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Courtney Iuppa, PharmD, BCPP
CPNP Recertification Editorial Board

Long-acting injectable antipsychotics (LAIAs) are commonly prescribed in community and inpatient mental health settings for both psychotic and mood disorders. While there is a great deal of evidence regarding their place in therapy and recommended dosing and monitoring, there is less evidence available that focuses on real world scenarios and what to do after recommended dosing or monitoring has not been followed.1-6 Psychiatric pharmacists are in a key position to recommend appropriate monitoring and modification of treatment plans after the occurrence of medication errors involving LAIAs, such as improper administration techniques, doses being given early or late, or inappropriate loading doses or dose titration schedules. This CPNP 2020 recertification session is designed to provide education on the evidence for appropriate use of LAIAs and modification of treatment and monitoring plans, using real word case examples as the basis for presentation of the evidence.

Objectives for this session are:

  • Recommend appropriate administration and monitoring for long-acting injectable antipsychotics
  • Analyze a long-acting injectable antipsychotic treatment plan for potential medication errors
  • Modify a treatment plan for a patient receiving a long-acting injectable antipsychotic in response to a medication error

The CPNP Recertification Editorial Board is excited to have Ericka Crouse, PharmD, BCPP, BCGP, FASHP, FASCP take us through real world examples that illustrate potential medication errors with LAIAs and best evidence for responding to those medication errors. Dr. Crouse has worked in psychiatric pharmacy for fifteen years. She received her PharmD degree from the University of Florida. She completed a Geriatrics Specialty Residency at the Durham VAMC in Durham, NC. She went on to complete a Specialty Residency in Psychiatric Pharmacy at the Virginia Commonwealth University Health System in Richmond Virginia. She practiced as a Clinical Pharmacy Specialist on the inpatient psychiatry wards at VCUHS for over 10 years prior to transitioning to a faculty member at the VCU School of Pharmacy. She currently is an Associate Professor in the Department of Pharmacotherapy and Outcomes Sciences at VCU. She continues to practice at VCUHealth in both the inpatient psychiatry unit as well as the outpatient Motivate (Substance Use Disorder) Clinic.

Dr. Crouse’s areas of interest include geriatric psychiatry including dementia and delirium, as well as schizophrenia, mood disorders, and substance abuse. She is interested in patient safety and reduction of medication errors. Dr. Crouse is actively involved in CPNP and is currently the Secretary of the Board of Directors for CPNP. She also serves as the board liaison for the Annual Programming Committee.

References

  1. Dixon L, Perkins D, Calmes C. Guidelines Watch (September 2009): practice guideline for the treatment of patients with schizophrenia. Available at https://psychiatryonline.org/pb/assets/raw/sitewide/practice_guidelines/guidelines/schizophrenia-watch.pdf. Accessed on October 23, 2019.
  2. Keramatian K, Chakrabarty T, Yatham LN. Long-acting injectable second-generation/atypical antipsychotics for the management of bipolar disorder: a systematic review. CNS Drugs. 2019 May;33(5):431-456
  3. Kishimoto T, Nitta M, Borenstein M, Kane JM, Correll CU. Long-acting injectable versus oral antipsychotics in schizophrenia: a systematic review and meta-analysis of mirror-image studies. J Clin Psychiatry. 2013;74(10):957-65.
  4. Miyamoto S, Wolfgang-Fleischhacker W. The use of long-acting injectable antipsychotics in schizophrenia. Curr Treat Options Psychiatry. 2017;4(2):117-26.
  5. National Institute for Health and Care Excellence. Psychosis and schizophrenia in adults: prevention and management. Available at https://nice.org.uk/guidance/cg178. Accessed on May 1, 2019.
  6. Pacchiarotti I, Tiihonen J, Kotzalidis GD, Verdolini N, Murru A, Goikolea JM, Valenti M, Aedo A, Vieta E. Long-acting injectable antipsychotics (LAIs) for maintenance treatment of bipolar and schizoaffective disorders: A systematic review. Eur Neuropsychopharmacol. 2019;29(4):457-70.
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