1000 resultados para Marché
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Report on a special investigation of Squaw Township for the period April 19, 2001 through March 18, 2009
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TERMINOLOGY AND PRINCIPLES OF COMBINING ANTIPSYCHOTICS WITH A SECOND MEDICATION: The term "combination" includes virtually all the ways in which one medication may be added to another. The other commonly used terms are "augmentation" which implies an additive effect from adding a second medicine to that obtained from prescribing a first, an "add on" which implies adding on to existing, possibly effective treatment which, for one reason or another, cannot or should not be stopped. The issues that arise in all potential indications are: a) how long it is reasonable to wait to prove insufficiency of response to monotherapy; b) by what criteria that response should be defined; c) how optimal is the dose of the first monotherapy and, therefore, how confident can one be that its lack of effect is due to a truly inadequate response? Before one considers combination treatment, one or more of the following criteria should be met; a) monotherapy has been only partially effective on core symptoms; b) monotherapy has been effective on some concurrent symptoms but not others, for which a further medicine is believed to be required; c) a particular combination might be indicated de novo in some indications; d) The combination could improve tolerability because two compounds may be employed below their individual dose thresholds for side effects. Regulators have been concerned primarily with a and, in principle at least, c above. In clinical practice, the use of combination treatment reflects the often unsatisfactory outcome of treatment with single agents. ANTIPSYCHOTICS IN MANIA: There is good evidence that most antipsychotics tested show efficacy in acute mania when added to lithium or valproate for patients showing no or a partial response to lithium or valproate alone. Conventional 2-armed trial designs could benefit from a third antipsychotic monotherapy arm. In the long term treatment of bipolar disorder, in patients responding acutely to the addition of quetiapine to lithium or valproate, this combination reduces the subsequent risk of relapse to depression, mania or mixed states compared to monotherapy with lithium or valproate. Comparable data is not available for combination with other antipsychotics. ANTIPSYCHOTICS IN MAJOR DEPRESSION: Some atypical antipsychotics have been shown to induce remission when added to an antidepressant (usually a SSRI or SNRI) in unipolar patients in a major depressive episode unresponsive to the antidepressant monotherapy. Refractoriness is defined as at least 6 weeks without meeting an adequate pre-defined treatment response. Long term data is not yet available to support continuing efficacy. SCHIZOPHRENIA: There is only limited evidence to support the combination of two or more antipsychotics in schizophrenia. Any monotherapy should be given at the maximal tolerated dose and at least two antipsychotics of different action/tolerability and clozapine should be given as a monotherapy before a combination is considered. The addition of a high potency D2/3 antagonist to a low potency antagonist like clozapine or quetiapine is the logical combination to treat positive symptoms, although further evidence from well conducted clinical trials is needed. Other mechanisms of action than D2/3 blockade, and hence other combinations might be more relevant for negative, cognitive or affective symptoms. OBSESSIVE-COMPULSIVE DISORDER: SSRI monotherapy has moderate overall average benefit in OCD and can take as long as 3 months for benefit to be decided. Antipsychotic addition may be considered in OCD with tic disorder and in refractory OCD. For OCD with poor insight (OCD with "psychotic features"), treatment of choice should be medium to high dose of SSRI, and only in refractory cases, augmentation with antipsychotics might be considered. Augmentation with haloperidol and risperidone was found to be effective (symptom reduction of more than 35%) for patients with tics. For refractory OCD, there is data suggesting a specific role for haloperidol and risperidone as well, and some data with regard to potential therapeutic benefit with olanzapine and quetiapine. ANTIPSYCHOTICS AND ADVERSE EFFECTS IN SEVERE MENTAL ILLNESS: Cardio-metabolic risk in patients with severe mental illness and especially when treated with antipsychotic agents are now much better recognized and efforts to ensure improved physical health screening and prevention are becoming established.
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A publication of the Governorʼs DD Council & ID Action. It was first created nearly two decades ago as a print-only publication, sent to a few hundred people. Today we offer our nearly 3,000 direct subscribers and a variety of services.
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A publication of the Governorʼs DD Council & ID Action. It was first created nearly two decades ago as a print-only publication, sent to a few hundred people. Today we offer our nearly 3,000 direct subscribers and a variety of services.
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A publication of the Governorʼs DD Council & ID Action. It was first created nearly two decades ago as a print-only publication, sent to a few hundred people. Today we offer our nearly 3,000 direct subscribers and a variety of services.
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A publication of the Governorʼs DD Council & ID Action. It was first created nearly two decades ago as a print-only publication, sent to a few hundred people. Today we offer our nearly 3,000 direct subscribers and a variety of services.
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A publication of the Governorʼs DD Council & ID Action. It was first created nearly two decades ago as a print-only publication, sent to a few hundred people. Today we offer our nearly 3,000 direct subscribers and a variety of services.
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Report on a special investigation of the Food Service Department of the Springville Community School District for the period July 1, 2005 through March 31, 2009
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Report on a review of selected general and application controls over the Iowa State University of Science and Technology (Iowa State University) Purchase Order/Requisition System for the period of March 20 through April 28, 2009
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Newsletter produced by Iowa Department of Agriculture and Land Stewardship about Organic News in farming.
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The IPERB newsletter is published by the Public Employment Relations Board. The opinions expressed should not be considered official opinions of the Iowa PERB.
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The monthly fuel tax report from Iowa Department of Transportation to the Iowa Department of Revenue and Finance.
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The monthly fuel tax report from Iowa Department of Transportation to the Iowa Department of Revenue and Finance.
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Report on a review of selected general and application controls over the Iowa State University of Science and Technology Accounts Receivable System for the period of March 29, 2010 through May 6, 2010
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Report on a special investigation of the Region 4 Fusion Office in Atlantic, Iowa for the period March 1, 2006 through August 31, 2009
