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Baclofen Withdrawal

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102. Hiccups

be recommended by a specialist. haloperidol oral 500 micrograms to 1mg if required 8 hourly, maintenance dose 1 to 3mg at bedtime baclofen oral 5 to 20mg, if required 8 hourly (avoid abrupt withdrawal) levomepromazine oral 3 to 6mg at bedtime (now used as an alternative to chlorpromazine; avoid if hypotensive) nifedipine oral 5 to 20mg, if required 8 hourly (avoid if hypotensive). Practice Points Peppermint water and prokinetics, eg metoclopramide, should not be used concurrently because of their opposing

2015 Scottish Palliative Care Guidelines

105. Dementia

and anxiety — the person may follow their carer around. The onset of depression in later life is a warning sign of dementia. Withdrawal or apathy. Disinhibition — the person may exhibit social or sexually inappropriate behaviour. Motor disturbance — wandering, restlessness, pacing, and repetitive activity may be reported. Sleep cycle disturbance or insomnia. Tendency to repeat phrases or questions. Difficulties with activities of daily living (ADLs): In the early stages of dementia this may lead

2019 NICE Clinical Knowledge Summaries

106. Cerebral palsy

), constipation, emotional distress, pain, posture, pressure sores, changes in home or work environments, including seating, and medication changes and side effects. Address any modifiable factors that may be exacerbating the person's spasticity or dystonia. For further information, see the CKS topics on , , , and . Consider prescribing enteral baclofen as the first-line drug treatment for adults with CP and generalised spasticity causing functional impairment, pain, or spasms. For more information, see (...) the section on . If enteral baclofen is ineffective or not tolerated, refer the person to a tone or spasticity management service, where other interventions may be offered, including Botulinum toxin type A injections, intrathecal baclofen, and selective dorsal rhizotomy. When considering a treatment for abnormal muscle tone, discuss with the person, and document their treatment goals. In addition, consider referring adults with spasticity in a limited number of muscle groups that is affecting their care

2019 NICE Clinical Knowledge Summaries

107. MI - secondary prevention

to cross the blood-brain barrier. Thrombocytopenia. Vertigo. Visual disturbances. [ ] Drug interactions Drug interactions Key drug interactions with beta-blockers include: Alpha-blockers, alprostadil, ACE-inhibitors, angiotensin II receptor antagonists, anxiolytics, baclofen, co-beneldopa, co-careldopa, diazoxide, diuretics. hydralazine, hypnotics, levodopa, MAOIs, methyldopa, minoxidil, moxonidine, nitrates, phenothiazines, sodium nitroprusside, tizanidine — enhanced hypotensive effect (...) because bradycardia and myocardial depression can occur. Class III anti-arrhythmics (such as amiodarone) The combination of a beta-blocker and amiodarone should be prescribed with caution as there is an increased risk of bradycardia, atrioventricular (AV) block, and myocardial depression — monitor pulse and blood pressure and check for signs of worsening heart failure. Clonidine — increased risk of withdrawal hypertension. Withdraw beta-blockers several days before slowly withdrawing clonidine

2019 NICE Clinical Knowledge Summaries

108. Multiple sclerosis

is healthcare professionals working within the NHS in the UK, and providing first contact or primary healthcare. How up-to-date is this topic? How up-to-date is this topic? Changes Changes October 2019 — minor update. Advice added to prescribe baclofen with caution to people who are at risk of misuse, abuse and dependence. February 2018 — minor update. New product availability added. March 2015 to September 2015 — new topic. The evidence base has been reviewed in detail, and recommendations are clearly

2018 NICE Clinical Knowledge Summaries

109. Hypertension - not diabetic

measures (such as weight loss, reduced alcohol consumption, regular exercise, and restriction of salt consumption). Withdraw antihypertensive drugs gradually, following the manufacturer's guidance and follow-up the person carefully (for example, at 4-weekly intervals for 6 months, then two or three times a year) to detect any recurrence of hypertension. Check renal function annually by measuring serum creatinine, electrolytes, and estimated glomerular filtration rate (eGFR), and dipstick urine to check

2018 NICE Clinical Knowledge Summaries

110. Obsessive-compulsive disorder

(skin-picking) disorder — suggested by recurrent picking of skin, resulting in skin lesions. Substance-induced or medication-induced obsessive-compulsive disorder — suggested by OCD-type symptoms that are attributable to effects of medication or drug of abuse, and develop during or soon after substance intoxication or withdrawal or after exposure to substance. ICD-10 and DSM-5 criteria for OCD ICD-10 and DSM-5 criteria for the diagnosis of obsessive-compulsive disorder International Classification (...) prescribing an SSRI: Escitalopram, fluoxetine, fluvoxamine, paroxetine, and sertraline are all licensed for the treatment of OCD in adults. Citalopram can also be prescribed as a treatment for OCD, but this is an unlicensed use. Discuss the potential for adverse effects and withdrawal symptoms before drug treatment is initiated. Explain that adverse effects early in treatment with an SSRI may include increased anxiety, agitation, and sleeping problems. Advise the person that in OCD, when compared

