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RE: Educating Steem: Is There A Disorder Caused by Marijuana?—Cannabinoid Hyperemesis Syndrome
Thank you for reading! Certainly, I believe Zofran now is the most common anti-emetic I see prescribed in the hospital. In the 4th source I provided, benzos seemed to be the best acutely for this condition. The other anti-emetic drugs were more refractory.
Zofran is most definitely a better drug (although it is relatively new in comparison) and remains very expensive in some countries, and is only approved for subsidised use for people receiving chemotherapy treatment, and benzos seems to be a very strange suggestion when discussing such things .
Benzos dependence is well known and documented . Lorazapam has a very short half life second only to alprazolam.
I wish you all the best in your career. When you see your first case of acute benzos withdrawal maybe you will rethink its endorsement.
Stopping thc is tough, ceasing benzos can be deadly.
I must add, I'm not at all a thc user, I personally don't like it. But I am not apposed to its use.
I agree with your remarks on benzodiazepines. My advice for use was in the emergency room setting. Benzos are never a drug I would want to prescribe for chronic use. Obviously, you can die from its withdrawal just like alcohol. I am thinking more in the acute setting of perfuse vomiting where other concerns such as volume/electrolyte status are taking precedence.
As for the case of lorazepam, I was going off an evidence based source (number 4). I agree that it does seem odd that a longer acting agent wouldn't be initiated. Very good point!
Unfortunately, zofran is refractory in these cases.
What would you recommend? Replete the fluid and put them in a hot shower? haha.
Thank you for your feedback and for your interest in the topic.
Hyperemesis is a tough one for sure. I'm sure you are quoting evidence based practices. I am always cautious when promoting benzo's as treatment. I know you speak of it being administered in an inpatient setting, but the reality of people self administering is something to be cautious about.
I wouldn't want a young keen and obviously passionate doctor who is only just embarking on his career, to be held liable for someones interpretation of your treatment advice.
For sure noted. I agree that a short acting one seems more dangerous and potentially unnecessary. I wish zofran worked for this condition.