3.Clinical and psychological characteristics of propofol abusers in Korea: a survey of propofol abuse in 38, non-healthcare professionals.
Eun Jung KIM ; Seon Hwa KIM ; Yang Jin HYUN ; Yeon Keun NOH ; Ho Sang JUNG ; Soon Young HAN ; Chan hye PARK ; Byung Moon CHOI ; Gyu Jeong NOH
Korean Journal of Anesthesiology 2015;68(6):586-593
BACKGROUND: The aim of this study is to investigate the characteristics of propofol abuse based on the results of a survey analysis of abusers among non-healthcare professionals in Korea. METHODS: Thirty-eight propofol abusers were questioned between October and December 2010, and were enrolled and voluntarily participated in a structured survey consisting of an interview and completing a previously prepared questionnaire. The questionnaire was divided into three distinct parts: part 1 dealt with the history of propofol abuse; part 2 highlighted the problems caused by propofol abuse; and part 3 enquired regarding demographics of abusers. RESULTS: Thirty-one (81.6%) of the 38 interviewees abused propofol for more than one year. During the last 12 months, 34 (89.0%) received propofol at two or three times a week. The minimum and maximum amounts of propofol (median, range) administered each time were 500 (100, 1000) and 2000 (500, 4000) mg, respectively. Stress relief and the maintenance of a sense of well-being were quoted the most important reasons for the first-time administration of propofol and its subsequent abuse, respectively. The majority of abusers (36.0, 97.3%) reported a sense of pleasure or euphoria at the time of their propofol injection. Withdrawal symptoms occurred in five abusers (13.2%). Thirteen (36.1%) reported disruptions in their work life. None of the respondents had previously admitted to and or reported abuse of any other controlled substances. CONCLUSIONS: These results provided reference data for the regulation of propofol in Korea as a controlled substance and may also be of interest to international agencies in other countries.
Controlled Substances
;
Surveys and Questionnaires
;
Demography
;
Euphoria
;
International Agencies
;
Korea*
;
Pleasure
;
Propofol*
;
Substance Withdrawal Syndrome
4.A Case of Codeine Induced Anaphylaxis via Oral Route.
Hye Soo YOO ; Eun Mi YANG ; Mi Ae KIM ; Sun Hyuk HWANG ; Yoo Seob SHIN ; Young Min YE ; Dong Ho NAHM ; Hae Sim PARK
Allergy, Asthma & Immunology Research 2014;6(1):95-97
Codeine is widely prescribed in clinical settings for the relief of pain and non-productive coughs. Common adverse drug reactions to codeine include constipation, euphoria, nausea, and drowsiness. However, there have been few reports of serious adverse reactions after codeine ingestion in adults. Here, we present a case of severe anaphylaxis after oral ingestion of a therapeutic dose of codeine. A 30-year-old Korean woman complained of the sudden onset of dyspnea, urticaria, chest tightness, and dizziness 10 minutes after taking a 10-mg dose of codeine to treat a chronic cough following a viral infection. She had previously experienced episodes of asthma exacerbation following upper respiratory infections, and had non-atopic rhinitis and a food allergy to seafood. A skin prick test showed a positive response to 1-10 mg/mL of codeine extract, with a mean wheal size of 3.5 mm, while negative results were obtained in 3 healthy adult controls. A basophil histamine release test showed a notable dose-dependent increase in histamine following serial incubations with codeine phosphate, while there were minimal changes in the healthy controls. Following a CYP2D6 genotype analysis, the patient was found to have the CYP2D6*1/*10 allele, indicating she was an intermediate metabolizer. An open label oral challenge test was positive. To the best of our knowledge, this is the first report of a patient presenting with severe anaphylaxis after the ingestion of a therapeutic dose of codeine, which may be mediated by the direct release of histamine by basophils following exposure to codeine.
Adult
;
Alleles
;
Anaphylaxis*
;
Asthma
;
Basophil Degranulation Test
;
Basophils
;
Codeine*
;
Constipation
;
Cough
;
Cytochrome P-450 CYP2D6
;
Dizziness
;
Drug-Related Side Effects and Adverse Reactions
;
Dyspnea
;
Eating
;
Euphoria
;
Female
;
Food Hypersensitivity
;
Genotype
;
Histamine
;
Histamine Release
;
Humans
;
Nausea
;
Respiratory Tract Infections
;
Rhinitis
;
Seafood
;
Skin
;
Sleep Stages
;
Thorax
;
Urticaria
5.The champion: Conquering the challenges of bipolar disorders.
