Abstract Purpose: To report the first descriptive case of a mouth lesion following one dose of sublingually administered asenapine. Summary: Asenapine is a second-generation antipsychotic, approved in the United States in August 2009, for the treatment of schizophrenia and acute mania associated with bipolar disorder. It is administered as a sublingual tablet to be taken twice daily. Although the mechanism of action has not been fully elucidated, it is thought to be mediated through a combination of antagonist activity at the dopamine and serotonin 5-HT2A receptors. Sublingual bioavailability is estimated at 35% and is highly plasma protein bound (95%). Oral administration results in low bioavailability (< 2%) due to extensive first-pass metabolism. Adverse tissue reactions identified by the manufacturer include mouth ulcers, blisters, and peeling/sloughing of the contact area. In one manufacturer-sponsored trial, oral paresthesia events were reported for the following administration routes: sublingual (7...
{"title":"An ulcerated mouth lesion following one dose of sublingual asenapine","authors":"G. Sweet, Nicole B Washington, Nancy Brahm","doi":"10.9740/MHC.2015.07.180","DOIUrl":"https://doi.org/10.9740/MHC.2015.07.180","url":null,"abstract":"Abstract Purpose: To report the first descriptive case of a mouth lesion following one dose of sublingually administered asenapine. Summary: Asenapine is a second-generation antipsychotic, approved in the United States in August 2009, for the treatment of schizophrenia and acute mania associated with bipolar disorder. It is administered as a sublingual tablet to be taken twice daily. Although the mechanism of action has not been fully elucidated, it is thought to be mediated through a combination of antagonist activity at the dopamine and serotonin 5-HT2A receptors. Sublingual bioavailability is estimated at 35% and is highly plasma protein bound (95%). Oral administration results in low bioavailability (< 2%) due to extensive first-pass metabolism. Adverse tissue reactions identified by the manufacturer include mouth ulcers, blisters, and peeling/sloughing of the contact area. In one manufacturer-sponsored trial, oral paresthesia events were reported for the following administration routes: sublingual (7...","PeriodicalId":18691,"journal":{"name":"Mental Health Clinician","volume":"178 1","pages":"180-183"},"PeriodicalIF":0.0,"publicationDate":"2015-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82995254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashley Hillman, Lindsey Kennedy, Shauna S Garris, Jacqueline E. McLaughlin, D. Rhoney
Abstract Introduction: Stigma is an important challenge facing patients with mental illness. Stigmatizing attitudes may impact the quantity and quality of care patients receive. Interaction with these patients may reduce stigmatizing attitudes in pharmacy learners. Patient medication education groups (PMEGs) provide learners with an opportunity for this interaction. The objectives of the study were to evaluate pharmacy learner's attitudes toward patients with mental illness and their comfort and ability to provide pharmaceutical services to this population before and after leading a PMEG on an adolescent inpatient psychiatric unit and to evaluate the feasibility of a larger, future trial. Methods: Third- or fourth-year student pharmacists or first-year pharmacy residents observed a postgraduate year-2 (PGY2) pharmacy specialty resident in psychiatry leading PMEGs on the adolescent unit of an inpatient psychiatric hospital. Then, they discussed their own ideas for design and delivery of a group (with feedb...
{"title":"Stigmatizing beliefs: How leading patient medication education groups on an inpatient psychiatric unit impacts pharmacy learners","authors":"Ashley Hillman, Lindsey Kennedy, Shauna S Garris, Jacqueline E. McLaughlin, D. Rhoney","doi":"10.9740/MHC.2015.07.162","DOIUrl":"https://doi.org/10.9740/MHC.2015.07.162","url":null,"abstract":"Abstract Introduction: Stigma is an important challenge facing patients with mental illness. Stigmatizing attitudes may impact the quantity and quality of care patients receive. Interaction with these patients may reduce stigmatizing attitudes in pharmacy learners. Patient medication education groups (PMEGs) provide learners with an opportunity for this interaction. The objectives of the study were to evaluate pharmacy learner's attitudes toward patients with mental illness and their comfort and ability to provide pharmaceutical services to this population before and after leading a PMEG on an adolescent inpatient psychiatric unit and to evaluate the feasibility of a larger, future trial. Methods: Third- or fourth-year student pharmacists or first-year pharmacy residents observed a postgraduate year-2 (PGY2) pharmacy specialty resident in psychiatry leading PMEGs on the adolescent unit of an inpatient psychiatric hospital. Then, they discussed their own ideas for design and delivery of a group (with feedb...","PeriodicalId":18691,"journal":{"name":"Mental Health Clinician","volume":"4 1","pages":"162-168"},"PeriodicalIF":0.0,"publicationDate":"2015-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86952531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephen R Saklad, Tiffany-Jade Kreys, Stephanie V. Phan
ABSTRACT Introduction: Patients with schizophrenia often relapse as a result of medication nonadherence. Methods: Long-acting injectable antipsychotics have been developed to improve medication adherence rates in this patient population. Results: Aripiprazole long-acting injection (LAI), branded Abilify Maintena®, received Food and Drug Administration approval for the treatment of schizophrenia in February of 2013. Aripiprazole LAI is the fourth intramuscular second-generation antipsychotic indicated for the treatment of schizophrenia. Discussion: This manuscript reviews important clinical information regarding its use as well as efficacy and tolerability data.
