Antidepressant Medication

Total Page:16

File Type:pdf, Size:1020Kb

Antidepressant Medication Antidepressant medication There is a lot of misinformation about antidepressant medication and there is no simple explanation as to how it works. Medication can be important in the treatment of moderate to severe depression and in some anxiety conditions. This fact sheet looks at what antidepressants do, how they work and where to get more information and help. How do antidepressants work? People with more severe forms of depression (bipolar disorder and depression with psychosis) Research shows that more severe forms do generally need to be treated with medication. of depression are associated with specific This may include one or a combination changes in the brain, including changes to of mood stabilisers, anti-psychotic drugs some hormones and chemical message and antidepressants. systems. In these forms of depression, there are alterations in the activity of the brain in areas Which antidepressants are the which may cause a major depressive episode. This is associated with the symptoms and most useful? disability seen with depression. Antidepressant Making a decision about which antidepressant medication is thought to influence the activity is best for a person can be complex. The decision of serotonin and noradrenaline in some areas of is made in consultation with a doctor, after careful the brain. However, depression is not simply a assessment and consideration. People can help deficiency of these chemicals. Different types of the doctor’s assessment by providing as much antidepressants work in slightly different ways, information as possible about themselves and but they all have an influence on parts of the their medical history. Important factors include brain related to emotions and motivation. the person’s age, symptoms, other medications and, if female, whether they are pregnant When is antidepressant or breastfeeding. medication used? There are many different types of antidepressant Antidepressant medication may be prescribed, medication which have been shown to work, but along with psychological treatments, when a their effectiveness differs from person to person. person experiences a moderate to severe episode Your doctor may wish to prescribe a particular of depression. Sometimes, antidepressants are antidepressant to tailor it to your particular prescribed when other treatments have not been symptoms. Antidepressants take at least two successful or when psychological treatments are weeks before they start to help, and it may also not possible due to the severity of the illness or a take some time for the doctor to find the most lack of access to the treatment. suitable medication and dosage. beyondblue.org.au 1300 22 4636 1 of 4 Age Antidepressant medication is generally not recommended for use by itself in people with Depression is common and can affect people bipolar disorder as it can trigger mania. of all ages, however, generally medication is not recommended as the first choice for the treatment of depression in children and “I resisted medication for years; young people. inaccurately believing it was ‘weak’ or I would turn into a ‘vegetable’. The Therapeutic Goods Administration (Australia’s regulatory agency for medical drugs) Many misconceptions exist regarding and manufacturers of antidepressants do not medication. In my case, medication recommend antidepressant use for depression propelled my recovery and helped me in young people under the age of 18. There are, to utilise psychological treatments however, no government (i.e. Pharmaceutical effectively.” Benefits Scheme) restrictions placed on the prescription of antidepressants and doctors are April, 25 not prevented from prescribing them if they feel they are needed. There is concern that a small percentage of Types of antidepressants young people up to the age of 24 years taking There are many different types of antidepressant Selective Serotonin Reuptake Inhibitors (SSRIs) medication. Your doctor may need to find the for the treatment of depression may experience medication and dose which is most effective an increase in suicidal thoughts and behaviour. for you. Keep in mind antidepressants take time Research shows the risk to be roughly 4 per before they start to help (at least two weeks). cent compared to 2 per cent for those taking a Below is a description of the different classes placebo dummy pill). of antidepressants. Please note, this list only A young person will require close medical includes the generic medication names and not supervision and monitoring in the early stages the pharmaceutical brand names. Please look on of treatment if an antidepressant is prescribed. your medication packaging to find the name of the medication you are taking (this is usually Chronic illness