• 제목/요약/키워드: Withdrawal Symptoms

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Pediatric Nurses' Knowledge and Attitude on Iatrogenic Narcotic Analgesic Withdrawal Symptoms Management (소아환자 마약성 진통제 금단증상관리에 대한 간호사의 지식과 태도)

  • Lee, Ka Young;Park, Jeong Yun
    • Journal of Korean Critical Care Nursing
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    • v.11 no.3
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    • pp.35-44
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    • 2018
  • Purpose : This study investigates pediatric nurses' knowledge and attitudes regarding iatrogenic narcotic analgesic withdrawal symptoms management (INAWSM). Methods : In this cross-sectional study, 253 pediatric nurses working at a tertiary hospital in Seoul participated. Instruments were the inventory consisting questionnaires on 35 items knowledge and 12 items attitude for INAWSM. Further, descriptive statistics, t-test, and analysis of variance were used to evaluate the nurses' knowledge and attitudes. Results : The correct answers rate of knowledge toward INAWSM was 44.9%. With respect to the pediatric nurses' attitudes, the participants scored an average value of $2.83{\pm}0.25$ out of 4 points. The factor related to the knowledge and attitude level was age, pediatric nursing experience, educational experience, and educational needs. Conclusions : Results revealed that pediatric nurses had inadequate knowledge and attitude on INAWSM despite a compulsory education. Therefore, it is necessary to develop an efficient INAWSM educational program.

Prognosis and Clinical Outcome of Alcohol Withdrawal Syndrome in Trauma Patients (외상 환자에서 알코올 금단 증후군의 발생이 예후에 미치는 영향)

  • Oh, Dong Gil;Cho, Min Soo;Bae, Keum Seok;Kang, Sung Joon
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.115-119
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    • 2008
  • Purpose: Abrupt abstinence from alcohol in cause of chronic alcohol addiction can trigger alcohol withdrawal syndrome. The authors studied the effect of post-operative alcohol withdrawal syndrome in patients who require intensive care due to trauma. Methods: For the study group, we selected 70 patients who had undergone emergency surgery from May 2003 to March 2007 due to trauma and who had been treated with prophylactic thiamine. Data was collected retrospectively. We excluded those who extended their hospital stay for other than traumatic causes, those who died within 3 days of surgery after trauma, those who transferred to other institutions, and those who received a psychiatric diagnosis. Patient groups were determined by the existence or the non-existence of withdrawal syndrome. Age, sex, injury mechanism, mortality, complications, durations of hospital stay and intensive care, use of mechanical ventilator, and sedative use were investigated. A Chi-square test and The Mann-Whitney method were used for statistical analysis in this study. Results: Twenty-four (24) patients from the 58 who had an ISS of 16 or more showed alcohol withdrawal syndrome, and men were shown to be affected with the syndrome significantly more than women. Although ISS was higher in the group with alcohol withdrawal syndrome, statistically, the difference was not significant (P<0.08). The total hospital stay in the patient group with alcohol withdrawal syndrome was on average 10 days longer. However, the difference was not significant (P<0.054). The duration of intensive care in the patient group with alcohol withdrawal syndrome was significantly longer (P<0.029). The patients with alcohol withdrawal syndrome showed no significant difference in the duration of mechanical ventilator use (P<0.783), or in the duration of sedative use (P<0.284). Respiratory distress, pneumonia, upper airway infection, sepsis, acute renal failure, and mortality in the alcohol withdrawal syndrome group were investigated, but no statistically significant difference were noted. Conclusion: We found that the duration of intensive care in chronic alcohol abusers was longer due to the development of alcohol withdrawal syndrome. We also discovered that, when the patients overcame the symptoms of alcohol withdrawal syndrome after intensive care, no difference was found in the frequency of developing complications, the morbidity, and the mortality. Therefore, we conclude that intensive care in trauma patients who are chronic alcohol abusers decreases the incidence of complications found in patients with post-operative alcohol withdrawal syndrome and does not adversely impact the prognoses for those patients.

