CPNP abstracts are printed in the Journal of Pharmacy Practice each spring.
Epilepsy is a disease requiring chronic therapy with anti-epileptic drugs (AEDs). Many conventional AEDs currently available have either too rapid an absorption or elimination, requiring the patient to take multiple doses per day, which may adversely impact adherence or cause peak-related side effects. Consequently, some AEDs with immediate-release (IR) characteristics have been modified to prolong absorption and/or reduce peak serum concentration, enabling dosage regimen simplification (Pellock, Epilepsy Research 2004; 301-7). Modified-release AED formulations have been labeled with various suffixes or names (XL, XR, CR, ER, SA, -Chrono), but such labeling may not adequately distinguish those modified-release AEDs with the most prolonged absorption or unique formulation characteristics. Such suffixes lack precise definition. We identified the formulation characteristics of currently available modified-release AEDs, attempting to distinguish them by suffix designation.
Studies indicate that controlled substance medications prescribed and dispensed in the US are routinely stored by patients in an unsecured manner, thereby increasing opportunities for diversion, nonmedical use, or accidental poisoning. Permanent drug donation boxes are one means of safely, legally and conveniently disposing of controlled substance medications in Tennessee. We analyzed annual trends in controlled substance (CS) donations received through permanent drug drop boxes across two years in Northeast Tennessee, a region with high rates of prescription drug abuse.
This pooled analysis of the Young Mania Rating Scale (YMRS) 11-line items evaluated the efficacy of aripiprazole in patients with bipolar I disorder experiencing acute manic or mixed episodes.
Ziconotide is a potent intrathecally administered analgesic derived from a polypeptide found in the venom of the marine snail, Conus magnus. Ziconotide has a black box warning for causing severe neuropsychiatric adverse events which appear to be dose-dependent and related to how quickly the dose is titrated. Ziconotide-induced neuropsychiatric adverse events, such as psychosis, presents similarly to other substance-induced psychotic disorders but the management of psychosis due to ziconotide is less clear and not well studied.
Ziconotide is a medication used intrathecally in the management of severe chronic pain that contains a warning against neuropsychiatric adverse events. The definition of psychiatric events is broad and management strategies are vague.
A 64 year old Hispanic male presented to the emergency department feeling upset and suicidal. He ate a regular diet and lived alone at his home in South Florida.
Agranulocytosis is rare adverse drug reaction occurring in approximately 0.05% of patients treated with first generation antipsychotics and 0.5–2.0% of patients treated with clozapine. Severe neutropenia and agranulocytosis have been reported with risperidone, olanzapine, quetiapine, and aripiprazole. The time course of antipsychotic-induced neutropenia is variable, with lowest values observable between days 40 and 50 in clozapine-induced neutropenia and between days 20 and 30 in other psychotropic agents. Agranulocytosis has been associated with the use of ziprasidone in two published cases. The lack of information regarding this adverse effect with ziprasidone, both in the published literature and from the drug manufacturer suggests this is an extremely rare occurrence.
Second-generation antipsychotics (SGAs) are essential for managing a variety of neuropsychiatric conditions. Despite the lack of long-term safety and efficacy data in children and adolescents, the use of SGAs in this population continues to increase. No current guidelines explicitly state which SGA is preferred in youths versus another. Ziprasidone is a desirable atypical antipsychotic to treat psychiatric conditions due to its lower risk of weight gain and metabolic effects compared to others within the class. Currently, ziprasidone does not hold an FDA-approved indication for any use in children or adolescents. The information gained from this study will be used to identify the risks and benefits associated with using ziprasidone in a pediatric inpatient psychiatric environment.
1 in 5 youth have or will have a mental illness, with 50% developing symptoms by age 14 years. In combination with behavioral interventions, psychotropic medications can play an important role in the management of mental illnesses in youth. Adolescent knowledge regarding psychotropic medications is lacking, raising concerns for medication non-adherence, side effects, and lack of appropriate follow up. While medication education groups on adult inpatient psychiatry units are widely discussed in literature, current evidence is lacking in pediatric populations.