written in lowercase). Like any medication, antidepressants can There are differences in effects and side-effects produce side-effects. In some cases, taking of the antidepressants listed below, which antidepressants can affect existing symptoms can be discussed with your prescribing health or treatments for other illnesses. It is important professional. for people to let doctors know about any illness they may have and any medication they Selective Serotonin Reuptake Inhibitors are taking. (SSRIs) This class includes sertraline; citalopram; Pregnancy and breastfeeding escitalopram; paroxetine; fluoxetine; fluvoxamine. The decision to take medication while pregnant SSRIs are: or breastfeeding is an individual one. It should • the most commonly prescribed be made in consultation with a doctor after antidepressants in Australia considering the risks and benefits to both the mother and baby. The lowest effective dose • often a doctors’ first choice for most types of should be used. depression If a woman is breastfeeding, generally specific • generally well tolerated by most people types of medications are preferred. While a • generally non-sedating. number of factors will influence the choice of antidepressant, a group of antidepressants Serotonin and Noradrenalin Reuptake called tricyclics, as well as sertraline, citalopram Inhibitors (SNRIs) and fluvoxamine are most commonly prescribed for women who are breastfeeding. This class includes venlafaxine; desvenlafaxine; duloxetine. SNRIs: Studies show that paroxetine is generally not recommended at this time.1,2 • have fewer side-effects compared to the older antidepressants (such as TriCyclic Antidepressants and bipolar disorder Antidepressants) People who have bipolar disorder and experience • are often prescribed for severe depression an episode of depression will often be given a • are safer if a person overdoses. mood stabiliser alone. It can take time for mood stabilisers to work. Sometimes antidepressants are used along with mood stabilisers to help ease the symptoms. beyondblue.org.au 1300 22 4636 2 of 4 Reversible Inhibitors of MonoAmine oxidase (RIMAs) Things to note The class includes moclobemide. RIMAs: • All of these drugs have been shown to have effect as antidepressants for • have fewer side-effects more severe depression however • are non-sedating their effectiveness differs from person to person. • may be less effective in treating more severe forms of depression than other antidepressants • When symptoms are directly due to depression, the person is likely to begin • are helpful for people who are experiencing to improve after 4-6 weeks of effective anxiety or sleeping difficulties. therapy. For example, although SSRIs commonly make sleep difficulties TriCyclic Antidepressants (TCAs) or insomnia worse initially, they are The class includes nortriptyline; clomipramine; associated with improved sleep 4-6 dothiepin; imipramine; amitriptyline. TCAs are: weeks later. • effective, but have more harmful side-effects • TCAs are commonly prescribed for their than newer drugs (i.e. SSRIs) wide range of general benefits, but are also the most toxic antidepressants if • more likely to cause low blood pressure – so taken in large quantities. this should be monitored by a doctor • SSRIs or clomipramie (TCA) would be • more risky if a person were to overdose. the first choice if obsessive compulsive disorder symptoms were prominent. Noradrenaline-Serotonin Specific Antidepressants (NaSSAs) This class includes mirtazapine. NaSSAs are: • helpful when there are problems with anxiety, sleeping or poor appetite Monoamine Oxidase Inhibitors (MAOIs) • generally low in sexual side-effects, but may This class includes tranylcypromine. MAOIs are cause weight gain. prescribed only under exceptional circumstances as they require a special diet and have adverse effects. Noradrenalin Reuptake Inhibitors (NARIs) Tetracyclics This class includes reboxetine. NARIs are: This class includes Mianserin. Tetracyclics: • designed to act selectively on one type of brain chemical – noradrenalin • operate via noradrenaline and serotonin neurotransmitters systems • less likely to cause sleepiness or drowsiness than some other antidepressants • include side-effects such as sedation and dizziness • more likely to: • can cause a rare side-effect to arise, so • make it difficult for people to sleep occasional blood tests are necessary. • cause increased sweating after the initial doses What are the side effects? • cause sexual difficulties after the initial doses Antidepressants can make people feel better, but they won’t change their personality or • cause difficulty urinating after the initial doses make them feel happy all the time. They will • cause increased heart rate after the not improve unhappiness due to a predicament initial doses.
