M. Grim. University of the South.
Children micardis 40mg mastercard blood pressure tracking chart excel, age 12-17 80 mg micardis amex blood pressure 40 year old woman, have PTSD symptoms similar to adults buy discount micardis 20mg arrhythmia only at night. Post-traumatic stress disorder is common in the military with 30% of those who spend time in a combat zone developing the disorder generic micardis 40 mg without a prescription blood pressure chart good and bad. Unfortunately, those in the military are less likely than average to get help for PTSD as they feel, mistakenly, that it is a sign of personal weakness. Those in the military also fear a negative impact on their career if they get help for post-traumatic stress disorder. A person does not have to be involved directly in a casualty-related event in order to develop PTSD. For some, any kind of work done in a combat zone can be traumatic. Post-traumatic stress disorder is a mental illness that develops after experiencing, or being exposed to, an event that physically harms or threatens to physically harm someone. This harm, or threat of harm, may be directed towards the sufferer or another individual. Post-traumatic stress disorder (PTSD) symptoms include the persistent reliving of the trauma, avoidance of any place that is a trauma-reminder, trouble sleeping and many others. PTSD symptoms can be terrifying and life-altering, as the person tries to avoid any situation that may bring about severe anxiety. They may even turn to drugs to numb the psychological pain caused by their symptoms. Prior to 1980, symptoms of PTSD were seen as a personal weakness or character flaw and not as an illness. Post-traumatic stress disorder is diagnosed using the latest version of the Diagnostic and Statistical Manual of Mental Disorders, the DSM-IV-TR. This may be through dreams, flashbacks, hallucinations or intense distress when confronted with cues that symbolize the traumatic event. Three of the following post-traumatic stress symptoms must be present:Avoidance of thoughts, feelings or conversations that are associated with the eventAvoidance of people, places or activities that may trigger recollections of the eventTrouble remembering important aspects of the eventSignificantly diminished interest or participation in important activitiesFeeling of detachment from othersNarrowed range of affect (reduced visible emotions)Sense of having a foreshortened futureTwo of the following post-traumatic stress symptoms must be present:Difficulty sleeping or falling asleepDecreased concentrationHypervigilance (an over-awareness to, searching for, possible dangers)Outbursts of anger or irritable moodExaggerated startle response (overly responsive when startled)Post-traumatic stress symptoms must be exhibited for more than one monthPost-traumatic stress symptoms must cause clinically significant distress or impairment of functioningWhile the diagnostic criteria for post-traumatic stress disorder are quite clear, there are additional signs that may suggest PTSD. If you have been through a trauma, you might ask yourself, "Do I have PTSD? Answer yes or no to each question and review the scoring instructions at the end of the test. You have experienced or witnessed a life-threatening event that caused intense fear, helplessness, or horror. Do you re-experience the event in at least one of the following ways? Repeated, distressing memories, or dreamsActing or feeling as if the event were happening again (flashbacks or a sense of reliving it)Intense physical and/or emotional distress when you are exposed to things that remind you of the eventDo reminders of the event affect you in at least three of the following ways? Irritability or outbursts of angerAn exaggerated startle responseHaving more than one illness at the same time can make it difficult to diagnose and treat the different conditions. Depression and substance abuse are among the conditions that occasionally complicate PTSD and other anxiety disorders. Have you experienced changes in sleeping or eating habits? During the last year, has the use of alcohol or drugs... Each yes on the above PTSD test indicates a greater likelihood of the presence of post-traumatic stress disorder. If you have answered yes to 13 or more questions, a clinical assessment for PTSD by a doctor or mental health professional