{"title":"Aripiprazole long-acting injectable (ABILIFY MAINTENA) for treatment of schizophrenia","authors":"Stephen R Saklad, Tiffany-Jade Kreys, Stephanie V. Phan","doi":"10.9740/MHC.2015.07.149","DOIUrl":"https://doi.org/10.9740/MHC.2015.07.149","url":null,"abstract":"ABSTRACT Introduction: Patients with schizophrenia often relapse as a result of medication nonadherence. Methods: Long-acting injectable antipsychotics have been developed to improve medication adherence rates in this patient population. Results: Aripiprazole long-acting injection (LAI), branded Abilify Maintena®, received Food and Drug Administration approval for the treatment of schizophrenia in February of 2013. Aripiprazole LAI is the fourth intramuscular second-generation antipsychotic indicated for the treatment of schizophrenia. Discussion: This manuscript reviews important clinical information regarding its use as well as efficacy and tolerability data.","PeriodicalId":18691,"journal":{"name":"Mental Health Clinician","volume":"31 1","pages":"149-161"},"PeriodicalIF":0.0,"publicationDate":"2015-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84460393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Youngil Shin, Sandra Benavides, J. Wurster, N. Patel
Abstract Introduction: Approximately half a million emergency department visits for traumatic brain injury (TBI) by children and adolescents occur each year. One of the complications of TBI is early-onset seizure. Current guidelines recommend the use of phenytoin for prevention of seizures following a TBI; however, several drug interactions and adverse reactions are associated with its use. Despite studies demonstrating efficacy of levetiracetam in adult patients, the efficacy and safety of levetiracetam in children with TBI is unknown. The purpose of this study was to determine the efficacy and safety of levetiracetam for the prevention of early-onset seizures in pediatric patients following TBI. Methods: A retrospective evaluation was conducted, which included children, ages 0 to 17 years, admitted secondary to a nonpenetrating TBI and who received levetiracetam for seizure prophylaxis for up to 7 days. The primary outcome was the number of children who had a seizure within the first 7 days following a ...
{"title":"Levetiracetam (Keppra) efficacy and safety in the prevention of early-onset seizures following traumatic brain injuries in pediatric patients","authors":"Youngil Shin, Sandra Benavides, J. Wurster, N. Patel","doi":"10.9740/MHC.2015.07.144","DOIUrl":"https://doi.org/10.9740/MHC.2015.07.144","url":null,"abstract":"Abstract Introduction: Approximately half a million emergency department visits for traumatic brain injury (TBI) by children and adolescents occur each year. One of the complications of TBI is early-onset seizure. Current guidelines recommend the use of phenytoin for prevention of seizures following a TBI; however, several drug interactions and adverse reactions are associated with its use. Despite studies demonstrating efficacy of levetiracetam in adult patients, the efficacy and safety of levetiracetam in children with TBI is unknown. The purpose of this study was to determine the efficacy and safety of levetiracetam for the prevention of early-onset seizures in pediatric patients following TBI. Methods: A retrospective evaluation was conducted, which included children, ages 0 to 17 years, admitted secondary to a nonpenetrating TBI and who received levetiracetam for seizure prophylaxis for up to 7 days. The primary outcome was the number of children who had a seizure within the first 7 days following a ...","PeriodicalId":18691,"journal":{"name":"Mental Health Clinician","volume":"50 1","pages":"144-148"},"PeriodicalIF":0.0,"publicationDate":"2015-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80935698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objective: To describe the effects of a look-alike, sound-alike medication error on the glycemic control and psychiatric well-being of a 23-year-old man. Case Summary: A 23-year-old man presented to the university-based Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT) team with a diagnosis of schizoaffective disorder, most recent episode manic, and hypertension. The patient was prescribed chlorpromazine 100 mg daily to treat symptoms of psychosis and anxiety. The anxiety, however, persisted and escalated over the following 2 weeks. Upon physical examination of the patient's medications, it was discovered that the patient was inadvertently given chlorpropamide in place of the chlorpromazine. Evaluations, clinical presentation, the medication list, and criteria for an adverse drug event indicated a probable relationship (7 of 12) between the use of chlorpropamide and a hypoglycemic episode. The medication error was noted and corrective actions were taken. Within 1 week...