Marian T. Villanueva ; Maria Angela A. Mabale ; John Bernard F. Bernardo ; Paolo Niccolo V. Bruno ; Roderick P. Lorenzo
Philippine Journal of Nursing 2014;84(2):67-70
Bipolar Disorder has been one of the leading psychiatric conditions here in the Philippines. . It is characterized by mood swings from profound depression to extreme euphoria (mania), with intervening period of normal mood (euthymia). The frequency, duration, and severity of manic and/or depressive episodes varies and is unique to each individual (Haber, 1997). In general, there are five in every 100 Filipinos who are suffering from some form of depression, and other may have a different reaction such as hyperactivity or swinging from depression to euphoria, unable to function normally, and in real danger of hurting themselves and others. Sadly, many of those with bipolar illness are left undiagnosed and, consequently, untreated. This case study presents how nurses play a role in helping patients overcome the challenges of having a psychiatric illness particularly those with Bipolar Disorder.
Human ; Male ; Adult ; Bipolar Disorder ; Depression ; Euphoria ; Depressive Disorder ; Cyclothymic Disorder
6.Propofol abuse among healthcare professionals.
Journal of the Korean Medical Association 2013;56(9):771-777
The number of healthcare professionals (HCPs) abusing propofol has been steadily growing, while recreational use of propofol among the general public has become a social concern. Propofol was once believed to be unsuited for the purpose of abuse because it wears off too quickly and induces unconsciousness more frequently than euphoria. However, studies have demonstrated the abuse potential of propofol. Animal studies have shown that propofol increases dopamine levels in the mesolimbic dopamine system, which is a putative mechanism of addiction for most addictive drugs. Behavior studies, not only with animals but also with human beings, have demonstrated that administration of propofol induces conditioned rewards and reinforcement. Although the incidence of propofol abuse among HCPs seems to be lower than that of abuse of common addictive substances, multiple articles and case reports have documented cases. Easy access to the drug is closely associated with its abuse among HCPs. In addition, the pharmacologic properties of propofol, specifically its short onset and offset, is one of reasons HCPs start to abuse this drug without any serious consideration and makes propofol abuse difficult to detect. To reduce propofol abuse among HCPs, we should develop a strict pharmacy control system for limiting access to propofol. Adopting radio-frequency identification system for controlled drugs could be an effective option. However, substance dependent HCPs are quite resourceful even in obtaining controlled drugs. Therefore, a multilateral approach to stem the rising tide of propofol abuse among HCPs is needed: a combination of preventative education, early identification and intervention, aggressive treatment, and consistent rehabilitation.
Animals
;
Delivery of Health Care
;
Dopamine
;
Euphoria
;
Humans
;
Incidence
;
Pharmacy
;
Propofol
;
Reinforcement (Psychology)
;
Reward
;
Substance-Related Disorders
;
Unconsciousness
7.Abuse potential of propofol used for sedation in gastric endoscopy and its correlation with subject characteristics.
Ja Hyun KIM ; Heewon BYUN ; Jun Hyun KIM
Korean Journal of Anesthesiology 2013;65(5):403-409
BACKGROUND: Propofol has been widely used for an induction and/or maintenance of general anesthesia, or for sedation for various procedures. Although it has many ideal aspects, there have been several cases of drug abuse and addiction. The authors investigated whether there are abuse liable groups among the general population. METHODS: We surveyed 169 patients after gastric endoscopic examination, which used propofol as a sedative, with the Addiction Research Center Inventory (ARCI) questionnaire. Other characteristics of the patients, such as past history, smoking habits, depression, anxiety, alcohol abuse liability and sleep disturbance, were recorded by history taking and several questionnaires before the exam. RESULTS: Propofol had a high Morphine-Benzedrine Group (MBG) score (representative value for euphoria) of 6.3, which is higher than marijuana, and a Pentobarbital-Chlorpromazine-Alcohol Group (PCAG) score (representative value of sedation) of 8.1, which is lower than most opioids. The MBG score showed no statistically significant correlation between any of the characteristics of the groups. In females, the PCAG score showed a correlation with age, and in males, it showed a correlation with a sleeping problem. CONCLUSIONS: Propofol had relatively high euphoria and low residual sedative effects. It had a more potent sedative effect in the female group who were young, and in the male group who had a low sleep quality index. There were differences in the abuse liability from a single exposure to propofol in the general population. Further study is needed to evaluate the abuse liability of repeated exposure.
