• Title/Summary/Keyword: psychiatric drugs

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Behavioral Toxicity of Psychotropic Drugs (향정신성약물의 행동학적 독성)

  • Yoon, Jin-Sang
    • Korean Journal of Biological Psychiatry
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    • v.5 no.1
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    • pp.46-55
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    • 1998
  • Any compound which disrupts the integrity of psychological aspects of performance, in particular, cognitive ability and psychomotor function analogous to the psychological behaviors of routine life, is known to be behaviorally toxic. A significant level of behavioral toxicity will interfere with patient safety and quality of life, and also may be counter-therapeutic by exacerbating the condition that the drug was prescribed for. Now, behavioral toxicity of psychotropic drugs has become one of the main growth areas of psychopharmacological research. Evaluation of the potential of drug-induced behavioral toxicity is important not only to the experimental researcher involved in human psychopharmacology, but also to the clinical practitioner treating psychiatric patients. This article attempts to describe behavioral toxicity of the three classes of psychotropic drugs - benzodiazepines, antidepressants and neuroleptics. After a brief discussion of some methodological issues arising in the investigation of behavioral toxicity, each of these drug classes is reviewed in the context of practical importance rather than purely scientific concern. The last session summarizes some suggestions for future studies on drug-induced behavioral toxicity.

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Therapeutic Drug Monitoring (TDM) of Psychotropic Drugs (향정신성약물의 치료적 약물농도 검사)

  • Yang, Byung-Hwan
    • Korean Journal of Biological Psychiatry
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    • v.5 no.1
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    • pp.56-65
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    • 1998
  • Clinicians can use therapeutic drug monitoring(TDM) to optimise dosage decisions with psychotropic drugs, in order to maximize efficacy and prevent toxicity, especially when individuals are nonresponsive to treatment or vulnerable to adverse reactions with standard doses because age, disease states or drug interactions. Currently, therapeutic drug concentrations have been established for the TCA and lithium. There is also evidence for the usefulness of TDM with carbamazepine, valproic acid and some antipsychotic drugs. However for most psychotropic drugs this approach remains experimental. TDM-assisted psychiatric treatment is potentially useful and cost effective, particularly when applied by psychiatrists who are knowledgeable of pharmacokinetics and pharmacodynamics.

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Psychosomatic Management of Medically Ill Elderly : Focused on Consultation Psychiatry (신체질환이 있는 노인 환자의 정신신체 의학적 치료 : 자문정신의학을 중심으로)

  • Ryu, Seong-Gon;Kwon, Hee-Jung
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.1
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    • pp.25-30
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    • 2008
  • With the rapid growth of geriatric population, geriatric psychiatric consultation has come to play a more important role in recent years. It is necessary to find out characteristics of psychiatric consultation-liaison in elderly and applicate practical guideline of consultation in medical setting. Management of medically ill elderly in psychiatric consultation requires different guideline from that of other age group patient. Because aging and each organ-specific diseases change the pharmacokinetics of psychotropic drugs variably. These pharmacokinetic changes should be considered in psychosomatic treatment in medically ill elderly. The relatively low consultation rates for psychiatric disorders in the elderly indicate that research is needed into factors that both prevent and facilitate elderly patients with psychological symptoms from consulting their general practitioners.

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Review of Nursing Research on Psychotropic Drugs in Korea (정신약물 복용과 관련된 국내 간호연구의 고찰)

  • Lee, Jongeun;Bae, Jeongyee;Im, Sookbin
    • Journal of Korean Public Health Nursing
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    • v.27 no.2
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    • pp.338-356
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    • 2013
  • Purpose: This study critically reviewed nursing research psychotropic drugs that has been published in Korean journals. Another aim of this study was to identify trends in nursing research on psychotropic drugs and make suggestions for further study in Korea. Methods: Data were collected from degree theses and original articles on psychotropic drugs published in Korean journals from 1992 to 2013. Thirty-four articles were analyzed of which at least one nursing author participated in the study. Search keywords were "psychotropic drug" and "mentally ill patient & medication". Results: For the research design, quasi-experimental study was 58.8%, descriptive study was 17.7%, descriptive correlational study was 8.8%, qualitative study was 8.8% and model development research was 5.9%. Variables measured were knowledge of medication & symptom management, knowledge of disease, side effects, drug attitude, medication pattern, diet & activity, quality of life, and self-care. Conclusion: Despite recent increased interest in psychiatric medication, research on psychotropic drugs remains very limited, particularly regarding findings from a nurse's perspective. More research project should be designed to develop programs for the treatment of side effects from a nursing view-point.

