在住院治疗后,对老年人处方抗精神病药物
Jillian Madey1, Samantha Tri2, Aleina Haines2
1PharmD, ACPR, is with Pharmacy Services, Saskatchewan Health Authority - Regina, Regina, Saskatchewan.
The Canadian journal of hospital pharmacy
|May 9, 2024
概括
老年人经常在出院后继续使用抗精神病药物,超过50%的人在90天后仍在服用这些药物. 许多患者缺乏明确的后续计划,强调需要更好的药物管理.
科学领域:
- 老年医学 老年医学
- 心理药理学 心理药理学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 在老年人中使用抗精神病药物治疗妄或痴呆相关行为有风险.
- 在没有明确的迹象的情况下,医院发起的抗精神病药物可以在出院后继续使用.
- 在萨斯喀彻温省卫生局 (SHA) - 雷吉纳地区住院后,老年人继续服用抗精神病药物的数据缺乏.
研究的目的:
- 确定医院出院后老年人抗精神病药物的持续率和持续时间.
- 为了确定处方模式,风险因素和药剂师参与退院后的抗精神病治疗.
- 评估这一群体中抗精神病药物的停止或逐渐减少计划的存在.
主要方法:
- 从SHA - Regina地区医院出院的65岁以上住院患者的回顾性图表审查.
- 纳入期间:2021年9月30日至2022年6月28日.
- 分析包括门诊分发数据,以跟踪药物持续使用.
主要成果:
- 189名老年人的31.7%在出院后继续服用抗精神病药物.
- 出院后30,90和180天的继续率分别为80.0%,55.0%和40.0%.
- 只有15.0%的继续治疗的患者有记录的门诊随访计划.
结论:
- 老年人退院后继续服用抗精神病药物是常见的,符合现有文献.
- 患者面临长期使用抗精神病药物的高风险,没有适当的后续计划.
- 质量改善举措应侧重于药物审查,适用性文档和反精神病治疗的定期重新评估.
相关概念视频
01:26Psychosis: Goals of Pharmacotherapy
123
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
123
01:28Psychosis and Antipsychotic Drugs: Overview
242
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
242
01:28Drug Therapy
42
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
42
01:21Antipsychotic Drugs: Therapeutic Uses and Side Effects
175
Antipsychotic drugs primarily block dopamine and serotonin receptors and cholinergic, adrenergic, and histaminergic receptors, thereby reducing hallucinations and delusions in conditions like schizophrenia. However, they can trigger unwanted extrapyramidal effects such as dystonias, Parkinson-like symptoms, and tardive dyskinesia.
Despite these side effects, antipsychotics are used therapeutically for various purposes, including managing schizophrenia, preventing nausea and vomiting, curbing...
Despite these side effects, antipsychotics are used therapeutically for various purposes, including managing schizophrenia, preventing nausea and vomiting, curbing...
175
01:24Parkinson's Disease: Treatment
263
Neurodegenerative disorders, such as Parkinson's Disease (PD), involve the gradual and irreversible destruction of neurons in particular brain areas. These disorders exhibit standard features like proteinopathies, selective vulnerability of some neurons, and an interaction of intrinsic properties, genetics, and environmental influences in neural injury.
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
Parkinson's Disease is primarily a result of the loss of dopaminergic neurons in the substantia nigra pars compacta. The cornerstone of...
263
01:21Antipsychotic Drugs: Typical and Atypical Agents
186
Antipsychotic drugs are classified into first-generation (typical) drugs including phenothiazines; and second-generation (atypical) drugs. Chlorpromazine hydrochloride (Thorazine), a phenothiazine derivative, broadly impacts the central, autonomic, and endocrine systems. This drug, along with typical agents like haloperidol (Haldol), primarily works by antagonizing D2 receptors, thus reducing dopaminergic neurotransmission. However, typical antipsychotics can cause side effects such as sedation...
186