Optimizing Medication Therapy & Improving Outcomes

November 30, 2016

Management of Bipolar Disorder

Bipolar disorder is a chronic illness that causes periodic shifts in mood through episodes of dysthymia, depression, hypomania, and mania. There are two major types of bipolar disorder: bipolar I disorder, which is characterized by the presence of at least one acute manic episode, and bipolar II disorder, which is typified by hypomania and longer depressive episodes and is sometimes misdiagnosed as major depressive disorder. Pharmacotherapeutic options include lithium, anticonvulsants, antipsychotics, and antidepressants. Pharmacists play a role in ensuring proper dosing regimens, checking for drug interactions, and monitoring for potential drug toxicity. When counseling patients, pharmacists should review optimal administration times and potential side effects to make certain that the patient has a comprehensive understanding of how to manage symptoms. Read more.

Barriers to Counseling Patients With Mental Health Disorders

Mental health disorders are a major public health problem worldwide. With the increasing use of psychotropic drugs and other advanced therapies, pharmacists form an important part of the multidisciplinary care team for patients with mental illnesses. One of the primary roles of pharmacists in this field is to counsel patients thoroughly in order to improve adherence and patient outcomes related to drug therapy. A range of barriers may deter pharmacists from counseling patients with mental illnesses, including pharmacist, patient, health system, and social or cultural factors. Interventions to improve the management of mental health patients should focus on enhancing communication and education. Read more.

The Use of Ketamine in the Acute Management of Depression

Ketamine, an antagonist at the N-methyl-d-aspartate (NMDA) receptor, produces rapid antidepressant effects with low, subanesthetic doses of 0.5 mg/kg administered IV over 40 minutes. Response rates range from 25% to 100%, and remission rates range from 8.3% to 89%. Duration of response has been less than 1 week to more than 3 months. Significant hemodynamic and psychiatric adverse effects are seen with the use of ketamine, and its potential for abuse has also raised questions. Research continues to delineate the most effective role for ketamine in depression, and how its use might foster the development of similar agents with a longer duration. Read more.

Medication Therapy Management in the News

Study Questions Cardiovascular Benefit of Raising HDL Levels

A low level of good cholesterol might not be a heart-disease risk factor on its own, and raising HDL does not likely reduce a person's risk of heart disease, according to a new Canadian study. Read more.

COPD Can Be Misdiagnosed Because of Underuse of Spirometry

Nearly a third of patients diagnosed with chronic obstructive lung disease (COPD) were misclassified because spirometric measurements did not confirm their disease, according to a study presented recently at the CHEST Annual Meeting 2016. Read more

Vitamin D Supplementation Linked to Reduced Severe Asthma Attacks

According to a meta-analysis of previous studies by the Cochrane Review, giving an oral vitamin D supplement reduced the risk of severe asthma attacks requiring hospital admission or emergency-department visits from 6% to around 3%. Read more.

Hormone Therapy Linked to Reduced Menopause-Associated Insomnia

Researchers from the University of Virginia administered either placebo or one of two hormone replacements to patients, and results indicate that insomnia and irritability decreased from baseline to 6 months after randomization in all groups. Read more.