Conventional intramuscular sedatives versus ziprasidone for severe agitation in adolescents: case-control study

<p>Abstract</p> <p>Objective</p> <p>The objective of this study was to compare intramuscular (IM) ziprasidone to conventional IM medications (haloperidol combined with lorazepam) for the treatment of severe agitation in adolescents (age 12–17).</p> <p>Methods</p> <p>We retrospectively identified consecutive severe agitation episodes (defined as requiring physical restraint) in adolescents treated with either IM ziprasidone or conventional IM agents in a psychiatric emergency room. For ziprasidone, the dosage was 20 mg for 23 episodes and 10 mg for 5 episodes. For 24 episodes treated with combined haloperidol and lorazepam, the dosages were 4.8 ± 0.3 SEM mg and 1.9 ± 0.4 mg respectively. Outcomes were the duration of restraint and need for adjunctive "rescue" medications within 60 minutes. These outcomes were decided prior to reviewing any records.</p> <p>Results</p> <p>No difference was found in restraint duration (ziprasidone, N = 28, 55 ± 5 minutes; haloperidol with lorazepam N = 24, 65 ± 7 minutes, P = NS). Use of "rescue" medications did not differ between the two groups. No changes in blood pressure were found, but pulse decreased 8.3 ± 2.4 for haloperidol with lorazepam and 8.9 ± 4.24 for ziprasidone (P = NS). No instances of excessive sedation or extra-pyramidal symptoms were documented.</p> <p>Conclusion</p> <p>In this study, IM ziprasidone appeared effective, well tolerated, and similar in clinical profile to combined conventional IM medications for treating severe agitation in adolescents. Given the reportedly favorable acute side effect profile of parenteral atypical agents, they may provide an alternative to conventional antipsychotics for treating acute agitation in both adult and adolescent populations. Future randomized, controlled studies are needed.</p

Throwing Buprenorphrine at a Wall (and Actually Having it Stick)

Objectives At the end of this presentation, learners will be able to: Discuss how buprenorphine\u27s unique pharmacology differs from full mu-opioid agonists. Distinguish between spontaneous opioid withdrawal and precipitated opioid withdrawal. Explain the rationale behind low-dose/crossover buprenorphine inductions. Enact effective buprenorphine inductions in the outpatient treatment setting

Decisional Capacity Conundrums

Presentation: 42:0

Localization of foreign multinational companies in Korea

In response to the 1997 Asian financial crisis that devastated the Korean economy, the government performed promotional efforts, comprehensive structural reform, and implemented policies to create a favorable environment for foreign direct investment (FDI). While the Korean government announced deregulation plans to support foreign companies, the public also became more aware of the need for foreign capital to overcome the crisis and revive the economy. The change of atmosphere and the perception on the need to induce the inflow of foreign capital provided the basis for this study. In addition, the crucial role of foreign multinational companies and their efforts to achieve market recognition in a more comprehensive way have provoked this study on the localization of foreign multinational companies in Korea. Investment purposes, entry methods, and the degree of competition by multinational companies in Korea were the variables that lead these companies to respond to localization.foreign direct investment, localization, integration, responsiveness, multinational corporations,