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Redalyc.Utilisation of Atypical Antipsychotic Drugs in Institutionalised Elderly Persons and Prevalence of Metabolic Alterations Farmacia Hospitalaria ISSN: 1130-6343 [email protected] Sociedad Española de Farmacia Hospitalaria España Martínez Romero, G.; Peris Martí, J.F.; Gomar Fayos, J.; Navarro Gosalbez, M.; Quintana Vargas, I.; Muelas Tirado, J. Utilisation of atypical antipsychotic drugs in institutionalised elderly persons and prevalence of metabolic alterations Farmacia Hospitalaria, vol. 34, núm. 3, 2010, pp. 139-147 Sociedad Española de Farmacia Hospitalaria Madrid, España Available in: http://www.redalyc.org/articulo.oa?id=365961366004 How to cite Complete issue Scientific Information System More information about this article Network of Scientific Journals from Latin America, the Caribbean, Spain and Portugal Journal's homepage in redalyc.org Non-profit academic project, developed under the open access initiative Documento descargado de http://www.elsevier.es el 09/12/2012. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato. Farm Hosp. 2010; 34(3): 139−147 Volumen 34. Número 1. Enero-Febrero 2010 ÓRGANO OFICIAL DE EXPRESIÓN CIENTÍFICA DE LA SOCIEDAD ESPAÑOLA DE FARMACIA HOSPITALARIA Originales 1 Evaluación de un programa de conciliación e información al paciente trasplantado cardíaco J. Hernández Martín, M. Montero Hernández, I. Font Noguera, L. Doménech Moral, V. Merino Sanjuán y J.L. Poveda Andrés 9 Intervención farmacéutica en el ámbito de la nutrición parenteral D. Sevilla Sánchez, M.M. Placeres Alsina, M.T. Miana Mena, E. López Suñé, C. Codina Jané y J. Ribas Sala 16 Role of “health-related quality of life” measurements in the design of drug clinical trials R. San Miguel, V. del Villar, C. Pérez, M. de Frutos, J. Mar y M.J. Coma Originales breves 23 Influencia del tiempo de perfusión de pamidronato en la función renal de pacientes Farmacia con mieloma múltiple F. Sierra, E. Román, C. Barreda, M. Moleón, J. Pastor y A. Navarro 27 Determinación de linezolid en fluidos biológicos mediante cromatografía líquida de alta eficacia L. Guerrero, M. Sarasa, Y. López y D. Soy Revisión 32 Resistencia a la aspirina: prevalencia, mecanismos de acción y asociación con eventos tromboembólicos. Revisión narrativa L. Cañivano Petreñas y C. García Yubero Cartas al Director HOSPITALARIA 44 Mifepristona como alternativa en el tratamiento de una coriorretinopatía serosa crónica L. Sánchez-Pacheco Tardón, A. Pardo Saiz, J. Nebot Martínez y S. Jornet Montaña 45 Insuficiencia renal por rabdomiolisis inducida por simvastatina en un paciente con hipotiroidismo subclínico E. Requena Carrión, L. Ayala Jiménez y F. Sierra García 47 Tratamiento con antitoxina botulínica en dos casos de botulismo alimentario M. Tejada García y C. Guindel Jiménez 48 Cidofovir tópico para el tratamiento de verrugas plantares A. Troncoso Mariño, J.R. Cuiña González, M.T. Inaraja Bobo y F. Allegue Rodríguez 50 Síndrome de resistencia insulínica tipo B M. García Palomo, J.M. Martínez Sesmero y P. Moya Gómez www.elsevier.es/farmhosp 52 Agradecimientos www.elsevier.es/farmhosp ORIGINAL ARTICLE Utilisation of atypical antipsychotic drugs in institutionalised elderly persons and prevalence of metabolic alterations G. Martínez Romero, a, * J.F. Peris Martí, a J. Gomar Fayos, b M. Navarro Gosalbez, b I. Quintana Vargas, a and J. Muelas Tirado b aServicio de Farmacia, Centro Sociosanitario de La Cañada (Valencia), Valencia, Spain bServicio de Ordenación y Control del Medicamento, Dirección General de Farmacia y Productos Sanitarios, Conselleria de Sanitat, Valencia, Spain Received November 12, 2008; accepted October 21, 2009 KEYWORDS Abstract Atypical Objectives: Describe and evaluate the use of atypical antipsychotics on the institutionalized antipsychotics; elderly population of the Valencian Community and prevalence of associated metabolic Elderly; disorders. Metabolic disorder; Material and methods: Multicentre transversal descriptive study on drug use and case-control of Drug use; the prevalence of disorders of glycaemia, cholesterol and triglycerides. The statistical analysis Social health centre of metabolic disorders is performed on the difference in prevalence and its statistical signicance between control and study groups. Results: Six hundred eighty-one patients were included (study group: 344; control group: 337) from 20 social-health-care centres. 