Class of 2013 Abstract / Specific Aims: The purpose of the project was to determine if implementation of a detailed pharmacist recommendation form written for providers, could be an effective tool to reduce the use of antipsychotics in the psychiatric nursing home patients with dementia by 15%. Methods: The project was conducted by a pharmacy student and a consultant pharmacist at a single psychiatric nursing home. Thirty recommendations were written to the nursing home providers. The prescribers made comments on the forms and returned them to investigators for analysis. Active orders were compared pre and post pharmacy recommendations. Main Results: Of the 30 interventions, the prescriber addressed 26 (87%) recommendations and agreed to 15 (58%) of them. Nine recommendations involved either a GDR, discontinuation of a medication, or switching to a non-pharmacological method. Six of the nine (66%) recommendations led to the prescriber reducing the dose or discontinuing the medication. Overall, six out of 30 (20%) interventions resulted in a successful reduction of the use of antipsychotics. Conclusion: This project showed that when the prescribers see a more detailed pharmacist written recommendation regarding the therapy, they are more likely to respond with an explanation. However, even though the overall reduction was 20%, black box warnings did not seem to be a deterrent for prescribing in this psychiatric nursing home. Antipsychotics are heavily relied on to control behaviors associated with dementia.

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Charles University in Prague Faculty of Pharmacy in Hradec Králové Department of Pharmacology & Toxicology Student: Lucie Hlinková Supervisor: Prof. MUDr. Radomír Hrdina, CSc. Title of diploma thesis: Treatment of schizophrenia Schizophrenia is a serious mental disease, mostly chronic. It affects about 1 % of population, first episode of the disease occurs mostly between the age of 15 and 35. It manifests itself with disorders of perception, behavior and thinking. The specific symptoms include hallucinations, delusions, disorganized speech and behavior, catatonia, disorders of attention and volition and social withdrawal. Etiopathogenesis of schizophrenia is likely affected by both genetic and environmental factors, the true cause of the disease has not been discovered yet. The goal of the treatment is to improve the patient's quality of life and prevent the occurrence of relapses. Drugs acting on the dopaminergic system are effective in the treatment of schizophrenia, where as antagonists bind to the dopamine receptors. These medicines are called antipsychotics, they are divided into two generations. The first generation is characterized by high affinity mainly for dopamine receptors, the second one in addition by binding to serotonin receptors. Each class of antipsychotics is characterized by the...

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published_or_final_version / Medicine / Master / Master of Medical Sciences

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Thesis (Ph. D.)--University of Texas at Austin, 2008. / Vita. Includes bibliographical references.