is suggested. Print out this post-traumatic stress disorder test, along with your answers, and discuss them with a doctor. Keep in mind, there are effective treatments for PTSD. If you answered yes to less than 13, but are concerned about post-traumatic stress disorder or any other mental illness, take this PTSD test along with your answers and discuss it with your doctor. No one can diagnose PTSD, or any other mental illness, except a licensed professional like your family doctor, a psychiatrist or a clinical psychologist. The causes of post-traumatic stress disorder (PTSD) are not well known or understood. Post-traumatic stress disorder is an anxiety disorder that occurs after being involved in a traumatic event involving harm, or threats of harm, to the self or others. Even learning about an event has the possibility of causing PTSD in some people. Prior to the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980, PTSD was not recognized, and those who exhibited the symptoms were considered to be having an exaggerated stress reaction. This reaction was attributed to a character flaw or personal weakness. We now know that character does not cause PTSD and there are physical, genetic and other causes of PTSD at work. Post-traumatic stress disorder is initiated by a trauma, but the causes of PTSD are related to the brain and risk factors for developing an anxiety disorder. Brain structures and brain chemicals have both been implicated in the causes of PTSD. Research shows that exposure to trauma can cause "fear conditioning" of the brain. Fear conditioning is where the person learns to predict traumas and the predicted traumas cause parts of the brain to activate. With post-traumatic stress disorder, fear conditioning causes the brain to anticipate danger where none exists, causing PTSD symptoms. Additionally, the parts of the brain that are designed to dampen this fear response seem less capable of doing so in those with PTSD. This may be caused by stress-induced atrophy of the brain structures in that area. Genetics is thought to pass down some of the physiological vulnerability that leads to the causes of PTSD. Personal characteristics are also known to increase the risk for PTSD. Characteristics that can contribute to post-traumatic stress disorder (PTSD) causes include:Exposure to previous traumas, particularly as a childPreexisting conditions like anxiety or depressionFamily history of anxiety or depressive disordersGender (more women than men develop PTSD)Some of the causes of PTSD are thought to be related to the type of trauma itself. Exposures that are more likely to cause PTSD are:Closer to the individualSome factors can predict a better outcome for PTSD. These predictive factors include:Availability of social supportLack of avoidance or emotional numbing symptomsLack of hyperarousal (also known as the fight-or-flight response) symptomsLack of symptoms related to re-experiencing the traumaPTSD treatments that have been scientifically validated can be very helpful in reducing and/or alleviating the symptoms of post-traumatic stress disorder. PTSD therapy and PTSD medications are effective treatments for those experiencing this severe anxiety disorder, developed after a traumatic event. For PTSD treatment, these techniques are usually combined for the best outcome. Because many psychiatric illnesses commonly occur alongside PTSD, they may also need treatment. Many people with post-traumatic stress disorder also have issues with substance abuse ( drug addiction information) ; in these cases, the substance abuse should be treated before the PTSD. In the cases where depression occurs with post-traumatic stress disorder, PTSD treatment should be the priority, as PTSD has a different biology and response than depression. Post-traumatic stress disorder can occur at any age and can be caused by any event or situation the person perceives as traumatic. About 7% - 10% of Americans will experience post-traumatic stress disorder (PTSD) at some point in their lives. Several types of therapy are used in the treatment of PTSD. The two primary PTSD therapies are:Cognitive behavioral therapy (CBT)Eye movement desensitization and reprocessing (EMDR)Cognitive behavioral therapy (CBT) for PTSD focuses on recognizing thought patterns and then ascertaining and addressing faulty patterns.
