Outpatient Psychotropic Drug Interactions in a Public Psychiatry Hospital in Bahrain: An Audit Study

2021 ◽  
Vol 10 ◽  
Author(s):  
Yasin Tayem ◽  
Saeed Aljaberi ◽  
Ali Alfehaid ◽  
Abdulaziz Almekhyal ◽  
Haitham Jahrami ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Psychotropic Drugs ◽  
Psychiatric Patients ◽  
Psychotropic Medications ◽  
Outpatient Psychiatry ◽  
High Prevalence ◽  
Public Psychiatry ◽  
And Gender ◽  
Potential Interactions ◽  
Outpatient Prescriptions

Background: Psychotropic polypharmacy is particularly common which puts psychiatric patients at high risk for developing drug-drug interactions. Objective: We aimed to study potential interactions between psychotropic medications prescribed within the outpatient psychiatry setting. Method: This was an audit study, which targeted a sample of outpatient prescriptions ordered within the outpatient clinics of the main psychiatry hospital in Bahrain over 2017. We studied the degree and correlation between psychotropic drugs. Results: The total number of prescriptions in our sample was 992 (56.1% males, 43.9% females). Psychotropic polypharmacy was detected in 842 prescriptions (84.9%). Potential interactions between psychotropic drugs were observed in 550 prescriptions (56.4%). The degree of interaction was minor in 43 prescriptions (7.8%), significant in 419 prescriptions (76.2%), and serious in 88 prescriptions (16%). Schizoaffective disorder subjects were the most likely to suffer from interactions (64.6%), whereas prescriptions issued for those who had schizophrenia contained the least number of interactions (51.6%). The total number of interactions was strongly associated with polypharmacy (p < .001), and gender (p < .01), but not with age (p > .05) or diagnosis (p > .05). Conclusion: High prevalence of polypharmacy and interactions between psychotropic medications were observed in our sample, particularly of the significant grade.

scholarly journals Appraisal and discernment of prevalent drug-drug interactions in patients with psychiatric disorders

2021 ◽  
Vol 10 (8) ◽  
pp. 1005
Author(s):  
Axa Jacob ◽  
Cristin Simon Thomas ◽  
Anay Deore ◽  
Prasanna Deshpande
Keyword(s):  
Drug Interactions ◽  
Hospital Admissions ◽  
Psychiatric Patients ◽  
Medical Complications ◽  
Medical Illness ◽  
Inclusion Criteria ◽  
Potential Ddis ◽  
Careful Monitoring ◽  
Mechanistic Approach ◽  
High Prevalence

Background: Drug-drug interactions (DDIs) contribute majorly to hospital admissions, treatment failures, avoidable medical complications and subsequent healthcare costs. Thus, we employ a mechanistic approach to prospectively investigate the incidence of potential DDIs in the psychiatric patients in a clinical setting.Methods: In this prospective, observational, multi centred study conducted for a span of 6 months, psychiatric inpatients (≥18 years) prescribed with 2 or more medications daily for any medical illness were included. The secured prescriptions of the inpatients selected in accordance to the inclusion criteria were then assessed for DDIs using Micromedex(TM) as a standard.Results: Of the total 400 enrolled participants, 383 (95%) of them showed at least one pDDI regardless of the severity. An average of 7.33 interactions per patient was also deduced. A high prevalence of pDDIs totalling to 2900 was recorded in our study with an average of 7.33 interactions per patient.  Most of the interactions were of major (56.52%) and moderate severity (39.07) followed by contraindicated (2.55) and minor (1.83). Cardiovascular system (41.77%) had the highest potential to be affected due to the pDDIs identified. Trihexyphenidyl, haloperidol, promethazine, amisulpride, risperidone, divalproex, trifluoperazine, olanzapine and clozapine where among the most commonly encountered drugs in these interactions.Conclusions: A high prevalence of pDDIs totalling to 2900 was recorded in our study with an average of 7.33 interactions per patient.  A significant association of the pDDIs with variables such as age, gender, diagnosis and total number of drugs used was identified. More studies are required to explore the overall pattern of DDIs in psychiatric patients along with their levels and correlation with different risk factors. Careful monitoring and documentation are necessary to prevent further complications thereby improving the therapeutic outcome.

