scholarly journals Use of Antipsychotics in Dementia Patients: A Descriptive Study

2020 ◽  
Vol 1 (4) ◽  
pp. 9-19
Author(s):  
Ziske Maritska ◽  
Muhammad Hilal Atthariq Ramadhan ◽  
Bintang Arroyantri Prananjaya

ABSTRACT Introduction. Dementia is a chronic progressive syndrome in which there is a decrease in the function of cognitive abilities including memory impairment, thinking ability, orientation, understanding, calculation, language, and assessment but without impaired consciousness. Apart from cognitive impairment, dementia is often accompanied by psychological symptoms and behavioural symptoms so that antipsychotic therapy is needed to overcome this. This study aims to identify the description of the use of antipsychotics in patients with dementia at Dr Mohammad Hoesin Palembang in the period 1 January 2014-31 December 2018. Methods. This research was a descriptive study using secondary data in the form of medical records of dementia patients receiving antipsychotic therapy at Dr Mohammad Hoesin General Hospital, Palembang. Samples were taken using a total sampling method. Results. There were 29 dementia patients (38.67%) receiving antipsychotic therapy. Most of the dementia patients who received antipsychotic therapy were in the late elderly age (27.59%) and were female (55.17%). The most commonly administered antipsychotic drug is haloperidol from the dopamine receptor antagonist (60%) with the most frequent dose of 0.5 mg (34.48%). Risperidone from the serotonin-dopamine antagonist class is the second most frequently prescribed antipsychotic drug (34.28%) at a dose of 1 mg (17.28%). The mean of haloperidol was 425 days, and risperidone was 295.5 days. Conclusion. Although in theory, psychological and behavioural symptoms are often found in dementia cases, not all dementia patients in RSUP Dr Mohammad Hoesin Palembang received antipsychotic therapy. People living with dementia who receive antipsychotic treatment get various types of drugs, dosages, and frequencies.

Psychiatry ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 6-15
Author(s):  
I. V. Kolykhalov

The objective of the study was to investigate syndromal-nosological specificities of neuropsychiatric symptoms (NPS) and the frequency of use of antipsychotics in patients with various types of dementias, institutionalized to geriatric units of mental hospitals.Patients and methods: a total of 106 in-patients of three psychogeriatric units were examined. The median age of patients is 75 years [69; 80].The diagnostic distribution of patients at the time of the examination was as follows: in 33 subjects (31.1%) Alzheimer’s disease (AD) was diagnosed, in 25 (23.6%) - mixed dementia (MD), in 32 (30.2%) - vascular dementia (VD) and in 16 (15.1%) patients had dementia of complex origin (DCO).Results: a high incidence (54.7%) of NPS was found in patients with dementia of various origins. The greatest number of patients with behavioral and psychotic symptoms was found in AD and MD. The proportion of dementia patients with such disorders in each of these types of dementia is about 70%, while in CGD and VD, the proportion of patients with NPS is noticeably smaller (30% and 40%, respectively). For the treatment of NPS, antipsychotics were most often prescribed, but their use caused adverse events (AEs) in 1/3 of cases. Patients with VD are most susceptible to the development of AE, and AD patients are the least susceptible.Conclusion: the study showed that NPS are one of the important components of dementia, regardless of the nosology and stage of the disease. The treatment of NPS in dementia is particularly challenging because, although the symptoms cause significant distress, there are currently no effective alternative therapies. The risk of AE can be minimized by carefully considering the indications for prescribing antipsychotics and their short-term use, regular monitoring of the patient’s condition, and educating caregivers.


2021 ◽  
pp. 000486742110256
Author(s):  
William Lugg

Objectives: Tardive dyskinesia, psychotic relapse and treatment-refractory psychosis have long been associated. A common underlying mechanism involving antipsychotic-induced ‘supersensitivity’, albeit in different brain pathways, was proposed as early as 1978. This piece seeks to reappraise the concept and potential implications of antipsychotic-induced supersensitivity. Conclusions: Evidence increasingly suggests that chronic antipsychotic exposure induces neuroadaptive physiological changes in dopaminergic, and other, neurotransmitter systems that may render some individuals more vulnerable to psychotic relapse - including those receiving continuous antipsychotic treatment. It is possible that in treating every episode of psychosis with prolonged or indefinite antipsychotic therapy, we paradoxically increase the risk of psychotic relapse in a significant proportion of people. A greater appreciation of supersensitivity may allow us to optimise any potential benefits of antipsychotics while minimising the risk of inadvertent iatrogenic harms. More research is needed to improve our understanding of the underlying neurophysiology of supersensitivity and to better identify which individuals are most vulnerable to its development. It is time we paid more attention to the concept, emerging evidence and potential implications of antipsychotic-induced supersensitivity and, where appropriate, adjusted our practice accordingly.


