Journal of Pharmacy Practice
CPNP abstracts are printed in the Journal of Pharmacy Practice each spring.
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All Annual Meeting Abstracts
ARIPIPRAZOLE AUGMENTATION TO CLOZAPINE IN REFRACTORY SCHIZOPHRENIA
Clozapine is considered the most effective antipsychotic medication in treatment resistant schizophrenia or schizoaffective disorder even though 40 to 70 percent of these patients are nonresponders or only partial responders to the medication. Considering this relative poor response to clozapine, many psychiatrists are faced with a difficult dilemma as to which medications to use in these refractory cases. Despite the lack of evidence to support a combination regimen, it is estimated that up to 35 percent of patients receiving clozapine are also receiving another antipsychotic. Aripiprazole is an activating atypical antipsychotic that could potentially benefit patients on clozapine therapy due to its unique mechanism of action and minimal side effect profile. Some psychiatrists have utilized this particular combination regardless of the lack of information to support this.
Development of Psychotropic Medication Utilization Parameters for Foster Children.
In both the professional and lay press, increased attention has been devoted to the use of psychotropic medication in children. In particular, foster children are a vulnerable population that are often fraught with mental or psychiatric disorders, and scrutiny has occurred regarding the use of psychotropic medication in these individuals. Methodologies improving the use of psychotropic medications in this population are needed.
Effect of the implementation of a pharmacist-operated medication therapy management clinic on psychotropic medication misdadventures among active duty soldiers with traumatic brain injury
The documented cases of medication misadventures among active duty soldiers with head traumas, traumatic brain injuries, or concussive injuries is a common but preventable occurrence. The development of cognitive deficits or changes in mental status that alter level of consciousness have the potential to affect comprehension when it comes to providing optimal education and retaining information about proper medication administration. The unique occurrence of cognitive and emotional symptoms associated with traumatic brain injury require due diligence on the part of health care providers in confirming that medication education about proper administration is understood and verbalized.
FORMULATION CONVERSION FROM DIVALPROEX SODIUM EC TO DIVALPROEX SODIUM ER: EFFECTS ON ADHERENCE
In June of 2006, the Louis Stokes Cleveland Veterans Affairs Medical Center underwent a formulary conversion from divalproex sodium EC (DSEC) to divalproex sodium ER (DSER). Previous studies have established safety, efficacy, and tolerability regarding conversion to the long-acting once daily DSER formulation from DSEC twice daily formulation. To date there are no published studies evaluating adherence between these two formulations with conversion of therapy. Previous studies in the psychiatric and non-psychiatric populations have indicated that once daily dosing vs. twice or three times daily dosing results in increased adherence rates. Increased adherence rates have also been demonstrated in studies comparing once daily extended release medication formulations and twice daily administration of an immediate release formulation.
The long-term impact of group attendance, function and psychotropic medications on weight loss in a pharmacy-based weight management clinic in psychiatry.
In February 2004, the American Diabetes Association published consensus guidelines recommending that patients on antipsychotic drugs be monitored for weight gain and receive nutrition and exercise counseling.
"Closing-in" on clozapine dosing: a case warranting therapeutic drug monitoring
Clozapine is an atypical antipsychotic used in the treatment of schizophrenia. The typical daily dose is 300-600mg divided twice daily with a maximum daily dose of 900mg. There is a wide variation in serum levels for patients on a fixed dose of clozapine. An eight-fold inter-individual and a large intra-individual variation have been previously reported. Accepted standards of clinical practice do not include obtaining routine clozapine serum levels. However, certain clinical situations may warrant therapeutic drug monitoring (TDM) of clozapine levels. One indication for TDM is poor clinical response at typical doses. The medical literature postulates that the therapeutic range is between 350-400 ng/mL and one reference suggests a target of >504 ng/ml.
160-week Interim Results from an Open-Label Extension Trial of Olanzapine Long-Acting Injection
The primary objective of this ongoing open-label study is to examine the long-term safety and tolerability of olanzapine long-acting injection (OLAI). Current results are from an interim analysis (maximum treatment duration=160 weeks).
: The impact of educational group therapy in addition to standard psychiatric care in incarcerated females on treatment outcomes and psychotropic utilization
The impact of educational group therapy in addition to standard psychiatric care in incarcerated females on treatment outcomes and psychotropic utilization
A 12-WEEK OPEN LABEL STUDY OF HIGH DOSE QUETIAPINE IN TREATMENT RESISTANT SCHIZOPHRENIA
Clozapine has been proven to be the most effective treatment for patients with treatment resistant schizophrenia. However, constant monitoring and potential for serious side effects has limited its use in clinical practice. Few controlled studies have evaluated the efficacy of quetiapine in treatment resistant schizophrenia when dosed above 800 mg/day.