scholarly journals Psychotropic Drugs: Implications For Dental Practice

2008 ◽  
Vol 55 (3) ◽  
pp. 89-99 ◽  
Author(s):  
Daniel E. Becker
Keyword(s):  
Anxiety Disorder ◽  
Side Effects ◽  
Drug Interactions ◽  
Dental Care ◽  
Psychotropic Drugs ◽  
Preoperative Assessment ◽  
Psychotropic Medications ◽  
Dental Practice ◽  
Dental Patients ◽  
Psychiatric Illnesses

Abstract Appropriate preoperative assessment of dental patients should always include analysis of their medications. Psychiatric illnesses including panic/anxiety disorder, depression, psychoses, and manic disorders are prevalent within our society. An impressive number of drug formulations are prescribed for these disorders, and they introduce concern regarding side effects and possible drug interactions with medications the dentist may deem necessary for dental care. This article will address essential pharmacology of these psychotropic medications.

scholarly journals Prescription for psychiatric patients in a Brazilian public hospital: cross-sectional study

2020 ◽  
Vol 10 (4) ◽  
pp. 0362
Author(s):  
Maria R. Fernandes ◽  
Laura J. Lopes ◽  
Milla P. Rocha ◽  
Laís P. Almeida ◽  
Tânia R. Ferreira ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Psychiatric Disorders ◽  
Psychotropic Drugs ◽  
Public Hospital ◽  
Psychiatric Patients ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Clinical Records ◽  
Inappropriate Prescriptions

Background: The growing use of psychotropic drugs has been attributed to a higher frequency of psychiatric disorders diagnosed, interaction of new drugs on the pharmaceutical market, and new therapeutic indications of existing drugs. Given this scenario, the adequacy of the use of psychotropic drugs needs to be analyzed considering the scientific evidences. Objectives: To assess the appropriateness of drug prescriptions used by psychiatric patients in a public hospital in Sorocaba, according to the best available scientific evidence, and to describe the profile of this population. Methods: This cross-sectional study collected data from clinical records of patients with psychiatric disorders hospitalized in the psychiatric sector of the Sorocaba Hospital Complex, state of São Paulo, Brazil, between August 2015 and December 2016. The outcomes measured were: inappropriate use, presence of contraindication and serious or contraindicated drug interactions, according to the information available on the Dynamed® and Micromedex® 2.0 databases. Results: Patients were predominantly adults, and diagnosed with paranoid schizophrenia or bipolar affective disorder. Antipsychotics, benzodiazepines, and lithium accounted for 84.0% (n=2,938) of the 3,500 drugs prescribed for mental disorders. There were 2,157 (61.6%) inappropriate prescriptions, of which 81.9% corresponded to antipsychotics, benzodiazepines, and lithium. There were 1,712 prescriptions with drug combinations that risked causing drug interactions, predominantly involving antipsychotic use (67.0%). Conclusion: The study revealed a high number of inappropriate prescriptions, pointing to a need for greater prescription adequacy to ensure effective safe treatment for psychiatric patients.

scholarly journals Demographic correlates of nicotine dependence in psychiatric patients

2021 ◽  
Vol 9 (2) ◽  
pp. 458
Author(s):  
Yogendra Singh ◽  
Anil Sisodia ◽  
Anil Gaur ◽  
Vikrant Agarwal
Keyword(s):  
Nicotine Dependence ◽  
Psychiatric Patients ◽  
Total Sample ◽  
Demographic Variables ◽  
High Prevalence ◽  
Demographic Correlates ◽  
History Of ◽  
Drug Abuse Screening Test ◽  
And Gender ◽  
High Level