2020 ◽  
Vol 32 (S1) ◽  
pp. 120-120

Name : Yuniar Pukuk KesumaStudy program : Psychiatry, Specialist II Geriatric PsychiatryCounsellor : Dr.dr. Martina Wiwie S. Nasrun, Sp.KJ(K)Background:Dementia is a clinical syndrome characterized by a decline in cognitive abilities and memory deficits globally. About 90% of patients experience behavioral and psychological symptoms. The use of psychotropic drugs is influenced by the patient symptoms, burden of the caregiver, and the habit of health workers.Objective:To determine the effect of psychoeducation modules to caregivers to increase knowledge, decrease of psychotropic drugs, reduce symptoms and burden of caregivers.Methods:There are 2 steps of studies. The first was a qualitative study to create psychoeducation module and the second was to conduct a pre-experimental study (one group pretest-posttest study). Psychoeducation is given in 2 consecutive weeks.Results:Fourty caregivers of dementia patients aged 41.3 (± 9.72) years. The psychoeducation modules is associated with decreasing symptoms and the use of psychotropic drugs, increasing knowledge and decreasing the burden of caregivers. At the end, 23% of patients were able to stop using psychotropic drugs and 62% of patients reduced their dose and/or the amount of psychotropic drugs.Conclusion:The psychoeducation modules to caregivers is associated with a decrease of patient symptoms and the use of psychotropic drugs. Psychoeducation also increases the knowledge of the caregiver and decreases the burden of the caregiver so that this psychoeducation module can be an additional therapy for patients with dementia.


Acta Comitas ◽  
2016 ◽  
Author(s):  
Ni Wayan Tirtawati ◽  
I Dewa Gde Atmadja ◽  
Gde Marhendra Wijaatmadja

Pawnshop Company is a State Owned Enterprises (SOEs), which is engaged in the business of providing credit services and applicable statutory lien for anyone with a moving objects collateral requirement. In order to develop the business, so Government Regulation No. 103 of 2000 was issued, stated of the granting of the loan based on the collateral of fiduciary money. As an institution that provides credit to guarantee the fiduciary shall comply with the provisions set out in Law No. 42 of 1999, especially Article 11, paragraph (1) which states that the objects are burdened with fiduciary collateral required to be registered, but in reality there is no Pawnshop Company comply with Article 11 paragraph (1) of Law No. 42 of 1999 on Fiduciary. Based on the gap das sein and das sollen, then can be formulated the problem of how fiduciary guarantee enrollment application pursuant to Article 11 paragraph (1) of Law No. 42 of 1999 on Company Pawnshop and how execution of fiduciary insurance company that is not registered by the Company Pawnshop when borrowers are in default. Empirical legal research is used in this thesis, because it’s getting out of the gap between das Sein and das sollen. The approach used in this thesis is the legislation approach, case-based approach, and the analytical approach. The nature of the research in this study was a descriptive study, sites in the Pawnshop Company branch Denpasar and Tabanan. The data used in this thesis is the primary data / field data and secondary data / literature. Data collecting techniques used in this thesis is planned interview techniques and reading literature. Sampling techniques used in this thesis is purposive sampling and the data obtained are presented in descriptive qualitative. The results of this problem study is application of fiduciary guarantee enrollment on the Pawnshops Company, that disobedience to law number 42 of 1999 Article 11 paragraph (1) was happened, while the execution of fiduciary insurance company that is not registered by Pawnshop Company if debtor in default is done by a family way.


Bionorte ◽  
2021 ◽  
pp. 160-167
Author(s):  
Maria Vitória Souza Pereira ◽  
Renata Souza Leite Vieira

Objective: to analyze the results of the LSIL and HSIL screening from July 2012 to July 2015. Materials and Methods: descriptive study based on secondary data from SISCOLO.Results: In the period from June 2012 to July 2015, 2,451,607 cytopathological exams were performed in Minas Gerais, with 743,276, 2013 1,099,876 and 2014 608,455 in women aged 10 to over 64 years. Where, there is a deficit in data collection. The main cities that had the highest number of positive cases for LSIL and HSIL, we have Belo Horizonte, Juiz de Fora, Montes Claros and Uberlândia, in both injuries, Belo Horizonte has the highest number of positive cases. Conclusion: there is a common age group between 25 and 34 years old with a high involvement of LSIL and HSIL


2018 ◽  
Vol 5 (2) ◽  
Author(s):  
Abhishek N. ◽  
M L Ashok ◽  
Divyashree M S

Income computation and disclosure standard is one of the competent standard which minimizes the divergence between accounting income and tax income. This standard does not require any additional books of accounts to be maintained by the business organizations but only the thing is the manner of computation of income for the purpose levying of tax under the head ‘Profit or gains from business or profession’ and ‘Income from other sources’. The present study is purely based on secondary data and is a descriptive study to analyse the impact of ICDS on business transactions and its implementation challenges in India.