2018 NICE Clinical Knowledge Summaries

113. Palliative care - oral

, carbamazepine, cetirizine, fluoxetine, levodopa, lithium, phenytoin. selegiline, topirimate, venlafaxine, zopiclone Other Allopurinol, baclofen, benzocaine, isoretinoin, penicillamine Data from: [ ] Excessive salivation Excessive salivation Excessive salivation is uncommon but can cause discomfort and embarrassment, as well as irritation of the lips and chin. The problem is exacerbated if the person also has difficulty swallowing. True hypersalivation (an absolute increase in the volume of saliva) is rare

2018 NICE Clinical Knowledge Summaries

114. Baclofen for Smoking Cessation in a Non-Psychiatric Population

of medication compliance (i.e. take the medication as directed for the trial period) than those in the placebo group. The tertiary hypothesis is that baclofen will lead to significant reductions in tobacco withdrawal and craving ratings as compared to placebo. Condition or disease Intervention/treatment Phase Nicotine Dependence Drug: Baclofen 30 mg/day Drug: placebo pill Drug: Baclofen 60 mg/day Phase 2 Detailed Description: This study will test a new medication strategy designed to help smokers quit (...) Baclofen for Smoking Cessation in a Non-Psychiatric Population Baclofen for Smoking Cessation in a Non-Psychiatric Population - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Baclofen for Smoking Cessation

2010 Clinical Trials

115. A Study on the Biobehavioral Mechanisms of Baclofen and Alcohol Drinking

an effect on alcohol consumption or that may interact with baclofen or cyproheptadine. medical contraindications for use of baclofen or cyproheptadine. a history of adverse reaction or hypersensitivity to baclofen or cyproheptadine. individuals with a reasonable expectation of being institutionalized during the course of the trial. participants who have significant alcohol withdrawal symptoms, defined as a Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar) >10. history of seizures (e.g (...) A Study on the Biobehavioral Mechanisms of Baclofen and Alcohol Drinking A Study on the Biobehavioral Mechanisms of Baclofen and Alcohol Drinking - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. A Study

2010 Clinical Trials

116. Treatment of Unexplained Chronic Cough

to other conditions, such as re?ux disease, sinonasal pathology, allergy, pulmonary diseases, and angiotensin-converting enzyme inhibitor treatment. Eight relevant articles were evaluated, including two RCTs. 22,34 A broad range of neuromodulators was studied, including gabapentin, pregabalin, amitriptyline, and baclofen. The review identi?ed positive effects of neuromodulator therapy oncough-speci?cqualityoflife and cough severity, and it recommended further study design improvements for future (...) in patients with UCC. 35 The study had 80% power to detect a 50% reduction in cough frequency. The authors did not report any adverse events. Erythromycin should be well tolerated in this study: it was prescribed at a low dosage, and all subjects completed the study except for two withdrawals for personal reasons. Because erythromycin is an experimentaltherapyforUCCandisnotwidelyusedfor UCC, this agent was not included in recommendations. Ipratropium Bromide: A randomized trial of inhaled ipratropium

2016 American College of Chest Physicians

117. Management of Substance Use Disorder

A. Screening 29 VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders December 2015 Page 4 of 169 B. Brief Alcohol Intervention 31 C. Determination of Treatment Setting 32 D. Treatment 33 a. Alcohol Use Disorder 33 b. Opioid Use Disorder 38 c. Cannabis Use Disorder 47 d. Stimulant Use Disorder 48 E. Promoting Group Mutual Help Involvement 50 F. Co-occurring Mental Health Conditions and Psychosocial Problems 52 G. Follow-up 52 H. Stabilization and Withdrawal 55 a. Assessment 55 b (...) . Alcohol Use Disorder Stabilization and Withdrawal 58 c. Opioid Use Disorder Stabilization and Withdrawal 60 d. Sedative Hypnotic Use Disorder Stabilization and Withdrawal 62 VII. Knowledge Gaps and Recommended Research 63 A. Determination of Treatment Setting 63 B. Pharmacotherapy 63 a. Opioid Use Disorder 63 b. Stimulant Use Disorder 63 C. Psychosocial Interventions 64 a. Substance Use Disorders 64 b. Opioid Use Disorder 64 D. Follow-up 64 E. Stabilization and Withdrawal 64 F. Telehealth 64 Appendix

2015 VA/DoD Clinical Practice Guidelines

119. Brain injury rehabilitation in adults

with this design there remain difficulties in assessing behaviours which do not reverse back to baseline after withdrawal of treatment, indicating that the treatment may not have been the key variable affecting change. Single case studies are usually ranked at the bottom of the traditional hierarchy of evidence. 17 Brain injury rehabilitation in adults| 5 Functional therapies tend to be safe, and due to their context-dependent nature, their effectiveness may be better examined using observational techniques

2013 SIGN

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