Background: Tobacco and nicotine dependence has high prevalence in patients with psychiatric disorders. The present study was conducted to delineate demographic correlates of tobacco and nicotine dependence in psychiatric patients.Methods: 102 patients were sampled from Institute of Mental Health and Hospital, Agra. Fagerström Test for Nicotine Dependence for Smoking, Fagerström Test for Nicotine Dependence for Smokeless Tobacco, The Drug Abuse Screening Test (DAST), Alcohol Use Disorders Identification Test (AUDIT) were used along with a proforma for recording demographic and clinical details of the patients.Results: The results suggested that the severity of nicotine dependence in total sample was as Very Low in 2.9%, Low in 15.7%, medium in 42.2%, and High in 39.2%. The results of association between demographic variables and nicotine dependence suggested that there was statistically significant association between nicotine dependence and gender, place of residence, marital status, type of family, annual income, history of mental illness, History of substance use and duration of tobacco use.Conclusions: The medium and high level of nicotine dependence amount to 81.40% sample is of true concern which warrant for an active intervention for tobacco cessation programs in majority of the patients.

scholarly journals Hierarchy of evidence in interpretation of clinical significance of drug interactions

2012 ◽  
Vol 65 (1-2) ◽  
pp. 45-49
Author(s):  
Bozana Nikolic ◽  
Miroslav Savic
Keyword(s):  
Drug Metabolism ◽  
Drug Interactions ◽  
Clinical Significance ◽  
Health Professionals ◽  
Molecular Entity ◽  
Population Pharmacokinetic ◽  
Pharmacokinetic Studies ◽  
Potential Interactions

Introduction. Since drug interactions may result in serious adverse effects or failure of therapy, it is of huge importance that health professionals base their decisions about drug prescription, dispensing and administration on reliable research evidence, taking into account the hierarchy of data sources for evaluation. Clinical Significance of Potential Interactions - Information Sources. The sources of data regarding drug interactions are numerous, beginning with various drug reference books. However, they are far from uniformity in the way of choosing and presenting putative clinically relevant interactions. Clinical Significance of Potential Interactions - Interpretation of Information. The difficulties in interpretation of drug interactions are illustrated through the analysis of a published example involving assessment made by two different groups of health professionals. Systematic Evaluation of Drug-Drug Interaction. The potential for interactions is mainly investigated before marketing a drug. Generally, the in vitro, followed by in vivo studies are to be performed. The major metabolic pathways involved in the metabolism of a new molecular entity, as well as the potential of induction of human enzymes involved in drug metabolism are to be examined. In the field of interaction research it is possible to make use of the population pharmacokinetic studies as well as of the pharmacodynamic assessment, and also the postregistration monitoring of the reported adverse reactions and other literature data. Conclusion. In vitro and in vivo drug metabolism and transport studies should be conducted to elucidate the mechanisms and potential for drug-drug interactions. The assessment of their clinical significance should be based on well-defined and validated exposure-response data.

scholarly journals Use of psychotropic medications by caregivers of elderly patients with dementia: is this a sign of caregiver burden?

2012 ◽  
Vol 70 (3) ◽  
pp. 169-174 ◽  
Author(s):  
Einstein Francisco Camargos ◽  
Andrea Brígida Souza ◽  
Aline Silva Nascimento ◽  
Alessandra Cicari Morais-e-Silva ◽  
Juliana Lima Quintas ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Caregiver Burden ◽  
Psychotropic Drugs ◽  
Cross Sectional Study ◽  
Psychotropic Medications ◽  
Sectional Study ◽  
Structured Interviews ◽  
Cross Sectional ◽  
Sleeping Pills

This study evaluated the consumption of psychotropic medications by caregivers of elderly patients with or without dementia. This was a cross-sectional study conducted at all geriatric units in Brasília, Brazil, during a two-month period. Structured interviews were performed with 311 caregivers of people with or without dementia and they completed questionnaires. Among the caregivers, 196 (63%) were caregivers of patients with dementia and 115 (37%) were caregivers of patients without dementia. Forty-four caregivers (14.1%) were taking psychotropic drugs (benzodiazepines or antidepressants), and this usage was more frequent among caregivers of patients with dementia (p<0.01). Twenty-two caregivers of patients with dementia (11.4%) had used sleeping pills after beginning care, compared with only five (4.3%) caregivers of patients without dementia (p<0.01). In conclusion, this study found that caregivers of patients with dementia took psychotropic drugs (benzodiazepines and antidepressants) more frequently than the ones of patients without dementia.

