The Mental Health Clinician最新文献_第8页

COVID-19 reinfection in a patient with a serious mental illness within a long-term inpatient psychiatric care hospital. 在一家长期住院的精神病护理医院中，一名患有严重精神疾病的病人再次感染了 COVID-19。

The Mental Health Clinician Pub Date : 2021-09-24 eCollection Date: 2021-09-01 DOI: 10.9740/mhc.2021.09.292

Brianna Englett, Amy Magdalany, Tiffany L Gordon, Kelly Holladay

引用次数: 0

Intranasal esketamine use in bipolar disorder: A case report. 鼻内使用艾氯胺酮治疗双相情感障碍:一例报告。

The Mental Health Clinician Pub Date : 2021-07-16 eCollection Date: 2021-07-01 DOI: 10.9740/mhc.2021.07.259

Courtney Skriptshak, Ashley Reich

引用次数: 6

Evaluation of drug-drug interactions in hospitalized patients on medications for OUD. OUD住院患者药物相互作用的评价。

The Mental Health Clinician Pub Date : 2021-07-16 eCollection Date: 2021-07-01 DOI: 10.9740/mhc.2021.07.231

Olivia Berger, Katherine Rector, Jacqueline Meredith, Jamielynn Sebaaly

{"title":"Evaluation of drug-drug interactions in hospitalized patients on medications for OUD.","authors":"Olivia Berger, Katherine Rector, Jacqueline Meredith, Jamielynn Sebaaly","doi":"10.9740/mhc.2021.07.231","DOIUrl":"https://doi.org/10.9740/mhc.2021.07.231","url":null,"abstract":"Introduction: Medications used to treat OUD have common metabolic pathways and pharmacodynamic properties that can lead to drug-drug interactions (DDIs) that may go unnoticed in the inpatient setting. The purpose of this study was to identify the frequency of DDIs between medications prescribed for OUD and commonly used inpatient medications.Methods: This was a retrospective review of orders for buprenorphine, buprenorphine-naloxone, and methadone to identify potential DDIs. Adult inpatients with an order for one of these medications for OUD were included. Medication regimens were evaluated throughout the inpatient stay and on day of discharge for DDIs. DDIs were classified by severity and type of interaction (increased risk of QT prolongation, additive CNS effects/respiratory depression, and opioid withdrawal). The primary endpoint was the number of potential DDIs. Other endpoints included number of each classification/severity of DDI, duration of therapy of interacting medications, and modifications made to OUD medications because of DDIs.Results: A total of 102 patients were included, with 215 inpatient interactions and 83 interactions at discharge identified. While inpatient, 85% of patients were on an interacting medication, and 46% of patients were on an interacting medication at discharge. The most common classification of DDI was additive CNS effects/respiratory depression (68.8% inpatient, 50.6% discharge), followed by QT prolongation (24.2% inpatient, 45.8% discharge). The majority of DDIs were classified as requiring close monitoring rather than contraindicated.Discussion: There are opportunities to optimize the prescribing practices surrounding OUD medications in both the inpatient setting and at discharge to ensure patient safety.","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"11 4","pages":"231-237"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/00/72/i2168-9709-11-4-231.PMC8287868.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39227522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Safety of ECT in patients receiving an oral anticoagulant. 接受口服抗凝剂患者电痉挛治疗的安全性。

The Mental Health Clinician Pub Date : 2021-07-16 eCollection Date: 2021-07-01 DOI: 10.9740/mhc.2021.07.254

Nicolette R Centanni, Wendy Y Craig, Dena L Whitesell, Wesley R Zemrak, Stephanie D Nichols