Alcoholism
;
Analgesics, Opioid
;
Anesthesia, General
;
Anxiety
;
Behavior, Addictive
;
Cannabis
;
Depression
;
Endoscopy*
;
Euphoria
;
Female
;
Humans
;
Hypnotics and Sedatives
;
Male
;
Propofol*
;
Surveys and Questionnaires
;
Smoke
;
Smoking
;
Substance Abuse, Intravenous
;
Substance-Related Disorders
8.Postoperative manic episode by sleep deprivation and stressful event
Jun Ha KONG ; Baek Soo LEE ; Yeo Gab KIM ; Yong Dae KWON ; Byung Wook YOON ; Byung Joon CHOI
Journal of the Korean Association of Maxillofacial Plastic and Reconstructive Surgeons 2008;30(1):114-116
euphoria and unstability. Patients who are not disaffected with insomnia can also be included.]]>
Bipolar Disorder
;
Euphoria
;
Humans
;
Life Change Events
;
Motivation
;
Motor Activity
;
Sleep Deprivation
;
Sleep Initiation and Maintenance Disorders
;
Surgery, Oral
;
Thinking
9.A Case of Orgasmic Aura Associated with Temporal Lobe Epilepsy from the Nondominant Hemisphere.
Chan Hee PARK ; Yang Je CHO ; Sang Don HAN ; Soochul PARK
Journal of the Korean Neurological Association 2005;23(3):386-388
We experienced a patient with an orgasmic aura originating from the right mesial temporal structure. A 36-year-old right-handed woman suffered from a specific sensation of sexual arousal and orgasm-like euphoria lasting 1~2 minutes for several years. Video EEG monitoring ascertained those sensations as epileptic in nature arising from the right mesial temporal area through a foramen ovale electrode. The findings of 99mTc-ECD-SPECT and 18F-FDG PET were concordant with those of the brain MRI which was pathologically consistent with hippocampal sclerosis.
Adult
;
Arousal
;
Brain
;
Electrodes
;
Electroencephalography
;
Epilepsy*
;
Epilepsy, Temporal Lobe*
;
Euphoria
;
Female
;
Fluorodeoxyglucose F18
;
Foramen Ovale
;
Humans
;
Magnetic Resonance Imaging
;
Orgasm*
;
Sclerosis
;
Sensation
;
Temporal Lobe*
10.The Change of Behavioral and Psychological Symptoms according to the Progression of Alzheimer's Disease.
Tae You KIM ; Sang Yun KIM ; Jae Woo KIM ; Kyoung Won PARK ; Bong Goo YOO ; Sang Chan LEE
Journal of the Korean Neurological Association 2004;22(1):34-39
BACKGROUND: The evaluation of behavioral and psychological symptoms (BPSD) is important for the diagnosis and management of Alzheimer's disease (AD). Previous studies have reported the prevalence and severity of BPSD changes. However, these studies have mainly focused on the AD patients with mild to moderate severity. Our study investigated the BPSD in AD patients with more advanced stages and looked at the prevalence and severity of BPSD with the progression of disease. METHODS: One hundred thirty six patients with probable AD received the Korean version of the neuropsychiatric inventory along with the expanded version of the Korean Clinical Dementia Rating Scale (CDR) and the Korean version of the Mini-Mental State Examination (K-MMSE). RESULTS: The mean K-MMSE, CDR and NPI scores were 10.1 (SD=7.1), 2.0 (SD=1.5) and 32.7 (SD=26.2), respectively. CDR and K-MMSE scores did not correlate with the total NPI score but did correlate with some of the subscale NPI scores. Apathy had the highest relationship to CDR (r=0.39, p<0.01). Aberrant motor was most correlated with the total score of NPI (r=0.65, p<0.01). The mean number of positive NPI items was 4.3, which ranged from 2.1 (CDR 5 group) to 5.4 (CDR 2 group). The most frequent symptom was apathy and the least was euphoria. The severity of BPSD increased as the dementia severity increased to CDR 2 except apathy. Night-time behavior and anxiety were frequent in the early stages whereas apathy and aberrant motor were frequent symptoms in later stages. CONCLUSIONS: These observations suggest that BPSD is relatively independent of cognitive functions. The prevalence and severity of BPSD with the exclusion of apathy, increased as the dementia severity increased from CDR 0.5 to CDR 2 and then declined declined except apathy.
Alzheimer Disease*
;
Anxiety
;
Apathy
;
Dementia
;
Diagnosis
;
Euphoria
;
Humans
;
Prevalence


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