Antidepressants increased the risk compared to placebo of suicidal thinking and behavior (suicidality) in children purchase micardis 80mg with amex pulse pressure gap, adolescents discount micardis 20mg online blood pressure chart man, and young adults in short-term studies of major depressive disorder (MDD) and other psychiatric disorders buy micardis 80mg without prescription blood pressure chart 50 year old male. Anyone considering the use of SEROQUEL or any other antidepressant in a child micardis 40mg amex arrhythmia when to see a doctor, adolescent, or young adult must balance this risk with the clinical need. Short-term studies did not show an increase in the risk of suicidality with antidepressants compared to placebo in adults beyond age 24; there was a reduction in risk with antidepressants compared to placebo in adults aged 65 and older. Depression and certain other psychiatric disorders are themselves associated with increases in the risk of suicide. Patients of all ages who are started on antidepressant therapy should be monitored appropriately and observed closely for clinical worsening, suicidality, or unusual changes in behavior. Families and caregivers should be advised of the need for close observation and communication with the prescriber. SEROQUEL is not approved for use in pediatric patients. The efficacy of SEROQUEL was established in two identical 8-week randomized, placebo-controlled double-blind clinical studies that included either bipolar I or II patients [see CLINICAL PHARMACOLOGY ]. Effectiveness has not been systematically evaluated in clinical trials for more than 8 weeks. The efficacy of SEROQUEL in acute bipolar mania was established in two 12-week monotherapy trials and one 3-week adjunct therapy trial of bipolar I patients initially hospitalized for up to 7 days for acute mania [see CLINICAL PHARMACOLOGY ]. Effectiveness has not been systematically evaluated in clinical trials for more than 12 weeks in monotherapy. Maintenance Treatment in Bipolar DisorderThe efficacy of SEROQUEL as adjunct maintenance therapy to lithium or divalproex was established in 2 identical randomized placebo-controlled double-blind studies in patients with Bipolar I Disorder. SEROQUEL is indicated for the treatment of schizophrenia. The efficacy of SEROQUEL in schizophrenia was established in short-term (6-week) controlled trials of schizophrenic inpatients [see CLINICAL PHARMACOLOGY ]. The effectiveness of SEROQUEL in long-term use, that is, for more than 6 weeks, has not been systematically evaluated in controlled trials. Therefore, the physician who elects to use SEROQUEL for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient [see DOSAGE AND ADMINISTRATION ]. Usual Dose: SEROQUEL should be administered once daily at bedtime to reach 300 mg/day by day 4. In these clinical trials supporting effectiveness, the dosing schedule was 50 mg, 100 mg, 200 mg and 300 mg/day for days 1-4 respectively. Patients receiving 600 mg increased to 400 mg on day 5 and 600 mg on day 8 (Week 1). Antidepressant efficacy was demonstrated with SEROQUEL at both 300 mg and 600 mg however, no additional benefit was seen in the 600 mg group. Usual Dose: When used as monotherapy or adjunct therapy (with lithium or divalproex), SEROQUEL should be initiated in bid doses totaling 100 mg/day on Day 1, increased to 400 mg/day on Day 4 in increments of up to 100 mg/day in bid divided doses. Further dosage adjustments up to 800 mg/day by Day 6 should be in increments of no greater than 200 mg/day. Data indicate that the majority of patients responded between 400 to 800 mg/day. The safety of doses above 800 mg/day has not been evaluated in clinical trials. Maintenance of efficacy in Bipolar I Disorder was demonstrated with SEROQUEL (administered twice daily totalling 400 to 800 mg per day) as adjunct therapy to lithium or divalproex. Generally, in the maintenance phase, patients continued on the same dose on which they were stabilized during the stabilization phase. Usual Dose: SEROQUEL should generally be administered with an initial dose of 25 mg bid, with increases in increments of 25-50 mg bid or tid on the second and third day, as tolerated, to a target dose range of 300 to 400 mg daily by the fourth day, given bid or tid. Further dosage adjustments, if indicated, should generally occur at intervals of not less than 2 days, as steady-state for SEROQUEL would not be achieved for approximately 1-2 days in the typical patient. When dosage adjustments are necessary, dose increments/decrements of 25-50 mg bid are recommended. Most efficacy data with SEROQUEL were obtained using tid regimens, but in one controlled trial 225 mg twice per day was also effective. Efficacy in schizophrenia was demonstrated in a dose range of 150 to 750 mg/day in the clinical trials supporting the effectiveness of SEROQUEL. In a dose response study, doses above 300 mg/day were not demonstrated to be more efficacious than the 300 mg/day dose. In other studies, however, doses in the range of 400-500 mg/day appeared to be needed. The safety