Clinical Pearl Topics
Tuesday, May 3: 4:45-5:45 p.m.
CPNP is pleased to announce the Clinical Pearls to be presented at the 2011 Annual Meeting. The following pearls were selected by the CPNP Program Committee after evaluating a number of member and non-member submissions.
- 4:30-4:45 p.m.
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Unique Side Effects of Olanzapine
Ericka Breden, PharmD, BCPP, CGP, FASCP
Case vignettes will be presented and discussed regarding uncommon and infrequent side effects encountered during routine clinical use of olanzapine for on- and off-label uses. Reduction in dose, or discontinuation of olanzapine resulted in improvement of adverse effects described.
- 4:45-5:00 p.m.
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Influence of CYP2 Genotyping on Psychiatric Pharmacist Consultations
Charlie Caley, PharmD, BCPP
Background: The promise of personalized medicine has clinical practitioners and the public eager for genetic test results to inform the treatment of psychiatric illnesses. On the forefront is the availability of cytochrome P450 enzyme genotyping. While there has been hope that cytochrome P450 polymorphisms may be associated with response and/or tolerability prediction, published literature results do not support this. Despite this, practitioners are incorporating cytochrome P450 genotyping into the clinical care of patients.
Description: During the routine process of providing clinical consultation, several patients with cytochrome P450 genotyping results have been encountered. A case series is used to illustrate the relevant aspects of consultations which have had cytochrome P450 genotyping data available. Pertinent information will be presented, including: gender, ethnicity, axis I diagnosis, current medications, rationale for obtaining CYP450 genotyping, CYP450 genotyping results, impact on consultation.
Conclusion: CYP450 genotyping is being incorporated into decisions about the pharmacotherapy of patients with psychiatric illnesses. In this case series genotyping results did not always apply to medications that the patients were taking at the time of consultation. However there were instances when CYP450 genotype data were used to support treatment recommendations. Psychiatric pharmacy practitioners should understand the basics of CYP450 genotyping and how / when to apply these results to the clinical care of patients with psychiatric illnesses in an effort to help deliver optimal pharmacotherapy outcomes.
- 5:00-5:15 p.m.
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Clozapine-Induced Gastrointestinal Hypomotility: More Than Just Constipation
Jill Fowler, PharmD, BCPP
Constipation is a common side effect of clozapine, though in some cases severe constipation can progress to small bowel obstruction and even death. The case of a patient admitted for a clozapine-induced partial small bowel obstruction, including the recognition of concerning symptoms and subsequent medication management, will be reviewed. The case discussion will highlight recommended prevention strategies for severe clozapine-induced gastrointestinal hypomotility along with the role of psychiatric pharmacists in providing patient and prescriber education and symptom monitoring.
- 5:15-5:30 p.m.
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The Misuse/Abuse of Psychiatric Medications in the Correctional Healthcare System
Jennifer Nelson, PharmD, BCPP