Benzodiazepine계 약물과 그 문제점

  • O Gang-Seop
    • 대한불안의학회:학술대회논문집
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    • 2005.05a
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    • pp.88-103
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    • 2005
  • o Rational Use of BZ - relative safe, widely useful o Hidden side effects/disastrous effects in vulnerable patients o Review tolerance, dependency, withdrawal symptoms o Consider Drug interaction o Periodic Evaluation of Risk/Benefit of BZ o Advice to patients planning a pregnancy

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Alcohol Withdrawal and Serum Nitrite Concentration (알코올 금단과 혈중 아질산염 농도)

  • Lee, Boung Chul;Son, Hyun-Gyun;Choi, Ihn-Geun
    • Korean Journal of Biological Psychiatry
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    • v.11 no.1
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    • pp.33-39
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    • 2004
  • Objective:Nitric oxide(NO) has been known to be associated with tolerance and preference to alcohol. It has also been known to affect various alcohol drinking behavior, alcohol withdrawal symptoms and alcohol- induced brain damage. The purpose of this study was to determine the difference, among alcohol dependence group, alcohol drinking group and abstinence group, in serum concentration of nitrite, a stable metabolite of NO, and it's relationship to clinical and biochemical markers of alcoholism. Methods:Forty subjects diagnosed as alcohol dependence according to DSM-IV diagnostic criteria were evaluated for the clinical characteristics and biochemical markers of alcohol dependence including nitrite with their CIWA-Ar scores checked just after admission. Thirty-nine healthy controls were also evaluated, divided into twenty-three alcohol drinking group and sixteen abstinence group. Clinical characteristics were evaluated by CIWA-Ar, CAGE and AUDIT questionnaires. Aspartate aminotransferase(AST), alanine aminotransferase (ALT), gamma glutamyltransferase(GGT) and mean corpuscular volume(MCV) were used as the biochemical markers of alcohol dependence. Serum nitrite concentrations were measured by Griess reaction. Results:1) The concentrations of nitrite in alcohol dependence patients were not different from those in the control subjects. 2) There were no significant association between the nitrite concentrations and the CIWA-Ar scores in alcohol dependence patients. 3) Nitrites are significantly increased in alcohol dependence group and alcohol drinking group compared with abstinence group. Conclusions:These findings suggest that serum nitrite concentration has no relation with alcohol withdrawal symptoms, but alcohol drinking increases serum nitrite concentration influenced by general condition of the body.

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Effects of Folic Acid on the Level of Nicotine-Induced Plasma Homocysteine in Rats;In a view of applying the results to Oriental Medicine-Formula for controlling withdrawal symptoms after stopping smoking (엽산 투여에 의한 니코틴-유도 혈장 homocysteine 농도에 대한 영향과 금단증상 완화를 위한 한의학적 처방에 대한 고찰)

  • Park, Yeong-Chul;Shin, Heon-Tae;Park, Hae-Mo;Lee, Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.11 no.1
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    • pp.45-53
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    • 2007
  • Homocysteine is a sulfur amino-acid produced during the metabolism of the essential amino acid methionine. Moderately increased plasma total homocysteine concentration have been implicated as a risk factor for occlusive vascular disease. Smoking is known to be one of the most significant factors leading to elevated plasma homocysteine concentration. However, the main component of a cigarette, nicotine has been not studied whether it is linked directly to the increase of homocysteine concentration in blood. The metabolism of homocysteine is closely linked to that of its cofactors, folate. Here, the effects of nicotine and folic acid on amount of plasma homocysteine were studied. The concentration of homocysteine was increased by about 70% in rat plasma after nicotine treatment for one month. This increased concentration of homocysteine was reduced by about 60% at 6 hours later after folate treatment. Thus, nicotine should be directly involved in increasing the concentration of plasma homocysteine. Also it is suggested that these results can be and applied and used for controlling withdrawal symptoms after stopping smoking as one of oriental medicine formulas.

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A clinical report of Delirium Tremens demonstrated Jusang(酒傷) (알콜성 진전섬망으로 진단된 신지부청(神志不淸) 환자 치험 1례)

  • Lee, Eun-Kyung;Choi, Chul-hong;Lee, Ji-In;Chung, Dae-Kyoo
    • Journal of Oriental Neuropsychiatry
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    • v.17 no.3
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    • pp.107-116
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    • 2006
  • Delirium Tremens is the most terrible and dramatic syndrome in Alcohol Withdrawal Syndrome. Delirium Tremens is one of acute psychiatric symptoms and happens that a chronic drinker is suddenly off drinking for any reasons. In Oriental medicine, Alcohol Withdrawal Syndrome is comprised in a category of Jusang(酒傷). In this case, we described a 53-year old man who diagnosed as Delirium tremens. He suffered mental derangement and headache, and his condition was improved through oriental medical treatment.