of doses above 800 mg/day has not been evaluated in clinical trials. Consideration should be given to a slower rate of dose titration and a lower target dose in the elderly and in patients who are debilitated or who have a predisposition to hypotensive reactions [see CLINICAL PHARMACOLOGY ]. When indicated, dose escalation should be performed with caution in these patients. Patients with hepatic impairment should be started on 25 mg/day. The dose should be increased daily in increments of 25-50 mg/day to an effective dose, depending on the clinical response and tolerability of the patient. The elimination of quetiapine was enhanced in the presence of phenytoin. Higher maintenance doses of quetiapine may be required when it is coadministered with phenytoin and other enzyme inducers such as carbamazepine and phenobarbital [see DRUG INTERACTIONS ]. While there is no body of evidence available to answer the question of how long the patient treated with SEROQUEL should be maintained, it is generally recommended that responding patients be continued beyond the acute response, but at the lowest dose needed to maintain remission. Patients should be periodically reassessed to determine the need for maintenance treatment. Although there are no data to specifically address reinitiation of treatment, it is recommended that when restarting patients who have had an interval of less than one week off SEROQUEL, titration of SEROQUEL is not required and the maintenance dose may be reinitiated. When restarting therapy of patients who have been off SEROQUEL for more than one week, the initial titration schedule should be followed. There are no systematically collected data to specifically address switching patients with schizophrenia from antipsychotics to SEROQUEL, or concerning concomitant administration with antipsychotics. While immediate discontinuation of the previous antipsychotic treatment may be acceptable for some patients with schizophrenia, more gradual discontinuation may be most appropriate for others. In all cases, the period of overlapping antipsychotic administration should be minimized. When switching patients with schizophrenia from depot antipsychotics, if medically appropriate, initiate SEROQUEL therapy in place of the next scheduled injection. The need for continuing existing EPS medication should be reevaluated periodically. Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. SEROQUEL (quetiapine fumarate) is not approved for the treatment of patients with dementia-related psychosis (see BOXED WARNING ). Patients with major depressive disorder (MDD), both adult and pediatric, may experience worsening of their depression and/or the emergence of suicidal ideation and behavior (suicidality) or unusual changes in behavior, whether or not they are taking antidepressant medications, and this risk may persist until significant remission occurs. Suicide is a known risk of depression and certain other psychiatric disorders, and these disorders themselves are the strongest predictors of suicide.
This must be weighed against the dose-related increase in adverse effects buy cheap micardis 80mg online zytiga arrhythmia. Thus discount micardis 40mg overnight delivery blood pressure 24, some patients may benefit from higher doses buy micardis 20 mg with visa heart attack telugu, up to 12 mg/day buy 80mg micardis visa hypertension jnc guidelines, and for some patients, a lower dose of 3 mg/day may be sufficient. Dose increases above 6 mg/day should be made only after clinical reassessment and generally should occur at intervals of more than 5 days. When dose increases are indicated, small increments of 3 mg/day are recommended. Clinical trials establishing the safety and efficacy of INVEGA??? were carried out in patients without regard to food intake. INVEGA??? must be swallowed whole with the aid of liquids. The medication is contained within a nonabsorbable shell designed to release the drug at a controlled rate. The tablet shell, along with insoluble core components, is eliminated from the body; patients should not be concerned if they occasionally notice in their stool something that looks like a tablet. Concomitant use of INVEGA??? with risperidone has not been studied. Since paliperidone is the major active metabolite of risperidone, consideration should be given to the additive paliperidone exposure if risperidone is coadministered with INVEGA???. For patients with mild to moderate hepatic impairment, (Child-Pugh Classification A and B), no dose adjustment is recommended (see CLINICAL PHARMACOLOGY: Pharmacokinetics: Special Populations: Hepatic Impairment). For patients with mild renal impairment (creatinine clearance = 50 to < 80 mL/min), the maximum recommended dose is 6 mg once daily. For patients with moderate to severe renal impairment (creatinine clearance 10 to < 50 mL/min), the maximum recommended dose of INVEGA??? is 3 mg once daily. Because elderly patients may have diminished renal function, dose adjustments may be required according to their renal function status. In general, recommended