Recommended publications
  • Efficacy of Treatments for Patients with Obsessive-Compulsive Disorder: a Systematic Review
    REVIEW Efficacy of treatments for patients with obsessive-compulsive disorder: A systematic review Yun-Jung Choi, PhD, RN, PMHNP (Lecturer) Keywords Abstract Systematic review; obsessive-compulsive disorder; efficacy of medication. Purpose: This systematic review examines the efficacy of pharmacological therapy for obsessive-compulsive disorder (OCD), addressing two major issues: Correspondence which treatment is most effective in treating the patient’s symptoms and which Yun-Jung Choi, PhD, RN, PMHNP, Red Cross is beneficial for maintaining remission. College of Nursing, 98 Saemoonan-Gil, Data sources: Seven databases were used to acquire articles. The key words Jongno-Gu, Seoul 110-102, Korea; used to search for the relative topics published from 1996 to 2007 were Tel: +82-2-3700-3676; fax: +82-2-3700-3400; ‘‘obsessive-compulsive disorder’’ and ‘‘Yale-Brown obsession-compulsion E-mail: [email protected] scale.’’ Based on the inclusion and exclusion criteria, 25 studies were selected Received: August 2007; from 57 potentially relevant studies. accepted: March 2008 Conclusions: The effects of treatment with clomipramine and selective sero- tonin reuptake inhibitors (SSRIs: fluvoxamine, sertraline, fluoxetine, citalo- doi:10.1111/j.1745-7599.2009.00408.x pram, and escitalopram) proved to be similar, except for the lower adherence rate in case of clomipramine because of its side effects. An adequate drug trial involves administering an effective daily dose for a minimum of 8 weeks. An augmentation strategy proven effective for individuals refractory to monother- apy with SSRI treatment alone is the use of atypical antipsychotics (risperidone, olanzapine, and quetiapine). Implications for practice: Administration of fluvoxamine or sertraline to patients for an adequate duration is recommended as the first-line prescription for OCD, and augmentation therapy with risperidone, olanzapine, or quetiapine is recommended for refractory OCD.
    [Show full text]
  • Antinociceptive Effects of Monoamine Reuptake Inhibitors in Assays of Pain-Stimulated and Pain-Depressed Behaviors
    Virginia Commonwealth University VCU Scholars Compass Theses and Dissertations Graduate School 2012 Antinociceptive Effects of Monoamine Reuptake Inhibitors in Assays of Pain-Stimulated and Pain-Depressed Behaviors Marisa Rosenberg Virginia Commonwealth University Follow this and additional works at: https://scholarscompass.vcu.edu/etd Part of the Medical Pharmacology Commons © The Author Downloaded from https://scholarscompass.vcu.edu/etd/2715 This Thesis is brought to you for free and open access by the Graduate School at VCU Scholars Compass. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of VCU Scholars Compass. For more information, please contact [email protected]. ANTINOCICEPTIVE EFFECTS OF MONOAMINE REUPTAKE INHIBITORS IN ASSAYS OF PAIN-STIMULATED AND PAIN-DEPRESSED BEHAVIOR A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science at Virginia Commonwealth University By Marisa B. Rosenberg Bachelor of Science, Temple University, 2008 Advisor: Sidney Stevens Negus, Ph.D. Professor, Department of Pharmacology/Toxicology Virginia Commonwealth University Richmond, VA May, 2012 Acknowledgement First and foremost, I’d like to thank my advisor Dr. Steven Negus, whose unwavering support, guidance and patience throughout my graduate career has helped me become the scientist I am today. His dedication to education, learning and the scientific process has instilled in me a quest for knowledge that I will continue to pursue in life. His thoroughness, attention to detail and understanding of pharmacology has been exemplary to a young person like me just starting out in the field of science. I’d also like to thank all of my committee members (Drs.
