Acute Intrathecal Baclofen Withdrawal: A Brief Review of Treatment Options.

01:59 EDT 23rd October 2014 | BioPortfolio

Summary of "Acute Intrathecal Baclofen Withdrawal: A Brief Review of Treatment Options."


BACKGROUND:
Acute baclofen toxicity and withdrawal can present with a constellation of symptoms making differentiation between these two entities and other potential diagnoses challenging. Baclofen withdrawal is associated with numerous complications which may require neurocritical care expertise such as respiratory failure, refractory seizures, delirium, and blood pressure lability.
METHODS:
Case report and literature review.
RESULTS:
This case report discusses a case of intrathecal baclofen (ITB) withdrawal, focusing on the differential diagnosis for acute baclofen withdrawal and reviews the various options that exist to treat the symptoms of acute baclofen withdrawal such as benzodiazepines, propofol, skeletal muscle relaxants, and tizanidine.
CONCLUSIONS:
Critical care practitioners should be prepared to treat this potentially devastating and often refractory complication of ITB therapy.

Affiliation

Department of Pharmacy, Saint Joseph Health System, 1 Saint Joseph Dr, Lexington, KY, 40504, USA.

Journal Details

This article was published in the following journal.

Name: Neurocritical care
ISSN: 1556-0961
Pages:

Links

PubMed Articles [31965 Associated PubMed Articles listed on BioPortfolio]

Intrathecal baclofen therapy for the symptomatic treatment of hereditary spastic paraplegia.

We study the effectiveness and safety of intrathecal baclofen therapy for the treatment of spasticity and gait improvement in patients suffering from hereditary spastic paraplegia.

Clinical relevance of pharmacological and physiological data in intrathecal baclofen therapy.

To review all pharmacological and physiological data available on intrathecal baclofen (ITB) therapy and to evaluate its use in clinical practice and future research.

Use of Intrathecal Baclofen in Children and Adolescents: Interdisciplinary Consensus Table 2013.

In recent years, intrathecal baclofen (ITB) has attained an important role in the treatment of severe spasticity and dystonia in children. There are principal differences between the use of ITB in chi...

Baclofen in the management of cannabis dependence syndrome.

Cannabis is the most commonly used illicit drug in the world. However, only few studies have shown the efficacy of pharmacologic agents in targeting cannabis withdrawal symptoms or reducing the reinfo...

Intrathecal baclofen therapy in children with acquired brain injuries after drowning: A case series.

Abstract Objective: To investigate clinical efficacy as well as the incidence and extent of complications regarding intrathecal baclofen (ITB) therapy in children. Methods: This is a retrospective med...

Clinical Trials [3675 Associated Clinical Trials listed on BioPortfolio]

Dutch National ITB Study in Children With Cerebral Palsy

The objective of this study is to determine the efficacy and safety of treatment with intrathecal baclofen for severe spasticity in children with cerebral palsy.

Intrathecal Administration of Baclofen (ITB) to Cerebral Palsy Patients With Therapy-Resistant Spasticity

Evaluation of the effect of intrathecal administration of Baclofen on spasticity of cerebral palsy patients, by means of standardized and internationally accepted scales

Treating Alcohol Withdrawal With Oral Baclofen

The purpose of this study is determine if subjects with alcohol withdrawal who receive oral baclofen, plus standard benzodiazepine therapy, will experience less severe withdrawal symptoms ...

SISTERS: Spasticity In Stroke Study

To demonstrate that Intrathecal Baclofen (ITB) Therapy, compared to Best Medical Treatment (BMT), has superior efficacy in the treatment of severe spasticity in adult post-stroke patients ...

Continuous Intrathecal Baclofen Infusion for Chronic Spasticity

The purpose of this clinical investigation is to demonstrate product performance of the Prometra Programmable Pump System in the delivery of intrathecal Lioresal® (baclofen) for the manag...

Medical and Biotech [MESH] Definitions

Review of the medical necessity of hospital or other health facility admissions, upon or within a short time following an admission, and periodic review of services provided during the course of treatment.

Physiological and psychological symptoms associated with withdrawal from the use of a drug after prolonged administration or habituation. The concept includes withdrawal from smoking or drinking, as well as withdrawal from an administered drug.

Formal programs for assessing drug prescription against some standard. Drug utilization review may consider clinical appropriateness, cost effectiveness, and, in some cases, outcomes. Review is usually retrospective, but some analysis may be done before drugs are dispensed (as in computer systems which advise physicians when prescriptions are entered). Drug utilization review is mandated for Medicaid programs beginning in 1993.

Organizations representing designated geographic areas which have contracts under the PRO program to review the medical necessity, appropriateness, quality, and cost-effectiveness of care received by Medicare beneficiaries. Peer Review Improvement Act, PL 97-248, 1982.

Withholding or withdrawal of a particular treatment or treatments, often (but not necessarily) life-prolonging treatment, from a patient or from a research subject as part of a research protocol. The concept is differentiated from REFUSAL TO TREAT, where the emphasis is on the health professional's or health facility's refusal to treat a patient or group of patients when the patient or the patient's representative requests treatment. Withholding of life-prolonging treatment is usually indexed only with EUTHANASIA, PASSIVE, unless the distinction between withholding and withdrawing treatment, or the issue of withholding palliative rather than curative treatment, is discussed.

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