Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0278080 (physical dependence)
 1,658 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Six female chronic spinal dogs were administered N-allylnormetazocine (NANM) chronically by the intravenous route starting at 0.3 mg/kg/day. The dose was escalated to a stabilization dose of 10 mg/kg/day. The dogs became tolerant to NANM's ability to produce canine delirium and its anorexigenic and respiratory stimulant effects. Naltrexone increased the amplitude of the flexor reflex and pulse rate in the body temperature, pupillary constriction, bradycardia and tachypnea. Appetite was decreased and weight was lost. These data indicate that chronic administration of NANM produces tolerance and a unique type of physical dependence. Some changes produced by chronically administered NANM were naltrexone antagonizable, others were not suggesting that NANM may have several mechanisms of action.
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PMID:Tolerance to and physical dependence on N-allylnormetazocine (NANM) in chronic spinal dogs. 689 Feb 39

Barbiturates can produce psychological and physical dependence and produce a withdrawal syndrome on the second to fourth day after the drug is suspended. Symptoms include anxiety, restlessness, insomnia, rhythmic intention tremor, dizziness, seizures, and psychosis. If the syndrome is not recognized and correctly treated, hyperthermia, circulatory failure, and death may ensue. Although barbiturates are less frequently used nowadays, they are employed in combination with other drugs in many medications used for the treatment of headache. We report the case of a 54-year-old woman who developed a barbiturate abstinence syndrome when she suspended self-administration of a drug containing butalbital. The patient had been using barbiturates, 900 mg/die, for 2+ years for persistent headache. She was admitted to the hospital because of seizures, hallucinations and delirium not controlled by benzodiazepine and phenothiazine administration. Her symptoms resolved after parenteral phenobarbital administration.
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PMID:[Barbiturate withdrawal syndrome: a case associated with the abuse of a headache medication]. 1034 6

Delirium is a common complication in the geriatric population following cardiac and noncardiac procedures. Postoperative delirium is a significant financial burden on the United States health care system and is independently associated with prolonged hospital stay, increased risk of early and long term mortality, increased physical dependence, and an increased rate of nursing home placement. The Confusion Assessment Method (CAM) is a bedside rating scale developed to assist nonpsychiatrically trained clinicians in the rapid and accurate diagnosis of delirium. The CAM has been adapted for use in ventilated intensive care unit (ICU) patients in the form of the CAM-ICU. The onset of delirium involves an interaction between predisposing and precipitating risk factors for delirium. The mainstay of delirium management is prevention. The approach involves control or elimination of modifiable risk factors. It is controversial whether anesthetic technique determines delirium. However, important modifiable risk factors under the anesthesiologist's control include adequate postoperative pain management, careful drug selection, and embracing and participating in a multidisciplinary care model for these complicated patients.
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PMID:Postoperative delirium in the elderly surgical patient. 1982 86

Gamma-hydroxybutyric acid (GHB) is an old anaesthetic drug which was misused in the 80-90's as an anabolic agent (bodybuilding), recreational drug (drunkenness, euphoric, disinhibiting and aphrodisiac effects) and as a date rape drug (disinhibiting, hypnotic and amnesic effects). Its use in the general population is low, and mainly concerns gay population in nightclubs and young people in parties. The intoxications, above all with alcohol combination, can be severe, with coma and breathing depression, or even fatal. Chronic use leads to psychic and physical dependence; withdrawal syndrome can be severe, with agitation and delirium. In 1999, GHB classification as a narcotic resulted in the increased use of GHB prodrugs gamma-butyrolactone (GBL) and 1,4-butanediol (1,4-BD), which were easily commercially available as solvent and cleaning products. Like GHB, they have a narrow window of use, and share similar toxicity. Their increased cases of recreational use and of severe drug intoxication, abuse and dependence, led the French Ministry of Health in 2011 to prohibit their sale and transfer to the public.
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PMID:[Current knowledge on gamma-hydroxybutyric acid (GHB), gamma-butyrolactone (GBL) and 1 ,4-butanediol (1,4-BD)]. 2273 Aug

Delirium is an acute, potentially life-threatening organ dysfunction with an incidence reported to range between 10 and 92 %. Delirium is potentially preventable and has a great impact on patients' outcomes, even beyond their stay in the hospital. It was found to be associated with persisting cognitive deficits, increased physical dependence, institutionalization, and increased mortality. Delirium is the result of the complex interplay of predisposing and hospital-associated precipitating risk factors, some of which are potentially preventable and modifiable.Delirium is frequently not or incorrectly diagnosed. Subtype, severity, and duration are associated with prognosis. Both prevention and treatment necessitate implementation of daily structured delirium screening. Prevention requires risk assessment: predisposing and precipitating factors should be recognized and treated, if modifiable. Prevention and treatment options include behavioral, cognitive training programs and possibly anti-inflammatory and antipsychotic drugs. Delirium requires search for underlying illness, intoxication or drug side effects.This review summarizes recent work from the last two years, giving a brief overview and background information with regard to risk factors, impact on outcome parameters, mechanisms of pathophysiology, non-pharmacological and pharmacological prevention and treatment strategies of delirium in critically ill patients.
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PMID:[Delirium on the ICU: clinical impact, diagnostic workup, and therapy]. 2461 26