PRN Medication for Psychiatric Inpatients

1987 ◽  
Vol 32 (3) ◽  
pp. 199-203 ◽  
Author(s):  
John L. Craven ◽  
Peter M. Voore ◽  
George Voineskos
Keyword(s):  
Personality Disorder ◽  
Drug Use ◽  
Psychotropic Drug ◽  
Teaching Hospital ◽  
Psychotropic Medication ◽  
Psychotropic Drugs ◽  
Psychiatric Inpatient ◽  
Psychiatric Inpatients ◽  
Psychotropic Medications ◽  
Inpatient Units

Little is known about the extent of the use of prn psychotropic medication in psychiatric inpatient units. A survey of the prn prescription and administration of psychotropic drugs in a psychiatric teaching hospital revealed that a large number of inpatients were prescribed and administered such drugs on a prn basis. Although 50% of the prescriptions were never administered, only 25% were actively discontinued by physicians. A diagnosis of personality disorder was the factor most frequently associated with the rate of prn prescriptions and of administrations. A large number of prn prescriptions had no instructions for indications, minimum time spacing between doses or maximum daily dosage. It is suggested that hospitals monitor the prn use of psychotropic medications in their inpatient units, and explore the reasons for such use. Psychotropic drug use on a prn basis should preferably be reserved for emergencies, and the instructions of prn prescriptions should be clear and detailed.

scholarly journals POTENTIAL DRUG INTERACTIONS IN HYPERTENSIVE PATIENTS IN LIWA DISTRICT HOSPITAL, LAMPUNG BARAT, INDONESIA

2017 ◽  
Vol 9 (6) ◽  
pp. 134
Author(s):  
Erna Yanti ◽  
Erna - Kristin ◽  
Alfi Yasmina
Keyword(s):  
Drug Interactions ◽  
District Hospital ◽  
Antihypertensive Agents ◽  
Potential Interaction ◽  
Multiple Drug ◽  
Potential Drug ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Multiple Drugs ◽  
Potential Interactions

Objective: Patients with hypertension often suffer from other comorbidities, resulting in prescriptions of multiple drugs to treat the conditions. Multiple drug treatment is potentially associated with drug interactions. This aim of the study was to assess potential drug interactions in hypertensive patients in Liwa District Hospital.Methods: The design of the study was cross-sectional. The prescriptions for in-patients with essential hypertension in the Internal Medicine Unit in Liwa District Hospital during April-December 2012 were collected. Potential drug interactions were analyzed with the Drug Interaction Facts version 4.0, and classified into minor, significant, and serious.Results: A total of 60 hypertensive patients were included. They were prescribed 265 prescriptions, with a median total of 6 (range 1-21) drugs prescribed per prescription. There were 1616 potential drug interactions, with 6 (1-31) potential interactions per prescription. Most interactions (75.6%) were classified as significant. Serious potential interactions were most common in the combinations of diltiazem-amlodipine and spironolactone-potassium chloride, while significant potential interaction may occur most often with the combinations of calcium chloride-amlodipine and bisoprolol-amlodipine.Conclusion: Numerous potential drug interactions might occur in hypertensive patients, and most interactions were significant in severity. The largest proportion of the interactions occurred between antihypertensive agents and other drugs. 

scholarly journals Clinicians' predictions of patient response to psychotropic medications

2004 ◽  
Vol 6 (1) ◽  
pp. 105-111
Keyword(s):  
Psychotropic Drugs ◽  
Predictive Value ◽  
Clinical Characteristics ◽  
Psychiatric Treatment ◽  
Clinical Information ◽  
Psychotropic Medications ◽  
Total Variance ◽  
Practical Relevance ◽  
Patient Response

Clinicians prescribe a medication when they assume that there is a reasonable probability of its success. There are many studies on the predictive value of social or clinical information, but these studies do not include the prognosis made by psychiatrists before treatment. These studies indicate that a small to moderate proportion of the total variance of outcome can be predicted from social or clinical information. It is peculiar that there are very few studies on the accuracy of psychiatrists' "bets" about the effects of psychotropic drugs when they use the clinical characteristics of patients as predictors, considering the practical relevance of predicting the outcome of a psychiatric treatment. The absence of studies on the accuracy of clinicians' bets or predictions in psychiatry is unfortunate.

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