Real-world Adverse Events Associated with Fluconazole and Itraconazole: Analysis of Nationwide Data Using a Spontaneous Reporting System Database (의약품부작용보고시스템 데이터베이스를 이용한 fluconazole 및 itraconazole 관련 이상사례 분석)

  • Lee, Yu gyeong;Lee, Jungmin;Chun, Pusoon
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.3
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    • pp.204-214
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    • 2022
  • Objective: This study aimed to investigate the occurrence and types of the adverse events (AEs) associated with oral fluconazole and itraconazole and factors associated with specific types of AEs. Methods: We analyzed AEs reported by community pharmacies nationwide over 10 years using the Korea Adverse Event Reporting System database. Various AE terms were categorized into 18 types, and concomitant medications were classified by drug-drug interaction (DDI) severity. The relationship between the specific type of AE and age, sex, and number of concomitant medications was investigated using multiple logistic regression analysis. Results: A total of 879 AE reports of fluconazole and 401 reports of itraconazole were analyzed; of these reports, 321 and 83 reports of fluconazole and itraconazole, respectively, described concomitant drug administration categorized as DDI severity of contraindicated or major. Women had a higher risk of psychiatric AEs associated with fluconazole use (OR, 1.587; p=0.042). Polypharmacy increased the risk for psychiatric AEs (OR, 3.598; p<0.001 for fluconazole and OR, 2.308; p=0.046 for itraconazole). In dermatologic AEs, the mean age of patients who received itraconazole was lower than that of patients who received fluconazole (46.3±16.8 vs. 54.9±15.4; p<0.001). Co-administration of fluconazole with 1-3 drugs increased the risk of neurological AEs (OR, 1.764; p=0.028). Conclusion: When using fluconazole and itraconazole, psychiatric AEs should be noted, particularly in women and in case of polypharmacy; moreover, when fluconazole is co-administered with other drugs, attention should be paid to the occurrence of neurological AEs.

Biological Monitoring on the Absorption of Antineoplastic Drugs in Nursing Personnel (항암제 취급간호사의 항암제 체내흡수에 관한 조사)

  • 김봉임
    • Journal of Korean Academy of Nursing
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    • v.27 no.3
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    • pp.520-530
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    • 1997
  • Antineoplastic agents may exhibit effects not only in patients therapeutically exposed, but also in health workers who prepare and administer these drugs. This study was done to clarify whether nurses who handle anticancer drugs show signs of drug absorption. The experimental group was 14 nurses handling anticancer drugs at three medical wards of a hospital in J city ; the control group was 12 psychiatric nurses at the same hospital. The test materials were the nurses' 24hr urine specimens, which were concentrated by XAD-2 column chromatograpy. Tester strains were TA98(±S9mix), TA100(±S9 mix), TA1535(±S9 mix) and TA1537(±S9 mix) : the salmonella mammalian microsomal test (Ames test) was used for the urinary mutagenicity assay. The results are summarized as follow : 1. In qualitative analysis of the results, both experimental group and control group showed 15.4% urine toxicity. 2. The experimental group revealed significantly higher urinary mutagenicity both in the activation method test and non-activation method test of the tester strains TA98, TA100 and TA1535. In the case of TA1537, the two groups showed no difference in the non-activation method test, but the activation method revealed a difference. 3. In urinary mutagenicity of the experimental group by ward career, there was a significant difference between the group with more than 20 months experience and the group with less than 20 months on the tester strains TA98, TA100, and TA1537. No Significant difference was found between two groups by the tester strain TA1535.

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The Prescribing Patterns of Antipsychotic Drugs and Antiparkinsonian Drugs in Elderly Patients with Dementia (노인 치매 환자의 항정신병약물 및 항파킨슨약물 처방 현황)

  • Yoon, Soo Mi;Lee, Sungwon;Chang, Ji-Eun;Lee, Young Sook;Rhew, Kiyon
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.2
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    • pp.81-86
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    • 2020
  • Background: The number of patients with dementia continues to increase as the age of aging continues to grow. Psychiatric symptoms caused by senile dementia are controlled using antipsychotics. However, these antipsychotics can lead to Parkinson's disease, and abuse of dopamine derivatives such as levodopa among Parkinsonian drugs can lead to psychosis. Therefore, we evaluated the patterns of prescribed antipsychotics and antiparkinsonian drugs in patients with senile dementia. Methods: We used data from the sample of elderly patients from the Health Insurance Review and Assessment Service (HIRA-APS-2016). We analyzed the patterns of prescribing antipsychotics and antiparkinsonian drugs including prescribed daily dosage, period of prescription, and number of patients with both antipsychotics and antiparkinsonian drugs for senile dementia. Results: Among the 159,391 patients with dementia included in this analysis, 4,963 patients (3.1%) and 16,499 patients (10.4%) were prescribed typical and atypical antipsychotic drugs, respectively. The most frequently prescribed typical antipsychotic was haloperidol (4,351 patients with dementia), whereas the atypical agent was quetiapine (12,719 patients). The most frequently prescribed antiparkinsonian drugs were in the order of levodopa/carbidopa, benztropine, and ropinirole. In addition, 1,103 and 3,508 patients prescribed typical and atypical antipsychotics, respectively, were co-prescribed antiparkinsonian drugs. Conclusions: Atypical antipsychotics were the preferred prescription in patients with senile dementia. The prescription dose was relatively low; however, the average treatment duration was mostly long-term. Selection of antipsychotics and/or antiparkinsonian drugs should be made carefully in senile dementia and the causal relationship of adverse drug reactions needs further study.

