Managing patient on anti-psychotic medication Managing patient on anti-psychotic medication According to an estimate of general population, the lifetime prevalence of psychotic disorders has rose from a previous of 3.06percent to 3.84percent. According to the report, lifetime prevalence of schizoaffective disorder is 0.32percent, 0.07percent for schizophreniform disorder, 0.87percent for schizophrenia, 0.34percent for bipolar I disorder, 0.35percent for major depressive disorder, 0.21percent for psychotic disorders induced by a general medical disorder and 0.42percent for substance-induced psychotic disorders (Perala, et al., 2007). Psychotic disorders have been treated with antipsychotic drugs since 1950s when they were introduced for the first time. Since that decade more than twenty of the antipsychotic agents have been introduced in United States. The antipsychotics used during the 1980s are collectively called conventional antipsychotics and the drugs that were introduced in the 1990s are called the atypical antipsychotics. Antipsychotics, unfortunately, have the tendency to be misused if the practitioner has sound knowledge about the psychopharmacological aspects of the drugs. Elderly patients are also at an increased risk of developing drug-induced motor or movement disorders as compared to the younger population (Saltz, Robinson, amp. Woerner, 2004). It is crucial to understand the pharmacological aspects of the antipsychotic drugs as improper management can lead to adverse drug reactions, drug-drug interactions, drug resistances and poor patient compliance. The second generation antipsychotics (SGA) are different from the first generation antipsychotics (FGA) because they also block the serotonin receptors. SGAs also have lesser extrapyrimidal symptoms as compared to the FGAs, however, SGAs ae associated with an increased risk of obesity, hyperglycemia and hyperlipidemia. According to studies only two SGAs cloazipine and olanzipine has been proved to be more effective than the FGAs. Antipsychotics are approved by the FDA for use in schizophrenia as well as some other psychiatric conditions and non-psychiatric disorders. They are also indicated in the treatment of bipolar disorders, autism, generalized anxiety disrder, major depressive disorder, perioperative nausea, preoperative restlessness, severe behavorial probles, severe nausea and vomiting, and refractory tourette syndrome and for the management of neuropsychiatric symptoms of dementia (Moore, DeJoseph, amp. Simmons, 2014). Both SGAs and FGAs are associated with risk factors and it is important to carry out a detailed assessment of the patient before intiating a new regimen. It is important to monitor fasting blood glucose levels, and blood lipid levels of patients taking SGAs and they must be counselled at the same time regarding their side effects, weight control and exercise programs.. It has been warned by the FDA that anti-psychotics are not indicated for the treatment of dementia-related psychosis, however, they still have to be used in certain conditions. In such circumstances, nonpharmacological interventions such as pet therapy, music, light exercise, positive reinforcement should be planned out for the patient (Moore, DeJoseph, amp. Simmons, 2014). Abuse and misuse are feared complications of antipsychotic use and hence constant monitoring and follow-up is advised. Monitoring for diabetes, catarcts, dyslipidemia, EPS, hypertension, leukopenia, menstrual disrders, myocarditis, obesity and QT prolongation should be done on a regular basis to prevent any serious adverse outcomes (Moore, DeJoseph, amp. Simmons, 2014).The information mentioned in the article is quite resourceful as it helps the reader to understand the various adverse effects associated with antipsychotic drugs as well as the steps to be taken to monitor the adverse effects. If a patient is on a first generation antipsychotic and is being treated for dementia related psychosis, this requires close cardiac monitoring, due to increased rike of MI and stoke. Moreover, the patient would have to be given soothing practices to calm the psychotic outbreaks. The article clearly mentions the new and up-dated advancements in the antipsychotic drugs, related adverse effects and their management. This aspect of the article is helpful as nursing mental health management requires up-to-date scientific knowledge. However, the article lacks in explaining the detailed differences between the first generation and second generation antipsychotics.I would recommend this article for reading as it is worthy of time and adds to the knowledge of the reader as well as helping in the clinical wards because of the detailed explanation of the adverse effects related to the antipsychotic drugs. The antipsychotic drugs are widely prescribed in various psychiatirc conditions and they require strict monitoring because of the very smally therapeutic index associated to them. With detailed knowledge and understanding of the psychopharamcology of the drugs, various fatal consequences such as stroke, myocarditis, EPS and MI can be prevented in such patients. ReferencesMoore, R., DeJoseph, D., amp. Simmons, B. B. (2014). Managing patients on anti-psychotics: Your domain, too. The Journal of Family Practice, 142-150.Perala, J., Suvisaari, J., Saarni, S., Kuoppasalmi, K., Isometsa, E., Pirkola, S., . . . Koskinen, S. (2007). Lifetime prevalence of psychotic and bipolar disorders in general population. Archives of General Psychiatry, 19-28.Saltz, B. L., Robinson, D. G., amp. Woerner, M. G. (2004). Recognizing and Managing Antipsychotic Drug Treatment Side Effects in the Elderly. The primary care companion to the journal of clinical Psychiatry, 14-19.
Managing patient on antipsychotic medication