{"title":"Hypoglycemia from a look-alike, sound-alike medication error","authors":"R. M. Milton, Nicole B Washington, Nancy Brahm","doi":"10.9740/MHC.2015.07.174","DOIUrl":"https://doi.org/10.9740/MHC.2015.07.174","url":null,"abstract":"Abstract Objective: To describe the effects of a look-alike, sound-alike medication error on the glycemic control and psychiatric well-being of a 23-year-old man. Case Summary: A 23-year-old man presented to the university-based Integrated Multidisciplinary Program of Assertive Community Treatment (IMPACT) team with a diagnosis of schizoaffective disorder, most recent episode manic, and hypertension. The patient was prescribed chlorpromazine 100 mg daily to treat symptoms of psychosis and anxiety. The anxiety, however, persisted and escalated over the following 2 weeks. Upon physical examination of the patient's medications, it was discovered that the patient was inadvertently given chlorpropamide in place of the chlorpromazine. Evaluations, clinical presentation, the medication list, and criteria for an adverse drug event indicated a probable relationship (7 of 12) between the use of chlorpropamide and a hypoglycemic episode. The medication error was noted and corrective actions were taken. Within 1 week...","PeriodicalId":18691,"journal":{"name":"Mental Health Clinician","volume":"26 1","pages":"174-179"},"PeriodicalIF":0.0,"publicationDate":"2015-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86325993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract During the past decade, pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) has become the topic of numerous debates, sparking research on its presentation, existence, and treatment. As the awareness of PANDAS has increased among the general community, health care providers have been forced to increase their knowledge of this controversial disease state. This article will review the background information, diagnostic criteria, treatment, and contentious issues related to PANDAS.
{"title":"Review of pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections","authors":"S. Mullen","doi":"10.9740/MHC.2015.07.184","DOIUrl":"https://doi.org/10.9740/MHC.2015.07.184","url":null,"abstract":"Abstract During the past decade, pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) has become the topic of numerous debates, sparking research on its presentation, existence, and treatment. As the awareness of PANDAS has increased among the general community, health care providers have been forced to increase their knowledge of this controversial disease state. This article will review the background information, diagnostic criteria, treatment, and contentious issues related to PANDAS.","PeriodicalId":18691,"journal":{"name":"Mental Health Clinician","volume":"19 1","pages":"184-188"},"PeriodicalIF":0.0,"publicationDate":"2015-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75352236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction: A previous study at Veterans Affairs (VA) Eastern Colorado Health Care System revealed low rates of compliance with VA Pharmacy Benefits Management Services recommendations for antipsychotic selection in schizophrenia and schizoaffective disorders. As a result, formulary restrictions of second-line antipsychotics were implemented. Since April 2013, new starts of second-line antipsychotic agents require a prior authorization drug review. The objectives of this study were to evaluate the impact of the prior authorization process on compliance with the VA criteria for prescribing aripiprazole, olanzapine, and ziprasidone. The primary objective was to compare compliance rates with VA antipsychotic selection criteria preimplementation and postimplementation of the prior authorization drug review policy. Methods: Single center, retrospective chart review of patients receiving aripiprazole, olanzapine, and ziprasidone. A report of all patients receiving a prescription for the above 3 agent...
{"title":"Evaluation of a prior authorization policy on compliance with VA pharmacy benefits management services recommendations for antipsychotic selection","authors":"O. N. Nevo, J. Gold, Sherri Hawk","doi":"10.9740/MHC.2015.07.169","DOIUrl":"https://doi.org/10.9740/MHC.2015.07.169","url":null,"abstract":"Abstract Introduction: A previous study at Veterans Affairs (VA) Eastern Colorado Health Care System revealed low rates of compliance with VA Pharmacy Benefits Management Services recommendations for antipsychotic selection in schizophrenia and schizoaffective disorders. As a result, formulary restrictions of second-line antipsychotics were implemented. Since April 2013, new starts of second-line antipsychotic agents require a prior authorization drug review. The objectives of this study were to evaluate the impact of the prior authorization process on compliance with the VA criteria for prescribing aripiprazole, olanzapine, and ziprasidone. The primary objective was to compare compliance rates with VA antipsychotic selection criteria preimplementation and postimplementation of the prior authorization drug review policy. Methods: Single center, retrospective chart review of patients receiving aripiprazole, olanzapine, and ziprasidone. A report of all patients receiving a prescription for the above 3 agent...","PeriodicalId":18691,"journal":{"name":"Mental Health Clinician","volume":"72 1","pages":"169-173"},"PeriodicalIF":0.0,"publicationDate":"2015-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86280997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Tapering opioids is one of the most daunting dilemmas in clinical practice today. The decision to taper opioids is based on many factors, including a lack of efficacy, unacceptable risk, p...