18.5% of the institutionalized patients are being treated with atypical antipsychotics. The most frequent diagnoses are: behavioural disorders associated with dementia (63.6%) and schizophrenia (18.4%). Risperidone is the most frequently used antipsychotic (66.0%). For all the drugs in general the doses used adjusted to those recommended for the elderly patients. The prevalence of disorders in glucose, cholesterol and triglyceride metabolism in the group under study is 23.96%, 34.83%, and 26.29%, respectively, with no statistically signicant differences from the control group. The analysis by type of drug did not show signicant differences. Conclusions: The results obtained show that use of atypical antipsychotics in elderly patients complies with the established general recommendations. The doses used in elderly patients with behavioural disorders associated with dementia, mostly treated with risperidone, do not have a signicant impact on the prevalence of metabolic disorders. © 2008 SEFH. Published by Elsevier España, S.L. All rights reserved. *Corresponding author. E-mail address: [email protected] (G. Martínez Romero). 1130-6343/$ - see front matter © 2008 SEFH. Published by Elsevier España, S.L. All rights reserved. Documento descargado de http://www.elsevier.es el 09/12/2012. Copia para uso personal, se prohíbe la transmisión de este documento por cualquier medio o formato. 140 G. Martínez Romero et al PALABRAS CLAVE Utilización de fármacos antipsicóticos atípicos en ancianos institucionalizados Antipsicóticos y prevalencia de alteraciones metabólicas atípicos; Anciano; Resumen Alteración Objetivos: Describir y evaluar la utilización de antipsicóticos atípicos en la población anciana metabólica; institucionalizada de la Comunidad Valenciana y la prevalencia de alteraciones metabólicas Utilización de asociadas. medicamentos; Material y métodos: Estudio multicéntrico, descriptivo y transversal de utilización de medica- Centro sociosanitario mentos y caso-control de la prevalencia de las alteraciones de la glucemia, colesterol y triglicé- ridos. El análisis estadístico de las alteraciones metabólicas se realiza a partir de la diferencia de prevalencia y su signicación estadística entre el grupo control y estudio. Resultados: Se incluyen 681 pacientes (grupo estudio: 344; grupo control: 337) de 20 centros sociosanitarios. El 18,5% de los pacientes institucionalizados está en tratamiento con antipsicó- ticos atípicos. Los diagnósticos más frecuentes son alteraciones de conducta asociada a la de- mencia (63,6%) y a la esquizofrenia (18,4%). La risperidona es el fármaco antipsicótico más uti- lizado (66,0%). En general, para todos los fármacos, las dosis utilizadas se ajustan a las recomendadas en el paciente anciano. La prevalencia de alteraciones en el metabolismo de la glucosa, el colesterol y los triglicéridos en el grupo de estudio es del 23,96, el 34,83 y el 26,29%, respectivamente, no encontrándose diferencias estadísticamente signicativas con respecto al grupo control. El análisis por tipo de fármaco no muestra diferencias signicativas. Conclusiones: Los resultados obtenidos muestran que la utilización de antipsicóticos atípicos en el paciente anciano sigue en líneas generales las recomendaciones establecidas. Las dosis utili- zadas en el paciente anciano con alteraciones de conducta asociadas a la demencia, mayorita- riamente tratado con risperidona, no tienen un impacto signicativo sobre el au mento de la prevalencia de alteraciones metabólicas. © 2008 SEFH. Publicado por Elsevier España, S.L. Todos los derechos reservados. Introduction problems, lipid metabolism disorders, and diabetes, all metabolic disorders. 7 It has been postulated that antagonism The elderly patient with dementia usually develops of the serotonin receptor 5HT 1A that these drugs cause behavioural disorders that include more or less severe could inhibit insulin secretion and contribute to these episodes of psychosis, hallucinations, and both verbal and adverse metabolic effects. 8 In May of 2004, the Spanish physical aggressiveness. Non-pharmacological strategies are Agency for Drug and Health Products, along with the considered to be the first choice for the treatment of these European Medicines Agency, published a note on the symptoms, 1 but in many cases these are difficult to publication of studies indicating a significant increase in implement in clinical practice or prove to be poor, and mortality and cerebrovascular accidents in patients treated consequently, drug treatment is required. Typical or with atypical antipsychotics for behavioural disorders conventional antipsychotics, such as haloperidol, reveal associated with dementia. In April, 2005, the Food and Drug discreet efficiency and an unfavourable adverse effect Administration published a report on the use of atypical profile in the treatment of behavioural disorders in antipsychotics in patients with dementia, associating it with dementia. 2 Atypical, or second-generation antipsychotics an increased risk of death compared with placebo are considered to have a more favourable adverse effect treatments. 9 With this background information, along with profile 3 and are currently the first choice for treatment of the scarcity of
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