2021 ◽  
Vol 9 (T3) ◽  
pp. 340-344
Author(s):  
Faisal Idrus ◽  
Theodorus Singara ◽  
Dwiwahyu Sunarto ◽  
Saidah Syamsuddin ◽  
Sonny T. Lisal

Background: Schizophrenia is one of the mental disorder with many problematic issues, in both psychologically and socially. This disease requires provision of long-term antipsychotic therapy, hence could rise other potential health problems. Antipsychotic treatment can cause serious glucometabolic side-effects, including type 2 diabetes and hyperglycemic emergency. Recent attention has also been focused on antipsychotic-induced hyperglycemic emergencies experienced by new users of typical and atypical antipsychotic. Patients treated with atypical APDs have ~10 times higher risk in developing hyperglycaemic emergencies. In our pre-eliminary study, hyperglycemia condition in new patients occurs in four  in seven patients who received typical and atypical antipsychotics. This condition is often overlooked and is not routinely evaluated. Moreover, it can develop into diabetes and increase the risk of morbidity and mortality in schizophrenia patients. In this study, we would like to determine the acute effects of metabolic (hyperglycemia) in patients treated with antipsychotic (Risperidone and Haloperidol) Measurement of blood sugar levels was performed in groups treated with haloperidol (N = 15) and treated with risperidone (N = 15). Plasma samples were taken at the beginning of treatment, in week IV, and in week VIII. The measurement of glucose levels was performed after meal and in early morning before breakfast (fasting blood glucose level 8 hours). Results: The blood sugar level after meals was significantly higher in the Risperidone group compared to the Haloperidol group  (p <0.001) after IV and VIII weeks. Meanwhile, the fasting blood sugar level was significantly higher in the Risperidone group compared to the Haloperidol group after VIII weeks of treatment ( p <0.001). Conclusions: Both antipsychotics can cause an increase in blood sugar levels. Treatment with Risperidone significantly increased the blood sugar levels compared to treatment with haloperidol. Measurement of blood sugar level is needed to monitor the metabolic effect of antipsychotic, especially in patients treated with Risperidone. It is necessary to have dietary regulation and physical activities to prevent undesired metabolic side effects.


Author(s):  
Hikmah Pratiwi Hafid ◽  
Salma Said ◽  
Wahyuddin Abdullah

This study discusses the Performance Allowance in the perspective of al-'Adl in the Indonesian Ministry of Religion, Gowa Regency. This type of research is a type of qualitative descriptive study with a phenomelogical approach that explains the phenomena and their meaning for individuals by conducting interviews with a number of individuals and the location of the study was conducted at the Indonesian Ministry of Religion, Gowa Regency. Sources of data obtained consisted of primary data sources of 12 informants, as well as secondary data. Data collection methods used are observation, interviews, and documentation. The results of this study indicate that the process of receiving performance allowances in the manner of payment and giving, addition, and reduction of performance allowances is in accordance with government regulations. In addition, the value of Al-'Adl is an imbalance in the receipt of performance benefits with employee performance which is assessed through employee performance appraisal. The value of Al-'Adl is that there is no equality in providing training opportunities and infrastructure for employees. The value of Al-'Adl is that there is a mismatch in the receipt of performance allowances based on the time of payment, employee workload, and employee obligations.


2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Andrew Malahasa Karambut ◽  
Jenny Morasa ◽  
Jessy D.L Warongan

This study aims to determine how the Administration of State Property Through the Use of SIMAK-BMN applications at the Office of State Assets and Auction Manado to find out whether the Administration of State Property at the Office of State Assets and Auction Manado is in accordance with the provisions of the applicable regulations in regulating administration BMN. This research is a qualitative descriptive study with the data used in this study are primary data and secondary data. The results of this study indicate that the Office of State Assets and Auction Services in Manado as the Accounting Unit for the Authorization of Goods Users (UAKPB) has carried out the Administration of State Property as well as recording through the use of the SIMAK-BMN application.