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Effect of Berberine on Depression- and Anxiety-Like Behaviors and Activation of the Noradrenergic System Induced by Development of Morphine Dependence in Rats

  • Lee, Bombi;Sur, Bongjun;Yeom, Mijung;Shim, Insop;Lee, Hyejung;Hahm, Dae-Hyun
    • The Korean Journal of Physiology and Pharmacology
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    • v.16 no.6
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    • pp.379-386
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    • 2012
  • The purpose of this study was to evaluate whether berberine (BER) administration could attenuate depression- and anxiety-like behaviors and increase corticotrophin-releasing factor (CRF) and tyrosine hydroxylase (TH) expression following chronic morphine withdrawal in rats. Male rats were exposed to chronic, intermittent, escalating morphine (10~50 mg/kg) for 10 days. After the last morphine injection, depression- and anxiety-like beahvior associated with morphine discontinuation persisted for at least three days during withdrawal without any change in ambulatory activity. Daily BER administration significantly decreased immobility in the forced swimming test and increased open-arm exploration in the elevated plus maze test. BER administration also significantly blocked the increase in hypothalamic CRF expression and TH expression in the locus coeruleus (LC) and the decrease in hippocampal brain-derived neurotrophic factor (BDNF) mRNA expression. Taken together, these findings demonstrated that BER administration significantly reduced morphine withdrawal-associated behaviors following discontinuation of repeated morphine administration in rats, possibly through modulation of hypothalamic CRF and the central noradrenergic system. BER may be a useful agent for treating or alleviating complex withdrawal symptoms and preventing morphine use relapses.

항불안제로서의 Benzodiazepine계 약물의 위치

  • O Gang-Seop
    • 대한불안의학회:학술대회논문집
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    • 2005.10a
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    • pp.80-91
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    • 2005
  • o Benzodiazepines can be effective in treating Anxiety Disorders o Efficacy of Benzodiazepines varies across Anxiety Disorders o Proper diagnosis is important before prescribing o Consider Side effects and withdrawal symptoms o Periodic Evalustion of Risk/Benefit of BZ o Advised gto use proper dose, duration for indicated Anxiety Disorders

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Relationship among Dysfunctional Attitudes, Stress Coping Strategies and Depressive Symptoms in Psychiatric Patients (정신질환자들의 역기능적 태도, 스트레스 대처 방식 및 우울증상 간의 관계)

  • Park, Chan-Moo;Seo, Kyung-Ran;Rhee, Min-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.5 no.1
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    • pp.31-42
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    • 1997
  • This study was aimed to investigate dysfunctional attitudes, stress coping strategies and depressive symptoms in psychiatric patients. The subjects of this study consisted of 210 patients(138 schizophrenic patients, 29 depression patients, 43 alcohol dependence patients) according to DSM-IV criteria. Futhermore, the instruments were K-BDI(Beck Depression Inventory-Korean version), DAS(Dysfunctional Attitude Scale) and multidimensional coping strategy scale. The results were the following. 1) There were statistically significant correlations between depressive symptoms and dysfunctional attitudes in psychiatric patients. 2) In terms of coping strategies, there were positive correlations between depressive symptoms and focus on and venting emotions, accommodation, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. Whereas, there was significant negative correlation between depressive symptom and active coping. 3) In terms of coping strategies, there were significant correlations between dysfunctional attitudes and focus on and venting emotions, active forgetting, self-criticism, positive comparison, fatalism, passive withdrawal. 4) Depression groups reported significantly higher BDI scores than schizophrenia groups. 5) In depression groups, DAS scores were significantly higher than those in schizophrenia groups. 6) In terms of coping strategies according to diagnosis, there were significant differences in venting emotions, active forgetting and self-criticism. As for venting emotions, alcoholic groups were scored significantly higher than schizophrenic groups. As for active forgetting, depression groups were scored significantly higher than schizophrenic groups. In self-criticism, depression groups and alcohol dependence groups reported significantly higher scores than schizophrenic groups.

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Effects of Smoking Cessation Program applying Aromatherapy Massage on Smoking Cessation in Female College Students (아로마테라피 마사지를 적용한 금연프로그램이 여대생의 금연에 미치는 효과)

  • Park, Kyung-Min;Kwon, Young-Soak;Lee, Sung-Hee
    • Research in Community and Public Health Nursing
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    • v.14 no.4
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    • pp.608-616
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    • 2003
  • Purpose: The purpose of this study was to examine the effects of smoking cessation program applying aromatherapy massage on female college students' quitting of smoking. Methods: Forty-eight female college students were assigned to a smoking cessation program applying aromatherapy massage or a control group. The treatment group was taught to conduct a self hand massage with aroma essence oil. Lavender extra, Camomile roman and Bergamotte aroma essence oil were used for massage. The results of this study showed that the smoking cessation program applying aromatherapy massage resulted in significant effects on the number of cigarettes smoked per day, anxiety, smoking cravings and withdrawal symptoms. Conclusions: The findings presented above suggest that the smoking cessation program applying aromatherapy massage may be an effective intervention for female college students attempting to quit smoking to alleviate smoking-related anxiety and to reduce the number of cigarettes smoked, smoking cravings and withdrawal symptoms.

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