    [Show full text]
  • ADHD Parents Medication Guide Revised July 2013
    ADHD Parents Medication Guide Revised July 2013 Attention-Deficit/Hyperactivity Disorder Prepared by: American Academy of Child & Adolescent Psychiatry and American Psychiatric Association Supported by the Elaine Schlosser Lewis Fund Physician: ___________________________________________________ Address: ___________________________________________________ ___________________________________________________ ___________________________________________________ Phone: ___________________________________________________ Email: ___________________________________________________ ADHD Parents Medication Guide – July 2013 2 Introduction Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder characterized by difficulty paying attention, excessive activity, and impulsivity (acting before you think). ADHD is usually identified when children are in grade school but can be diagnosed at any time from preschool to adulthood. Recent studies indicate that almost 10 percent of children between the ages of 4 to 17 are reported by their parents as being diagnosed with ADHD. So in a classroom of 30 children, two to three children may have ADHD.1,2,3,4,5 Short attention spans and high levels of activity are a normal part of childhood. For children with ADHD, these behaviors are excessive, inappropriate for their age, and interfere with daily functioning at home, school, and with peers. Some children with ADHD only have problems with attention; other children only have issues with hyperactivity and impulsivity; most children with ADHD have problems with all three. As they grow into adolescence and young adulthood, children with ADHD may become less hyperactive yet continue to have significant problems with distraction, disorganization, and poor impulse control. ADHD can interfere with a child’s ability to perform in school, do homework, follow rules, and develop and maintain peer relationships. When children become adolescents, ADHD can increase their risk of dropping out of school or having disciplinary problems.
    [Show full text]
  • 22 Psychiatric Medications for Monitoring in Primary Care
    22 Psychiatric Medications for Monitoring in Primary Care Medication Warnings, Precautions, and Adverse Events Comments Class: SSRI Fluvoxamine Boxed Warnings: Suicidality Used much less than SSRIs in the group of eight Indications: Warnings and Precautions: Similar to other SSRIs medications for prescribing, probably because it has no Adult: OCD Adverse Events: Similar to other SSRIs FDA indication for MDD or any anxiety disorder. Still Child/Adolescent: OCD (10-17 years) somewhat popular as a medication for OCD. Uses: Anxiety, OCD Monitoring: Same as other SSRIs Citalopram Boxed Warning: Suicidality. Escitalopram, one of the SSRIs in the group of Indications: Warnings and Precautions: Similar to other SSRIs medications for prescribing, is an active metabolite of Adult: MDD Adverse Events: Similar to other SSRIs citalopram. Escitalopram reportedly has fewer AEs and Child/Adolescent: None less interaction with hepatic metabolic enzymes than Uses: Anxiety, MDD, OCD citalopram but is otherwise essentially identical. Citalopram offers no advantage other than price, as Monitoring: Same as other SSRIs escitalopram is branded until 2012. Paroxetine Boxed Warnings: Suicidality. Paroxetine used much less than the SSRIs for Indications: Warnings and Precautions: Similar to other SSRIs prescribing, probably because of its nonlinear kinetics. Adult: MDD, OCD, Panic Disorder, Generalized Anxiety Adverse Events: Similar to other SSRIs A study of children and adolescents showed doubling Disorder, Social Anxiety Disorder, Posttraumatic Stress Disorder the dose of paroxetine from 10 mg/day to 20 mg/day Child/Adolescent: None resulted in a 7-fold increase in blood levels (Findling et Uses: Anxiety, MDD, OCD al, 1999). Thus, once metabolic enzymes are saturated, paroxetine levels can increase dramatically with dose Monitoring: Same as other SSRIs increases and decrease dramatically with dose decreases, sometimes leading to adverse events.
