Monitoring Mental Activity

TRYPTOPHAN ANTICANCER AND IMMUNOMODULATING DRUGS-PROCARBAZINE Risk of hyperreflexia, shivering, hyperventilation, hyperthermia, mania or hypomania, disorientation/confusion Tryptophan is a precursor of a number of neurotransmitters, including serotonin. Procarbazine has MAOI activity, which inhibits the breakdown of neurotransmitters Tryptophan should be started under specialist supervision. Recommended to start with low doses and titrate the dose upwards with close monitoring of mental status and BP... 

Designation of a mental health coordinator is a crucial first step in the formulation of a team. This is the person who will manage the command center, decide what resources are needed, activate appropriate mental health agencies, and assign staff to locations such as neighborhood centers. Red Cross shelters (when requested), family assistance centers, schools, hospitals, and so on. This person also monitors field reports regarding the ongoing needs of victims, workers, and counselors, and adapts the plan as events unfold. 

Austrian, 1995 Maxmen Ward, 1995). A working therapeutic relationship also ensures that the client is actively involved in his or her treatment process and that the client is taking responsibility for monitoring a complex mental illness. 

In a study in 14 healthy subjects, two 20-mg doses of dextromethorphan given 4 hours apart, before and during the use of linezolid 600 mg every 12 hours, had no effect on linezolid pharmacokinetics. The AUC and maximum level of the dextromethorphan metabolite, dextrorphan was decreased by 30%, but this was not considered sufficient to warrant any dosing alterations. There was no evidence of the serotonin syndrome, as measured by changes in body temperature, alertness and mental performance. However, the manufacturers describe one case where the concurrent use of linezolid and dextromethorphan resulted in the serotonin syndrome. Linezolid has mild reversible MAOI activity, and the serotonin syndrome has been described when dextromethorphan was taken by patients also taking antidepressant MAOIs, see MAOIs or RIMAs + Dextromethorphan , p.l 134. If the concurrent use of linezolid and dextromethorphan is considered necessary, it would seem prudent to monitor for symptoms of the serotonin syndrome , (p.9). 

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