Medications, problems with

The consumption of sucrose as a sweetener has been associated with several nutritional and medical problems, with dental caries being the most well-documented [1]. Sucrose intake may also be a factor in cardiovascular disease, diabetes mellitus, obesity, and micronutrient deficiency [2]. Therefore, there has been a continual demand for novel... 

As most of the harmful effects of inhalant abuse are not felt immediately, chronic abuse of inhalants is associated with a variety of medical problems with a real risk of death. There are a number of solvents that have become the target for abuse. A great number of them are known to be toxic (see Table 1). 

I will discuss in detail the medical problems with mustard gas during World War I. I have chosen mustard because the issues of diagnosis, evacuation, treatment, and contamination are similar to those with nerve agents, and because mustard is still used as a weapon today. During World War I, patients and stretcher-bearers alike had to don masks, limiting their vision and activity and making head-wounded patients difficult to mask and treat. In the U.S. forces, gassed patients were identified by a crayon cross on their foreheads because patients could appear well when evacuated but suffer from symptoms hours after exposure to mustard. 

Delirium is a medical problem, with a medical cause. Work closely with medical colleagues to ensure a full delirium work-up (Appendix A2). 

Anxiety disorders and insomnia represent relatively common medical problems within the general population. These problems typically recur over a person s lifetime (3,4). Epidemiological studies in the United States indicate that the lifetime prevalence for significant anxiety disorders is about 15%. Anxiety disorders are serious medical problems affecting not only quaUty of life, but additionally may indirecdy result in considerable morbidity owing to association with depression, cardiovascular disease, suicidal behavior, and substance-related disorders. 

Do not use the drug indiscriminately. Check with a primary health care provider before using an antacid if other medical problems, such as a cardiac condition (some laxatives contain sodium), exist. 

Appendix A contains a MedWatch form, which is used by health care professionals for voluntary reporting of adverse reactions and problems with tiie drag product. Is also contains advice about voluntary reporting. This form is a part of tiie FDA medical products reporting program. 

Social detoxification, which involves the nonpharmacological treatment of alcohol withdrawal, has been shown to be effective (see Naranjo et al. 1983). It consists of frequent reassurance, reality orientation, monitoring of vital signs, personal attention, and general nursing care (Naranjo and Sellers 1986). Social detoxification is most appropriate for patients in mild-to-mod-erate withdrawal. The medical problems commonly associated with alcoholism (Sullivan and O Connor 2004) may substantially complicate therapy, so that care must be taken to refer patients whose condition requires medical management. 

With all of these pharmacotherapies, concurrent behavioral treatment is critical to retain the patient in treatment and maintain adherence to medication treatment. Contingency management programs in which patients receive vouchers that can be used to purchase pro-social goods and services are the most common reinforcer approaches used to initiate and maintain stimulant-free urine test results (Anker and Crowley 1982 Boudin 1972 Higgins et al. 1991, 1993, 1994). The major problem with these approaches has been maintaining abstinence after the reinforcers are withdrawn completely and devel-... 

The most difficult problem of risk evaluation linked to chemicals will be discussed in this Part. This is primarily a medical problem, which therefore comes within the competence of the company medical officer and epidemiologists, but neverthel need not only be dealt with by them. The person in charge of safety control in a place where chemicals are handled also has to tackle this problem. This person will have to take into account the level of toxicity risk of a substance. This will determine the constraint level of the measures to be taken, its favoured means of penetration, which depends on the activity, and its penetration properties specific to the organism. The physical properties of the substance (which will determine the nature of the precautions to be taken) and also the values of toxicity parameters have to be taken into account. He has to check the container labelling and know how to interpret and explain the toxicity instructions on this labelling. 

The treatment of acute PCP toxicity depends on the pattern of intoxication and the physical findings. On the prison wards of the LAC/USC Medical Center, approximately 60 percent of patients are treated and released within 24 hours. Most of these patients have minor patterns of intoxication and no medical complications. Another 10 percent of patients have minor problems with medical complications, usually trauma. 

Various components of drug use in the elderly are worth noting. Problems with health literacy (i.e., the understanding of medical... 

If withdrawal is from alcohol, administer the CIWA-Ar to determine withdrawal severity. A score of 8 to 10 denotes relatively mild withdrawal, and the patient can be treated as an outpatient with supportive care only. A score from 11 to 14 can be treated on either an outpatient or inpatient basis, with either supportive care or with benzodiazepines, depending on the presence of underlying medical problems and the prior history of... 

Withdrawal from opioids is uncomfortable but unlikely to be fatal unless the patient has underlying medical problems. Administer the COWS to determine the severity of withdrawal. Those with a score of 5 or less require no pharmacologic intervention, while those with scores from 6 to 24 are likely to benefit from either a symptoms-based approach or the initiation of buprenorphine. Those with scores greater than 25 should receive either buprenorphine or an alternative full p agonist. 

---