    [Show full text]
  • Drugs That Can Cause Delirium (Anticholinergic / Toxic Metabolites)
    Drugs that can Cause Delirium (anticholinergic / toxic metabolites) Deliriants (drugs causing delirium) Prescription drugs . Central acting agents – Sedative hypnotics (e.g., benzodiazepines) – Anticonvulsants (e.g., barbiturates) – Antiparkinsonian agents (e.g., benztropine, trihexyphenidyl) . Analgesics – Narcotics (NB. meperidine*) – Non-steroidal anti-inflammatory drugs* . Antihistamines (first generation, e.g., hydroxyzine) . Gastrointestinal agents – Antispasmodics – H2-blockers* . Antinauseants – Scopolamine – Dimenhydrinate . Antibiotics – Fluoroquinolones* . Psychotropic medications – Tricyclic antidepressants – Lithium* . Cardiac medications – Antiarrhythmics – Digitalis* – Antihypertensives (b-blockers, methyldopa) . Miscellaneous – Skeletal muscle relaxants – Steroids Over the counter medications and complementary/alternative medications . Antihistamines (NB. first generation) – diphenhydramine, chlorpheniramine). Antinauseants – dimenhydrinate, scopolamine . Liquid medications containing alcohol . Mandrake . Henbane . Jimson weed . Atropa belladonna extract * Requires adjustment in renal impairment. From: K Alagiakrishnan, C A Wiens. (2004). An approach to drug induced delirium in the elderly. Postgrad Med J, 80, 388–393. Delirium in the Older Person: A Medical Emergency. Island Health www.viha.ca/mhas/resources/delirium/ Drugs that can cause delirium. Reviewed: 8-2014 Some commonly used medications with moderate to high anticholinergic properties and alternative suggestions Type of medication Alternatives with less deliriogenic
    [Show full text]
  • TAYSIDE PRESCRIBER Issue No
    TAYSIDE PRESCRIBER Issue No. 122 – May 2012 Produced by the NS Tayside Medicines Governance Unit in conjunction with Mental Health Citalopram & escitalopram:QT interval prolongation New maximum daily dose restrictions, contraindications, and warnings Information has been issued via Drug Safety Update, Volume 5, Issue 5, December 2011 and ‘Dear Healthcare Professional Letters’ for both citalopram and escitalopram regarding new restrictions on the maximum daily doses, contraindications, and warnings. This is as a result of an assessment of a QT study that revealed dose-dependent increase in the QT interval observed with ECG monitoring for both citalopram and escitalopram. Maximum licensed daily doses for citalopram and escitalopram Adults Adults > 65 years Adults with hepatic impairment Citalopram 40 mg 20 mg 20 mg Escitalopram (non-formulary) 20 mg 10 mg 10mg The guidance in NHS Tayside is: ⇒ to review all patients on high dose* citalopram or escitalopram with aim of reducing to new maximum licensed doses ( * above new maximum licensed daily doses as stated in the table above) ⇒ not to prescribe citalopram or escitalopram with other medication known to prolong the QT interval ⇒ not to prescribe citalopram and escitalopram in patients with known QT prolongation or congenital long QT syndrome ⇒ to consider alternative antidepressant in patients with cardiac disease ( e.g. patients with significant bradycardia; recent myocardial infarction or decompensated heart failure) See flow diagram on page 3 for further guidance and table below on medicines known to prolong the QT interval. Medicines known to increase plasma levels of citalopram or escitalopram, e.g. omeprazole & some antivirals may require dose reduction of citalopram or escitalopram and should be used with caution.
    [Show full text]
  • Headshop Highs & Lows
    HeadshopHeadshop HighsHighs && LowsLows AA PresentationPresentation byby DrDr DesDes CorriganCorrigan HeadshopsHeadshops A.K.A.A.K.A. ““SmartSmart ShopsShops””,, ““HempHemp ShopsShops””,, ““HemporiaHemporia”” oror ““GrowshopsGrowshops”” RetailRetail oror OnlineOnline OutletsOutlets sellingselling PsychoactivePsychoactive Plants,Plants, ‘‘LegalLegal’’ && ““HerbalHerbal”” HighsHighs asas wellwell asas DrugDrug ParaphernaliaParaphernalia includingincluding CannabisCannabis growinggrowing equipment.equipment. Headshops supply Cannabis Paraphernalia HeadshopsHeadshops && SkunkSkunk--typetype (( HighHigh Strength)Strength) CannabisCannabis 1.1. SaleSale ofof SkunkSkunk--typetype seedsseeds 2.2. AdviceAdvice onon SinsemillaSinsemilla TechniqueTechnique 