Chronopharmacology of alcoholism

Author(s):  
Е.В. Филиппова ◽  
Ю.К. Кондрашова ◽  
Ю.Ш. Тагоев

В статье представлен анализ информации из литературных источников, посвященной изучению хронофармакологии алкоголизма. Для лечения алкоголизма используется комплексный подход, определяющийся тяжестью состояния больного и индивидуальными особенностями симптоматики. В связи со способностью фармакологических соединений вмешиваться в течение ритмических процессов на всех уровнях организации биосистемы хронофармакологический эффект лекарственных средств может быть полезным или нежелательным. Высокой степенью осложнений со стороны сердечно-сосудистой и нервной систем, а также печени и желудочно-кишечного тракта характеризуется хроническая алкогольная интоксикация. Надежного средства патогенетической фармакотерапии алкоголизма до настоящего времени не разработано. При этом лекарственные препараты используют в основном для купирования явлений абстиненции. Одно из первых мест в терапии алкогольного абстинентного синдрома, сопровождающегося тревогой, страхом и беспокойством, занимают депримирующие средства. Однако расширение их применения в Российской Федерации для лечения алкоголизма остается необоснованным. Так как алкоголизм вызывает крайне разнообразные по своим клиническим проявлениям и по степени тяжести психические расстройства, то для их лечения используется широкий спектр психотропных препаратов. Для проведения противогипоксической и детоксифицирующей терапии используются энергокорригирующие средства. Алкогольный абстинентный синдром с преобладанием неврозоподобных и вегетативнососудистых расстройств является показанием к применению препаратов из класса антиоксидантов. Они сочетают в себе свойства транквилизаторов и ноотропов, не оказывая токсического воздействия на сердце и защищая миокард в условиях гипоксии. Однако на данный момент существует дефицит информации об эффективности их применения при алкогольной абстиненции. The article presents an analysis of information from literary sources devoted to the study of the chronopharmacology of alcoholism. For the treatment of alcoholism, an integrated approach is used, which is determined by the severity of the patient's condition and the individual characteristics of the symptoms. Due to the ability of pharmacological compounds to interfere during rhythmic processes at all levels of the organization of the biosystem, the chronopharmacological effect of drugs may be useful or undesirable. Chronic alcohol intoxication is characterized by a high degree of complications from the cardiovascular, nervous systems, liver and gastrointestinal tract. A reliable means of pathogenetic pharmacotherapy of alcoholism has not yet been developed. At the same time, medications are used mainly for the relief of withdrawal symptoms. One of the first places in the treatment of alcohol withdrawal syndrome, accompanied by anxiety, fear and anxiety, is occupied by depressants. However, the expansion of their use in the Russian Federation for the treatment of alcoholism remains unfounded. Since alcoholism causes extremely diverse mental disorders in their clinical manifestations and severity, a wide range of psychotropic drugs is used for their treatment. For antihypoxic and detoxifying therapy, energy-correcting agents are also used. Alcohol withdrawal syndrome with a predominance of neurosis-like and vegetative-vascular disorders is an indication for the use of drugs from the class of antioxidants. They combine the properties of tranquilizers and nootropics, without having a toxic effect on the heart and protecting the myocardium in hypoxia. However, at the moment there is a lack of information about the effectiveness of their use in alcohol withdrawal.

1973 ◽  
Vol 18 (5) ◽  
pp. 385-387
Author(s):  
J.B. Frost

Forty patients admitted for the treatment of alcohol withdrawal were placed on either chlorpromazine or mesoridazine on a double-blind basis. No significant difference in rate or degree of improvement between the two groups was noted and both groups showed an improvement which was more marked in the first week of treatment. There were few significant side effects from either drug. Improvement on either therapeutic regime is predictable and both are effective in relieving or lessening agitation, tremulousness, hallucinations and anxiety in patients recovering from acute alcohol intoxication.


1958 ◽  
Vol 19 (1) ◽  
pp. 118-124 ◽  
Author(s):  
Lincoln Godfrey ◽  
Martin D. Kissen ◽  
Thomas M. Downs

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Tessa L. Steel ◽  
Shewit P. Giovanni ◽  
Sarah C. Katsandres ◽  
Shawn M. Cohen ◽  
Kevin B. Stephenson ◽  
...  

Abstract Background The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) is commonly used in hospitals to titrate medications for alcohol withdrawal syndrome (AWS), but may be difficult to apply to intensive care unit (ICU) patients who are too sick or otherwise unable to communicate. Objectives To evaluate the frequency of CIWA-Ar monitoring among ICU patients with AWS and variation in CIWA-Ar monitoring across patient demographic and clinical characteristics. Methods The study included all adults admitted to an ICU in 2017 after treatment for AWS in the Emergency Department of an academic hospital that standardly uses the CIWA-Ar to assess AWS severity and response to treatment. Demographic and clinical data, including Richmond Agitation-Sedation Scale (RASS) assessments (an alternative measure of agitation/sedation), were obtained via chart review. Associations between patient characteristics and CIWA-Ar monitoring were tested using logistic regression. Results After treatment for AWS, only 56% (n = 54/97) of ICU patients were evaluated using the CIWA-Ar; 94% of patients had a documented RASS assessment (n = 91/97). Patients were significantly less likely to receive CIWA-Ar monitoring if they were intubated or identified as Black. Conclusions CIWA-Ar monitoring was used inconsistently in ICU patients with AWS and completed less often in those who were intubated or identified as Black. These hypothesis-generating findings raise questions about the utility of the CIWA-Ar in ICU settings. Future studies should assess alternative measures for titrating AWS medications in the ICU that do not require verbal responses from patients and further explore the association of race with AWS monitoring.


Sign in / Sign up

Export Citation Format

Share Document