Intravenous hemin (as heme arginate or hematin) is the recommended therapy for acute attacks. Acute attacks can be severe enough to cause death if not treated quickly and correctly. Hospitalization is typically required for administration of hemin, and appropriate drug selection is key to avoid exacerbating symptoms with drugs that interact poorly with porphyrias. Proper drug selection is most difficult when it comes to treatment of the seizures that can accompany HCP, as most anti-seizure medications can make the symptoms worse. Gabapentin and levetiracetam are two anti-seizure drugs that are thought to be safe.In patients where management of symptoms is difficult even with hemin, liver transplant is an option before the symptoms have progressed to advanced paralysis. Combined liver and kidney transplants are sometimes undertaken in people with kidney failure.Long term treatment of acute porphyrias is centered on the avoidance of acute attacks by eliminating precipitating factors, such as drugs, dietary changes, and infections. Females often have attacks coincident with their menstrual cycle, which can be managed effectively with hormonal birth control. Because of the reduced penetrance of HCP, family members of a patient may carry the same mutation without ever presenting with symptoms. Molecular analysis of CPOX is the best way to identify these patients, as they will not express a biochemical phenotype on laboratory testing unless they are symptomatic. Identification of asymptomatic patients allows them to adjust their lifestyle to avoid common triggering factors. References
External links

Porphyria at NLM Genetics Home Reference
Coproporphyria at NIHs Office of Rare Diseases
MedlinePlus Encyclopedia: Porphyria
This led to new elements being introduced to the concept of self-esteem, including the reasons why people tend to feel less worthy and why people become discouraged or unable to meet challenges by themselves.In 1992 the political scientist Francis Fukuyama associated self-esteem with what Plato called thymos – the "spiritedness" part of the Platonic soul.From 1997, the core self-evaluations approach included self-esteem as one of four dimensions that comprise ones fundamental appraisal of oneself – along with locus of control, neuroticism, and self-efficacy. The concept of core self-evaluations as first examined by Judge, Locke, and Durham (1997),  has since proven to have the ability to predict job satisfaction and job performance. Self-esteem may be essential to self-evaluation. In public policy
The importance of self-esteem gained endorsement from some government and non-government groups starting around the 1970s, such that one can speak of a self-esteem movement. This movement can be used as an example of promising evidence that psychological research can have an effect on forming public policy. The underlying idea of the movement was that low self-esteem was the root of  problems for individuals, making it the root of societal problems and dysfunctions. A leading figure of the movement, psychologist Nathaniel Branden, stated: "[I] cannot think of a single psychological problem – from anxiety and depression, to fear of intimacy or of success, to spouse battery or child molestation – that is not traced back to the problem of low self-esteem".