 inches for males and >35 inches for females LCD, low-calorie diet.)... 

First, optimize current mood stabilizer or initiate mood-stabilizing medication lithium,0 valproate,0 or carba-mazepine0 Consider adding a benzodiazepine (lorazepam or clonazepam) for short-term adjunctive treatment of agitation or insomnia if needed Alternative medication treatment options carbam-azepine0 if patient does not respond or tolerate, consider atypical antipsychotic (e.g., olanzapine, quetiapine, risperidone) or oxcarbazepine. 

Fourth, you should consider a collaborative referral for an adjunct therapist if you meet the needs of the client in most areas, but find that the client would benefit from specialized treatment in another area. An example of a reason for this type of referral would be the discovery that your client may need a psychiatric evaluation and perhaps medication management after you have been working with her or him for a period of time. You are not relinquishing your relationship with the client, but it may be necessary to bring in an outside expert in another area of care to help the client reach her or his goals for treatment. 

Miscellaneous. In recent years, other medication classes have been tested in the treatment of specihc anxiety syndromes. For example, atypical antipsychotics have been used as adjunctive treatments for OCD and GAD, and mood stabilizers have been used to treat PTSD. These syndrome-specific regimens will be discussed in the following sections. 

Medications may play an adjunctive role during this initial acute phase of treatment. For the restricting subtype of AN, cyproheptadine may provide some benefit... 

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