Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0085631 (agitation)
 12,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The abuse of methylenedioxymethamphetamine (MDMA), flunitrazepam, ketamine hydrochloride, and gamma-hydroxybutyrate (GHB) is discussed. Club drugs are chemical substances used recreationally in social settings. Use is increasingly frequent among young people, especially during all-night dance parties. All four agents have been classified as controlled substances. MDMA ("ecstasy") is available as a tablet, a capsule, and a powder; formulations may contain many adulterants. MDMA increases the release of neurotransmitters. The desired effects are euphoria, a feeling of intimacy, altered visual perception, enhanced libido, and increased energy. The most common adverse effects are agitation, anxiety, tachycardia, and hypertension. More serious adverse effects include arrhythmias, hyperthermia, and rhabdomyolysis. Flunitrazepam is a potent benzodiazepine. At higher doses, the drug can cause lack of muscle control and loss of consciousness. Other adverse effects are hypotension, dizziness, confusion, and occasional aggression. Ketamine is a dissociative anesthetic used primarily in veterinary practice. It may be injected, swallowed, snorted, or smoked. Like phencyclidine, ketamine interacts with the N-methyl-D-aspartate channel. Analgesic effects occur at lower doses and amnestic effects at higher doses. Cardiovascular and respiratory toxicity may occur, as well as confusion, hostility, and delirium. GHB, a naturally occurring fatty acid derivative of gamma-aminobutyric acid, was introduced as a dietary supplement. Increasing doses progressively produce amnesia, drowsiness, dizziness, euphoria, seizures, coma, and death. Flunitrazepam, ketamine, and GHB have been used to facilitate sexual assault. Supportive care is indicated for most cases of club drug intoxication. The increasing abuse of MDMA, flunitrazepam, ketamine hydrochloride, and GHB, particularly by young people in social settings such as clubs, should put health care professionals on guard to recognize and manage serious reactions.
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PMID:Club drugs: methylenedioxymethamphetamine, flunitrazepam, ketamine hydrochloride, and gamma-hydroxybutyrate. 1206 92

The present study aims to describe a case of work injury and occupational disease which is unique for the type of disease diagnosed, conditions of onset and mode of management by INAIL (Italian National Institute of Insurance for Injuries at Work and Occupational Diseases). A worker, after a verbal animated dispute with some collegues and superiors, had an acute psychiatric agitation attack and went to the nearest emergency room, where he was subjected to clinical exams. No neuropsychiatric alteration was found, but the physicians diagnosed an anxiety crisis reactive to the work environment. Consequently, the medical certificate for work injury was edited and sent to INAIL. The worker has been off work for 110 days because of a anxious and depressive syndrome, due to the verbal conflict. In a later assessment, INAIL recognized only the first 30 days of the employee's time off as injury at work, while judging the following period off work as related to affectivity disturbance due to common disease, not related to work environment. The following year, "anxious-depressive syndrome" is worsened and attributed by the same worker to the recurrence of acts of persecution and discrimination against him at work. For this reason he applied for recognition of occupational disease diagnosed as "Chronic Adjustment Disorder with prolonged depressive reaction and somatic anxiety, which developed into a protracted conflict marked the employment situation". INAIL rejected that request, but in the same year the employee has submitted the complaint for "mobbing". Even this request was rejected. Literature shows many examples of traumatic events during working activities which cause psychiatric disturbances. These events include industrial disasters, explosions, transport and mining accidents, accidents in psychiatric units with high risks of assaults, armed conflicts, war, assault and sexual assault, natural disasters. Victims show symptoms of acute stress disorder (ASD) or post-traumatic stress disorder (PTSD). Cases of acute stress disorder resulting only from verbal conflict recognised as work injury aren't currently described. This case opens new perspective for the occupational physician in the assessment of ASD as work injury and of PTSD as professional disease, suggesting to put more attention to psychiatric health of workers.
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PMID:[Reactive anxiety crisis and chronic adjustment disorder: a unique case of work injury and suspected occupational disease]. 2505 33