3.3. SaleSale ofof HydroponicsHydroponics && IntenseIntense LightingLighting .. CannabisCannabis PotencyPotency expressedexpressed asas %% THCTHC ContentContent ¾¾ IrelandIreland ¾¾ HerbHerb 6%6% HashHash 4%4% ¾¾ UKUK ¾¾ HerbHerb** 1212--18%18% HashHash 3.4%3.4% ¾¾ NetherlandsNetherlands ¾¾ HerbHerb** 20%20% HashHash 37%37% * Skunk-type SkunkSkunk--TypeType CannabisCannabis && PsychosisPsychosis ¾¾ComparedCompared toto HashHash smokingsmoking controlscontrols ¾¾ SkunkSkunk useuse -- 77 xx riskrisk ¾¾ DailyDaily SkunkSkunk useuse -- 1212 xx riskrisk ¾¾ DiDi FortiForti etet alal .. Br.Br. J.J. PsychiatryPsychiatry 20092009 CannabinoidsCannabinoids ¾¾ PhytoCannabinoidsPhytoCannabinoids-- onlyonly inin CannabisCannabis plantsplants ¾¾ EndocannabinoidsEndocannabinoids –– naturallynaturally occurringoccurring
    [Show full text]
  • Beta Blocker
    Medication Information Beta Blocker Other names for this medication Acebutol Nadolol Atenolol Pindolol Bisoprolol Propanolol Carvediol Sotalol Labetalol Timolol Metoprolol There are many other names for this medication. How this medication is used This medication causes your heart to beat slower. This helps rest the heart after a heart attack. This medication helps prevent and/or reduce chest pain and irregular heart beats. It does not stop chest pain or angina after the pain has started. Bisoprolol, Carvedilol and Metoprolol can be used to prevent heart failure. They work by relaxing the blood vessels. This allows more blood to go to the heart. The more blood that goes to the heart, the more oxygen the heart gets. This helps the heart work better. Some of these medications are used to treat high blood pressure, migraine headaches and muscle tremors. Beta Blocker How to take this medication Take this medication exactly as directed by your doctor or health care provider. It must be taken regularly, even if you feel well. Do not suddenly stop taking this medication without checking with your doctor or health care provider first. Suddenly stopping this medication can cause: • chest pain • irregular heart beats • high blood pressure. When it is time to stop taking this medication your doctor or health care provider may slowly decrease the amount. If you miss a dose of this medication, take it as soon as possible. However, if it is almost time for the next dose, skip the missed dose and go back to your regular time. Do not take 2 doses at one time.
    [Show full text]
  • The Psychoactive Effects of Psychiatric Medication: the Elephant in the Room
    Journal of Psychoactive Drugs, 45 (5), 409–415, 2013 Published with license by Taylor & Francis ISSN: 0279-1072 print / 2159-9777 online DOI: 10.1080/02791072.2013.845328 The Psychoactive Effects of Psychiatric Medication: The Elephant in the Room Joanna Moncrieff, M.B.B.S.a; David Cohenb & Sally Porterc Abstract —The psychoactive effects of psychiatric medications have been obscured by the presump- tion that these medications have disease-specific actions. Exploiting the parallels with the psychoactive effects and uses of recreational substances helps to highlight the psychoactive properties of psychi- atric medications and their impact on people with psychiatric problems. We discuss how psychoactive effects produced by different drugs prescribed in psychiatric practice might modify various disturb- ing and distressing symptoms, and we also consider the costs of these psychoactive effects on the mental well-being of the user. We examine the issue of dependence, and the need for support for peo- ple wishing to withdraw from psychiatric medication. We consider how the reality of psychoactive effects undermines the idea that psychiatric drugs work by targeting underlying disease processes, since psychoactive effects can themselves directly modify mental and behavioral symptoms and thus affect the results of placebo-controlled trials. These effects and their impact also raise questions about the validity and importance of modern diagnosis systems. Extensive research is needed to clarify the range of acute and longer-term mental, behavioral, and physical effects induced by psychiatric drugs, both during and after consumption and withdrawal, to enable users and prescribers to exploit their psychoactive effects judiciously in a safe and more informed manner.