Analysis of Clinical Characteristics by Gender in Children and Adolescents with Intentional Poisoning at Emergency Department (의도적 음독으로 응급실에 내원한 소아 청소년 환자들의 성별에 따른 특성 분석)

  • Kim, Yun Jae;So, Byung Hak;Kim, Hyung Min;Jeong, Won Jung;Cha, Kyeong Man;Kim, Seong Wook
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.2
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    • pp.63-69
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    • 2014
  • Purpose: The aim of this study is to investigate the difference between male and female in some clinically meaningful aspects and to prevent intentional poisoning in children and adolescents. Methods: Retrograde medical records review of patients who visited the emergency department of two secondary hospitals for drug ingestion from March 2010 through March 2013 was performed. Unintentional ingestion or ingestion by others was excluded. Results: A total of 138 cases were reported, male 25.4% (n=35), female 74.6% (n=103). The reason for poisoning was intentional in 132 cases (95.7%) and misuse in six cases (4.3%). In female patients, non-prescription drugs was the most common cause of intentional poisoning (68.9%). Male patients tend to use life substances for intentional poisoning more frequently (20.0%) than female (3.9%). Seven male patients and 12 female patients had previous psychiatric history and 34.3% of male and 41.7% of female were consulted to the psychiatric department. Conclusion: Female adolescents are more likely to ingest drugs intentionally for suicide attempt than males of comparable ages. The drugs they ingested were, in many cases, obtained with ease from the drug store nearby and, remarkably, most of the drugs they obtained in that way were acetaminophen-containing. This suggests that some guidelines or control in the pharmacy that restrict children or adolescents from obtaining potentially or possibly life-threatening drugs might be necessary. In addition, education regarding drugs is thought to be necessary in school for teenagers as they tend to misuse them with incorrect acknowledgement.

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Neuropsychiatric Aspects of Pulmonary Disease (호흡기 질환의 신경정신과적 측면)

  • Nam, Beom-Woo
    • Korean Journal of Psychosomatic Medicine
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    • v.17 no.2
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    • pp.45-51
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    • 2009
  • Pulmonary diseases distress millions of people worldwide. Numerous studies have shown an association between pulmonary disease and psychiatric disorders. Despite this, little is known about the treatment of psychiatric disorder in patients with pulmonary disease. The three main goals of this article are 1) to discuss the major disorders such as asthma, chronic obstructive pulmonary disease, hyperventilation, tuberculosis, lung cancer that most clinicians see in practice, 2) to provide an information about psychiatric treatment such as anxiety, depression, psychosis in pulmonary disease, and 3) to provide some clinically relevant suggestions about pharmacologic interactions between pulmonary and psychotropic drugs.

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Neuroinflammation and Psychiatric Illness (신경염증과 정신질환)

  • Song, Hoo Rim;Lee, Hwa-Young;Shim, Se-Hoon;Kwon, Young-Joon
    • Korean Journal of Biological Psychiatry
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    • v.23 no.1
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    • pp.12-17
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    • 2016
  • Neuroinflammation is one of important allostatic loads contributory to the various psychiatric illness. It is mediated mainly by glial cells, which produce both proinflammatory and antiinflammatory cytokines, and the balance of them determines the inflammatory process in the central nervous system. S100 calcium-binding protein B, which is used as an inflammatory marker is also released by glial cells. In the molecular level, oxidative stress contributes to the neuroinflammation. Their disturbances have been revealed in the psychiatric illness and related with the dysregulation of the glutamatergic and monoaminergic systems. There is a possibility to use them as disease markers. The approach for inflammation using antiinflammatory drugs and antioxidants could be connected to the development of disease-modifying treatments. Also, a searching examination about specific subtypes who are vulnerable to inflammation in the patients is required to confirm their efficacy clearly.