Supportive therapy

As with the other sex hormones, the first clinical use of Hiidrogens was for support therapy in individuals deficient in the endogenous hormone. The discovery that androgens exert an ana-hnlic effect greatly extended the indications for their use. 

O Malley et al. (1992) conducted a double-blind study combining naltrexone and CBT for alcohohsm. Patients were randomly assigned to participate in cognitive-behavioral coping skills treatment or supportive therapy and to receive 50 mg/day of naltrexone or placebo. Naltrexone-treated patients who received supportive therapy had more continuous abstinence than the other treatment groups. However, naltrexone-treated patients who received CBT had a lower level of craving and lower risk of relapse than the other three groups. This interaction would not have been observed in a study that manipulated only psychosocial treatment or only medication. 

MCPEAK P, RUKMiNi c, REDDY SASTRY c (2001) Supportive therapy for diabetes, hyperglycemia and hypoglycemia. US Patent 6,303,586 Bl. 

Usually resolve within 12-24 h with cessation of precipitating agent or supportive therapy but can be prolonged with long half-life drugs... 

Uncomplicated GERD usually resolves by 12 to 18 months of life and responds to supportive therapy, including dietary... 

ARF is a potentially life-threatening condition that can lead to significant morbidity and mortality. Supportive therapy, prompt correction of hypo- or hypervolemia, treatment of underlying conditions, and avoidance of nephrotoxic drugs is essential. 

Although it has received the most attention, CBT is not the only form of psychotherapy that is effective for depression. Other psychological treatments include interpersonal psychotherapy, short-term psychodynamic therapy and non-directive supportive therapy. Interpersonal psychotherapy focuses on problems that arise in interpersonal relationships, such as marital conflict, the loss of a loved one and social isolation.20 Short-term psychodynamic therapy focuses on acquiring insight and understanding of unresolved conflicts arising from the person s childhood. It is based on Freud s psychoanalytic theory, but requires only months, rather than the years it takes for a full psychoanalysis.21 Non-directive supportive therapy provides a warm, supportive atmosphere in which the depressed person can explore life issues... 

Supportive therapy must be instituted to maintain adequate ventilation, euglycemia, blood pressure, and body temperature. Underlying disorders such as sepsis and myocardial infarction must be diagnosed and treated. 

Disseminated histoplasmosis Acute (Infantile) Subacute Progressive histoplasmosis (immunocompetent patients and immunosuppressed patients without AIDS) 0.02-0.05 Disseminated histoplasmosis Untreated mortality 83% to 93% relapse 5% to 23% in non-AIDS patients therapy is recommended tor all patients Nonimmunosuppressedpatients Ketoconazole 400 mj day orally x 6-12 months or amphotericin B 35 mg/kg IV Immunosuppressed patients (non-AIDS) or endocarditis or CNS disease Amphotericin B >35 mg/kg x 3 months followed by fluconazole or itraconazole 200 mg orally twice daily x 12 months Life-threatening disease Amphotericin B 0.7-1 mg/kg/day IV for a total dosage of 35 mj kg over 2-4 months once the patient is afebrile, able to take oral medications, and no longer requires blood pressure or ventilatory support therapy can be changed to itraconazole 200 mg orally twice daily for 6-18 months Non-life-threatening disease Itraconazole 200-400 mg orally daily for 6-18 months fluconazole therapy 400-800 mg daily should be reserved for patients intolerant to itraconazole, and the development of resistance can lead to relapses... 

An algorithm for pain management in oncology patients is shown in Fig. 54-2. Pharmacologic therapies should be coupled with psychological, surgical, and supportive therapies. 

Hypotension, poikilothermia, and respiratory depression can occur and may require supportive therapies. 

Drugs Available Yes. (Ciprofloxacin, Doxycycline, and Penicillin), although such drugs are usually not effective after symptoms are present. Supportive therapy may be necessary. Oral ciprofloxacin can be used for known or imminent exposure. 

Clinical Diagnosis A presumptive diagnosis can be made from by Gram or Wayson stain of lymph node aspirates, sputum, or cerebrospinal fluid. Plague can also be cultured. As for treatment, early administration of antibiotics is very effective. Supportive therapy for pneumonic and septicemic forms is required. 

There is no proven treatment for smallpox, but in persons exposed to smallpox who do not show symptoms as yet, the vaccine — if given within four days after exposure — can lessen the severity of or even prevent illness. However, once a patient shows symptom, treatment is limited to supportive therapy and antibiotics to treat bacterial infections. Patients with smallpox can benefit from supportive therapy such as intravenous fluids, and medicines to control fever or pain. 

Drugs Available No specific anti-viral drugs are available, but supportive therapy might call for analgesics and anticonvulsants. 

Nerve agent intoxication requires rapid decontamination to prevent further absorption by the patient and to prevent exposure to others, ventilation when necessary, administration of antidotes, as well as supportive therapy. Skin decontamination is not necessary with exposure to vapor alone, but clothing should be removed to get rid of any trapped vapor. With nerve agents, there can be high airway resistance due to bronchoconstric-tion and secretions, and initial ventilation is often difficult. The restriction will decrease with atropine administration. Copious secretions which maybe thickened by atropine also impede ventilatory actions and will require frequent suctioning. For inhalation exposure to nerve agents, ventilation support is essential. 

Treatment — As with all viral hemorrhagic fevers, supportive therapy must be given, dependent on the complications experienced by patients. Treatment would be intravenous ribavarin for 4 to 6 days. While no human studies to date verify the efficacy of this treatment, cell and rodent studies attest to its efficacy. An effective inactivated vaccine that can be administered in three doses is available. Protective antibodies appear before 14 days and last 1 year. Annual boosters must be given.3... 

Treatment — Oral superactivated charcoal preparation is standard therapy for poison ingestion. This type of preparation is five times stronger than ordinary charcoal. Supportive therapy must be provided, depending on the symptoms displayed. No antitoxin is currently available for human use. However, an experimental antitoxin has shown some promise in animals.3... 

---