    [Show full text]
  • Antidepressants for Functional Gastrointestinal Disorders
    Antidepressants for the treatment of Functional Gastrointestinal Disorders Commonly IBS, constipation, diarrhea, functional abdominal pain and esophageal hypersensitivity Document adapted from literature available from the UNC Center for Functional GI & Motility Disorders What are Functional Gastrointestinal Disorders (FGIDs)? There are many different FGIDs (over 20), but among them, IBS is the most common. FGIDs are characterized by abnormal changes in the movement of muscles throughout the intestines (motility abnormality), an increase in the sensations produced by digestive tract activity (visceral hypersensitivity), and brain-gut dysfunction, especially in the brain’s ability to regulate painful signals from the GI tract. People with IBS have an increased awareness and interpretation of these activities as being abnormal. Motility Abnormality Visceral Hypersensitivity Brain-Gut Dysfunction Instead of normal muscular People with IBS, and other When nerve impulses from the gut reach activity (motility) during digestion, FGIDs, may experience an the brain, they may be experienced as people with IBS may experience increased sensitivity in the more severe or less severe based on the painful spasms and cramping. If nerves of the GI tract. This can regulatory activity of the brain-gut axis. motility is too fast it may produce happen after a GI infection or Signals of pain or discomfort travel from diarrhea and if it is too slow it operation which causes injury the intestines back to the brain. The may result in constipation. Motility to the nerves. This produces a brain usually has the ability to “turn abnormalities may be associated lower pain threshold for normal down” the pain by sending signals that with: cramping, belching, digestive sensations, leading to block nerve impulses produced in the GI urgency, and abdominal pain and discomfort.
    [Show full text]
  • Pharmacology 101
    Pharmacology 101 Tyler Fischback, PharmD, BCPS, DPLA Clinical Pharmacy Manager Confluence Health Wenatchee, WA Objectives • Define Pharmacology, Pharmacokinetics and Pharmacodynamics • Understand how drug interactions work • Understand how some specific drugs behave in the body (opioids, benzodiazepines, amiodarone) • Apply pharmacology principles into practice Medication Errors and Adverse Drug Events • Error: An error of commission or omission at any step along the pathway that begins when a clinician prescribes a medication and ends when the patient actually received the medication. • ADE: Harm experienced by a patient as a result of exposure to a medication. ADE does not necessarily indicate an error or poor care. However, ~1/2 of ADEs are preventable. Anyone here ever seen a medication error or adverse drug event? Anyone here ever made a medication error? How many different prescription medications are available on the U.S. market? 1,000 So, it’s no surprise why we see so many problems………………… EXCEPT……. The real number is 10,000 Adverse Drug Events • ~1/3 of U.S. adults use 5 or more medications • Annually, ADE = 700,000 ER visits and 100,000 hospitalizations • So, is pharmacology important to your work? • Additionally, 5% of hospitalized patient experience an ADE during their stay • High risk: Anticoagulants, Opioids, Insulin, Cardiac, and Transitions of Care Adverse Drug Events, cont. • Elderly are more susceptible • Pediatrics patients more susceptible (weight-based dosing), especially liquids • Caregivers and patients admittedly
    [Show full text]
  • Specialty Pharmacy Drug List
    Specialty Pharmacy Drug List Our Specialty Pharmacy provides patients with comprehensive support services and coordinated delivery related to high-cost oral, inhaled or injectable specialty medications, used to treat complex conditions. We are your single source for high-touch patient care management to control side effects, patient support and education to ensure compliance or continued treatment, and specialized handling and distribution of medications directly to the patient or care provider. Specialty medications may be covered under either the medical or pharmacy benefit. Please consult your insurance documentation to determine which benefit covers these medications. We offer a broad specialty medication list containing nearly 500 drugs, covering 42 therapeutic categories and specialty disease states. This list is updated with new information each quarter. Characteristics of Specialty Medications “Specialty” medications are defined as high-cost oral or injectable medications used to treat complex chronic conditions. These are highly complex medications, typically biology-based, that structurally mimic compounds found within the body. High-touch patient care management is usually required to control side effects and ensure compliance. Specialized handling and distribution are also necessary to ensure appropriate medication administration. Medications must have at least one of the following characteristics in order to be classified as a specialty medication by Magellan Rx Management. High Cost High Complexity High Touch High-cost medications
    [Show full text]