dosing for elderly patients with normal renal function is the same as for younger adult patients with normal renal function. For patients with moderate to severe renal impairment (creatinine clearance 10 to < 50 mL/min) the maximum recommended dose of INVEGA??? is 3 mg once daily (see Renal Impairment above). INVEGA??? (paliperidone) Extended-Release Tablets are available in the following strengths and packages. Store up to 25T-C (77T-F); excursions permitted to 15 - 30T-C (59 - 86T-F) [see USP Controlled Room Temperature]. This information is generalized and is not intended as specific medical advice. If you have questions about the medicines you are taking or would like more information, check with your doctor, pharmacist, or nurse. Generic Name: lurasidone HCILurasidone HCI is a psychotropic drug that is available as LATUDA used in the treatment of schizophrenia. Elderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Analyses of 17 placebo-controlled trials (modal duration of 10 weeks), largely in patients taking atypical antipsychotic drugs, revealed a risk of death in drug-treated patients of between 1. Over the course of a typical 10-week controlled trial, the rate of death in drug-treated patients was about 4. Although the causes of death were varied, most of the deaths appeared to be either cardiovascular (e. Observational studies suggest that, similar to atypical antipsychotic drugs, treatment with conventional antipsychotic drugs may increase mortality. The extent to which the findings of increased mortality in observational studies may be attributed to the antipsychotic drug as opposed to some characteristic(s) of the patients is not clear. Latuda is not approved for the treatment of patients with dementia-related psychosis. Latuda is indicated for the treatment of patients with schizophrenia. The efficacy of Latuda in schizophrenia was established in four 6-week controlled studies of adult patients with schizophrenia [see Clinical Studies ]. The effectiveness of Latuda for longer-term use, that is, for more than 6 weeks, has not been established in controlled studies. Therefore, the physician who elects to use Latuda for extended periods should periodically re-evaluate the long-term usefulness of the drug for the individual patient [see Dosage and Administration ]. The recommended starting dose of Latuda is 40 mg once daily. Latuda has been shown to be effective in a dose range of 40 mg/day to 120 mg/day [see Clinical Studies ]. In the 6-week controlled trials, there was no suggestion of added benefit with the 120 mg/day dose, but there was a dose-related increase in certain adverse reactions. Therefore, the maximum recommended dose is 80 mg/day. Dosage adjustments are not recommended on the basis of age, gender, and race [see Use in Specific Populations ]. Dose adjustment is recommended in moderate and severe renal impairment patients. The dose in these patients should not exceed 40 mg/day [see Use in Specific Populations ]. Dose adjustment is recommended in moderate and severe hepatic impairment patients. The dose in these patients should not exceed 40 mg/day [see Use in Specific Populations ]. Dosing recommendation for patients taking Latuda concomitantly with potential CYP3A4 inhibitors: When coadministration of Latuda with a moderate CYP3A4 inhibitor such as diltiazem is considered, the dose should not exceed 40 mg/day. Latuda should not be used in combination with a strong CYP3A4 inhibitor (e. Dosing recommendation for patients taking Latuda concomitantly with potential CYP3A4 inducers: Latuda should not be used in combination with a strong CYP3A4 inducer (e. Latuda tablets are available in the following shape and color (Table 1) with respective one-sided debossing: 40 mg (white to off-white, round, "L40"), or 80 mg (pale green, oval, "L80"). Table 1: Latuda Tablet PresentationsLatuda is contraindicated in any patient with a known hypersensitivity to lurasidone HCl or any components in the formulation. Angioedema has been observed with lurasidone [see Adverse Reactions ]. Latuda is contraindicated with strong CYP3A4 inhibitors (e. Increased Mortality in Elderly Patients with Dementia-Related PsychosisElderly patients with dementia-related psychosis treated with antipsychotic drugs are at an increased risk of death. Latuda is not approved for the treatment of dementia-related psychosis [see Boxed Warning ]. Cerebrovascular Adverse Reactions, Including StrokeIn placebo-controlled trials with risperidone, aripiprazole, and olanzapine in elderly subjects with dementia, there was a higher incidence of cerebrovascular adverse reactions (cerebrovascular accidents and transient ischemic attacks), including fatalities, compared to placebo-treated subjects. Latuda is not approved for the treatment of patients with dementia-related psychosis [see also Boxed Warning and Warnings and Precautions ]. A potentially fatal symptom complex sometimes referred to as Neuroleptic Malignant Syndrome (NMS) has been reported in association with administration of antipsychotic drugs, including Latuda.