{"title":"A practical guide to tapering opioids","authors":"L. Král, Kenneth Jackson, Tanya J. Uritsky","doi":"10.9740/MHC.2015.05.102","DOIUrl":"https://doi.org/10.9740/MHC.2015.05.102","url":null,"abstract":"Abstract Tapering opioids is one of the most daunting dilemmas in clinical practice today. The decision to taper opioids is based on many factors, including a lack of efficacy, unacceptable risk, p...","PeriodicalId":18691,"journal":{"name":"Mental Health Clinician","volume":"26 1","pages":"102-108"},"PeriodicalIF":0.0,"publicationDate":"2015-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85473634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Introduction: Migraine is a common pediatric disorder, which results in chronic pain. Because of the limited effectiveness of conventional drug regimens, an increased number of pediatric patients look for an alternative medication regimen to prevent and treat migraines. Method: Search terms “pediatric, headache, migraine, treatment, alternative treatment” were used. Butterbur and riboflavin are suggested as alternative remedies for migraine prophylaxis, and a combination of feverfew and ginger for acute treatment. In addition to previous search terms, “butterbur, riboflavin, feverfew, ginger” were used to review their effectiveness. Result: Butterbur or riboflavin may be an appropriate alternative regimen to prevent migraine, and a combination of feverfew and ginger may be an option for acute episode. Conclusion: Study results are promising, but not yet conclusive. Study samples are relatively small. These alternative regimens may benefit pediatric migraine sufferers, but they should be carefully...
{"title":"Pediatric migraine sufferers and alternative therapies","authors":"J. Huh, Jami L. Butz","doi":"10.9740/MHC.2015.05.134","DOIUrl":"https://doi.org/10.9740/MHC.2015.05.134","url":null,"abstract":"Abstract Introduction: Migraine is a common pediatric disorder, which results in chronic pain. Because of the limited effectiveness of conventional drug regimens, an increased number of pediatric patients look for an alternative medication regimen to prevent and treat migraines. Method: Search terms “pediatric, headache, migraine, treatment, alternative treatment” were used. Butterbur and riboflavin are suggested as alternative remedies for migraine prophylaxis, and a combination of feverfew and ginger for acute treatment. In addition to previous search terms, “butterbur, riboflavin, feverfew, ginger” were used to review their effectiveness. Result: Butterbur or riboflavin may be an appropriate alternative regimen to prevent migraine, and a combination of feverfew and ginger may be an option for acute episode. Conclusion: Study results are promising, but not yet conclusive. Study samples are relatively small. These alternative regimens may benefit pediatric migraine sufferers, but they should be carefully...","PeriodicalId":18691,"journal":{"name":"Mental Health Clinician","volume":"81 1","pages":"134-137"},"PeriodicalIF":0.0,"publicationDate":"2015-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81215125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract The older adult population is one of the fastest growing age groups in the United States. As this population continues to expand, determining the safest way to provide pain management has become increasingly important. More than 50% of community-dwelling older adults experience pain on a daily basis, and up to 83% of those in assisted living facilities experience persistent pain. Pain is exceedingly challenging to treat safely and effectively in the elderly because of the physiologic changes that occur as people age. In addition, many nonnarcotic medications with analgesic properties are listed in both the 2012 American Geriatrics Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults and the Pharmacy Quality Alliance high-risk medications lists. An approach to the growing challenge of managing pain in the elderly that is gaining popularity among community-dwelling patients is the use of topical pain medications. The goal of this article is to review some of the avail...
{"title":"Alternative methods of pain management for the older adult population: Review of topical pain medications","authors":"Candice Tavares","doi":"10.9740/MHC.2015.05.109","DOIUrl":"https://doi.org/10.9740/MHC.2015.05.109","url":null,"abstract":"Abstract The older adult population is one of the fastest growing age groups in the United States. As this population continues to expand, determining the safest way to provide pain management has become increasingly important. More than 50% of community-dwelling older adults experience pain on a daily basis, and up to 83% of those in assisted living facilities experience persistent pain. Pain is exceedingly challenging to treat safely and effectively in the elderly because of the physiologic changes that occur as people age. In addition, many nonnarcotic medications with analgesic properties are listed in both the 2012 American Geriatrics Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults and the Pharmacy Quality Alliance high-risk medications lists. An approach to the growing challenge of managing pain in the elderly that is gaining popularity among community-dwelling patients is the use of topical pain medications. The goal of this article is to review some of the avail...","PeriodicalId":18691,"journal":{"name":"Mental Health Clinician","volume":"205 1","pages":"109-122"},"PeriodicalIF":0.0,"publicationDate":"2015-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77477084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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