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High incidence of pharmacotherapeutic situations in the department of psychiatry of the tertiary hospital
Date Issued |
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2019-06-29 |
Oral Presentation.
Introduction: The role of clinical pharmacologist (CP) is not yet systematically developed in Lithuania. There is a need to analyze and identify clinically meaningful pharmacotherapeutic situations in the tertiary hospital. Objectives: To analyze and identify clinically meaningful pharmacotherapeutic situations in the tertiary hospital. Methods: 33 consecutive patients by psychiatric ICD code (F01-F59) were included from the Department of psychiatry of tertiary hospital in December 2018. The prescribed pharmacotherapy was analyzed by diagnose, efficacy, safety, adverse events, contraindications, drug interactions, off label use, therapeutic drug monitoring. The results are presented as descriptive statistics. Results: Total 156 prescriptions (33 patients: 12 women and 21 men) from the Department of psychiatry were analyzed. Median age was 44 (18; 80). 29 out of 33 patients (87.9%) had at least one pharmacotherapeutic situation. 18 out of 33 patients (54.5%) had efficacy, 25 out of 33 patients (75,8%) had safety situations and 23 out of 33 patients (69.7%) had drug-drug interactions, such as high risk of occurrence of serotoninergic syndrome (5/23 - 21.74%), sedation of central nervous system (CNS) (17/23 – 73.9%), prolongation of QTc interval (6/23 -26.1%). Adverse reactions occurred to 4 patients out of 33 (12.1%), they were an allergic reaction, hyponatremia and signs of dyspepsia. Off label use was identified to 5 out of 33 patients (15.2%), the use of trihexyphenidyl for prophylaxis of extrapyramidal symptoms. Summary / Conclusions: There is a very high risk covering predominantly safety risk as well as efficacy issues and unexpectedly, rather low level of off label use and contraindications in psychiatric patients. There is unexplored use of safer combination of antipsychotics diminishing risk for serotoninergic syndrome, sedation of CNS and prolongation of QTc interval. The reasons why safer alterna...[...].