A general and forensic psychiatrist in private practice buy 40mg micardis visa arteria poplitea, Dr discount micardis 40mg without prescription prehypertension pediatrics. Turkus frequently provides supervision generic micardis 80 mg fast delivery blood pressure monitor walmart, consultation cheap 80 mg micardis with mastercard blood pressure medication for acne, and teaching for therapists on a national basis. She is co-editor of the forthcoming book, Multiple Personality Disorder: Continuum of Care. Dissociative Disorder CommunityFrom the Archives of Dissociative Living... Multiple Personality Disorder Part 3We have 2514 guests and 3 members onlineHTTP/1. Since then, Debbie has devoted her life to keeping children safe. She is the Founder and President of the child protection group, Safeguarding Our Children - United Mothers (SOC-UM). Our topic tonight is "Protecting Your Children From Sexual Predators". Our guest, Debbie Mahoney, is author and founder of the child protection group Safeguarding Our Children-United Mothers (SOC-UM), which is a site inside the Abuse Issues Community. How old was your son when he was abused by your former neighbor? Like most children, Brian did not disclose the abuse. They did a search on his house and found a project that Brian and I had worked on. I attributed those signs of child abuse to other things, such as puberty, and just being a boy. David: You mentioned there were signs that abuse was occurring to your son, what are the warning signs that parents should be aware of? Debbie: There are a variety of warning signs of child abuse. Behavioral indicators such as anger, chronic depression, poor self esteem, lack of confidence, problems relating with peers, weight change, age inappropriate understanding of sex, frightened by physical contact or closeness, unwilling to dress or undress in front of others, nightmares, change in behavior, going from happy go lucky to withdrawn, change in behavior toward a particular person, suddenly finding excuses to avoid that person, withdrawals, self-mutilation. David: We, the general public, tend to think that child molesters are a certain "type," seedy people who can be easily spotted. People who are child molesters are usually in a position of trust. They can be teachers, coaches, lawyers, police officers, family, friends. Child molesters are good at manipulation and are not wearing trench coats. The statistics for child sexual abuse are as follows:One quarter of children sexually abused are abused by a biological parent. One quarter of children are sexually abused by stepparents, guardian etc. And one half of children are sexually abused by someone that the child knows. So three quarters are abused by someone other than the biological parent, but someone that the child knows. David: Debbie, here are a few audience questions: Debbie: We found that out later. The same man had a top secret government clearance, he worked at one of our national weapons labs and was a former big brother, and a tutor at a former school, and my next door neighbor. Debbie: If we are talking about public disclosure, then I agree. The recidivist rate for a convicted sex offender is higher than any other crime. David: So considering that some molesters are "trusted" individuals, teachers, lawyers, even police officers, how can a parent reasonably protect their child from sexual predators, short of locking them up in a room 24/7? Debbie: Well, I believe giving parents the info on who these sexual predators are. Public disclosure and educating children is the biggest advantage we can give our children. The biggest asset a sex offender has is silence, the secret nature of the crime. David: How about giving us 3 specific things that parents here tonight can carry with them when they leave, dealing with protecting their child? We can teach children that if someone tries to touch them in ways that make them uncomfortable or afraid, or in parts of their body that is covered in bathing suits, that they should tell. We can go down and find out the registered sex offenders in our area. If we find out one of neighbors is a sex offender, you need to talk to your child and tell them if that person approaches them that they need to tell their parents. We can tell parents that children do not disclose because they believe that what happened is their own fault. And the main reason children do not disclose is because they feel dirty. It is important that we talk to the child, but be careful not to make the child fearful. Cindee12345: Is there a web site that we could look up past sexual offenders names? Debbie: There are various states that have databases online but not all states. For instance, California has 40,000 registered sex offenders and only part of California database of sex offenders are online. Some states show their pictures, but it varies depending on the state. Debbie: We do believe that the majority of sex offenders were abused themselves as children. Eagle: Here in the UK, you have no access to child abuser records. How do we protect in any other way which is related. Debbie: Well, my first suggestion for the UK is to find someway to pass legislation to make sex offender databases open to the public. Next, parents should be informed about this subject and inform their children. TOBI: How do you feel about the June 24th MBLD movement - Candles in windows. June 24th is the day all boy-lovers pronounce their love of children. If you see these "white" candles, notify your local police or call the FBI. Debbie: Boy lovers are male pedophiles sexually attracted to boy children and they have the largest organized community on the internet. Your website is listed in my book:) Charles: How much should we say to our children and when? Are we asking them to understand grown up things before they are ready? Debbie: Well, I think you can talk to children depending on their age. Good communication skills with your child are very important, and just talking about safety one time is not enough.
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