Jurnal Akta ◽  
2018 ◽  
Vol 5 (1) ◽  
pp. 211
Author(s):  
Magmun Migfar ◽  
Amin Purnawan

ABSTRAKDalam memberikan kredit, Perusahaan Pembiayaan wajib mempunyai keyakinan didasarkan pada unsur perinsip kehati-hatian biasa di kenal dengan 5C, yaitu terdiri dari character (watak), capacity (kemampuan), capital (modal), collateral (jaminan), dan condition of economic (kondisi ekonomi).Di dalam penelitian penulis membuat rumusan masalahanuntuk mengetahui tanggung jawab para pihak dalam pembutan akta jaminan fidusia pada Notaris dan penyelesaian sengketanya apabila debitur mengalihkan objek jaminan fidusia tanpa persetujuan tertulis oleh pihak PT. Bussan auto Finance (BAF) Rembang.Penelitian ini merupakan penelitian yang bersifat diskriptif dan apabila dilihat dari tujuannya teremasuk penelitian hukum empiris. Lokasi penelitian di PT. BAF Rembang. Jenis data yang digunakan meliputi data primer dan data sekunder. Teknik pengumpulan data yang dipergunakan yaitu melalui penelitian kepustakaan dan wawancara. Analisis data menggunakan kualitatif analitis.Berdasarkan hasil penelitian dapat diketahui dalam perjanjian pembiayaan antara kreditur dan debitur saling mengikatkan diri, debitur harus membaca dan memahami surat perjanjian pembiayaan, sebelum melakukan kesepakatan sengan Leasing, setelah menandatangi perjanjian pembiayaan, debitur harus memenuhi kewajiban membayar angsuran secara tepat waktu sesuai dengan besaran dan tanggal yang telah disepakati, kemudian timbulah hak dan kewajiban supaya jangan sampai ada konflik atau kesalah pahaman yang bias merugikan debitur dikemudian hari.Dalam hal benda jaminan yang menjadi objek jaminan fidusia dialihkan kepada pihak ketiga berlaku asas drot de suite, kreditur tetap dapat mengeksekusi benda jaminan tersebut di tangan siapaun benda tersebut berada. Pengalihan benda yang menjadi objek jaminan fidusia pada pihak ketiga dan seterusnya tidak menghalangi hak kreditur untuk tetap mengeksekusi benda jaminan fidusia tersebut. Memang dalam peneyelesain sengketa benda jamian fidusia di PT BAF Rembang masih mengedepankan cara musyawarah dahulu akan tetapi jika PT BAF Rembang berpedoman pada POJK No.29/POJK.05/2014 Tentang Penyelenggaraan Usaha Perusahaan Pembiayaan dan perlu adanya pendampingan dai pihak kepolisian maka akan sangat mudah dan mungkin untuk mengatasi debitur yang nakal.Kata kunci : Debitur, Kreditur, Eksekusi Benda Jaminan Fidusia.           ABSTRACTIn granting credit, a Financing Company must have confidence based on the usual principle of prudence known as 5C, which consists of character, capability, capital, collateral and condition of economic ( economic conditions). In the study the authors make the formulation of the problem to know the responsibility of the parties in the fiduciary guarantee certificate pembutan notary and settlement of disputes if the debtor divert the fiduciary guarantee object without written approval by the PT. Bussan auto Finance (BAF) Rembang.Penelitian is a descriptive study and when viewed from its purpose including research empirical law. Research location at PT. BAF Rembang. Types of data used include primary data and secondary data. Data collection techniques used are through literature research and interviews. Analytical data use qualitative analytical.Based on the results of the research can be known in the financing agreement between the creditor and the debtor bind each other, the debtor must read and understand the letter of financing agreement, before making leasing agreement, after signing the financing agreement, the debtor must meet the obligation to pay installments in a timely manner in accordance with the amount and date which has been agreed, then arise rights and obligations so that there will be no conflicts or misunderstandings that bias detrimental to the debtor in the future. In the event that the collateral object becomes the object of fiduciary guarantee transferred to a third party applies the principle of drot de suite, the lender can still execute the guarantee object in the hands of whoever the object is located. The transfer of objects which become the object of fiduciary collateral to a third party and so on shall not preclude the right of the creditor to keep executing the fiduciary assurance object. Indeed, in peneyelesain dispute fiduciary jamian objects in PT BAF Rembang still put forward the first musyawarah way but if PT BAF Rembang based on POJK No.29 / POJK.05 / 2014 About the Implementation of Financing Company Business and the need for assistance from the police then it will be very easy and possibly to deal with naughty debtors.Keywords: Debtor, Creditors, Execution of Fiduciary Guarantee Items.


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