{"title":"Safety of ECT in patients receiving an oral anticoagulant.","authors":"Nicolette R Centanni, Wendy Y Craig, Dena L Whitesell, Wesley R Zemrak, Stephanie D Nichols","doi":"10.9740/mhc.2021.07.254","DOIUrl":"https://doi.org/10.9740/mhc.2021.07.254","url":null,"abstract":"Introduction: This study assessed the use, tolerability, and safety of anticoagulation via direct oral anticoagulants or warfarin in medical and psychiatric inpatients receiving ECT.Methods: This retrospective cohort study included 32 patients who received ECT while on either a direct oral anticoagulant (9) or warfarin (23) and spanned 247 encounters at Maine Medical Center between December 2012 and December 2018. Data are presented descriptively and analyzed using SPSS version 25 and Microsoft Excel version 2016.Results: Among the 247 ECT patient encounters, there were few major adverse effects of ECT in this medically complex population. These adverse effects included headache during 4 encounters (1.6%), respiratory distress during 2 encounters (0.8%) and a cardiovascular event during 1 encounter (0.4%). One patient (3.1%) who was receiving concurrent rivaroxaban and venlafaxine experienced gastrointestinal bleeding that was determined to be unrelated to ECT. One patient on fluoxetine and warfarin experienced hemoptysis thought to be secondary to epistaxis. No other major bleeding or clotting event occurred during an ECT session nor for the duration of the hospitalization.Discussion: Direct oral anticoagulants and warfarin appear safe in the treatment of patients with atrial fibrillation or acute venous thromboembolism who are receiving concomitant ECT. Prospective studies are needed to confirm these findings.","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"11 4","pages":"254-258"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ba/24/i2168-9709-11-4-254.PMC8287866.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39227526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 3

Characterization of hospitalized patients who received naloxone while receiving opioids with or without gabapentinoids. 接受纳洛酮同时接受阿片类药物加巴喷丁或不加巴喷丁的住院患者的特征

The Mental Health Clinician Pub Date : 2021-07-16 eCollection Date: 2021-07-01 DOI: 10.9740/mhc.2021.07.225

Payal H Desai, Olesya Taylor, Kunal J Shah, Kirk E Evoy, Alyssa M Peckham

{"title":"Characterization of hospitalized patients who received naloxone while receiving opioids with or without gabapentinoids.","authors":"Payal H Desai, Olesya Taylor, Kunal J Shah, Kirk E Evoy, Alyssa M Peckham","doi":"10.9740/mhc.2021.07.225","DOIUrl":"https://doi.org/10.9740/mhc.2021.07.225","url":null,"abstract":"Introduction Gabapentin and pregabalin (gabapentinoids) can be given with opioids for opioid-sparing and adjuvant analgesic effects. In the context of certain comorbidities and high dosages, coadministration of these agents can lead to respiratory depression or oversedation, necessitating naloxone administration. Methods A retrospective chart review from January 2015 to December 2017 was conducted to include patients who received naloxone and opioids with or without gabapentinoids. Exclusion criteria included pregnancy or having received naloxone in the emergency department, intensive care, or pediatrics units. The primary outcome was to characterize differences between groups regarding comorbidities, history of renal or hepatic dysfunction, history of SUD, opioid tolerance, initiation and dose appropriateness of gabapentinoids, and dose intensity of gabapentinoids and opioids. Secondary outcomes were concomitant CNS depressant use and naloxone episodes for documented respiratory depression. Results Of 126 patients who met inclusion criteria, 36 received opioids and gabapentinoids (gabapentinoid group) and 90 received opioids alone (nongabapentinoid group). There were 136 naloxone episodes between the 2 groups. More than 50% of the naloxone episodes in the gabapentinoid group involved opioids of at least 90 oral morphine mg equivalents. Respiratory depression accounted for 39% and 15.8% of the naloxone episodes in the gabapentinoid and nongabapentinoid groups, respectively. Discussion There may be increased naloxone episodes among patients receiving opioids and gabapentinoids. Future studies are needed to evaluate the incremental risk of respiratory depression and oversedation as it pertains to concomitant medication administration and patient-specific factors.","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"11 4","pages":"225-230"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/94/5e/i2168-9709-11-4-225.PMC8287869.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39227595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Effect of cannabis use on PTSD treatment outcomes in veterans. 大麻使用对退伍军人PTSD治疗结果的影响。

The Mental Health Clinician Pub Date : 2021-07-16 eCollection Date: 2021-07-01 DOI: 10.9740/mhc.2021.07.238

Meagan Petersen, Katherine Koller, Craig Straley, Ellen Reed

{"title":"Effect of cannabis use on PTSD treatment outcomes in veterans.","authors":"Meagan Petersen, Katherine Koller, Craig Straley, Ellen Reed","doi":"10.9740/mhc.2021.07.238","DOIUrl":"https://doi.org/10.9740/mhc.2021.07.238","url":null,"abstract":"Introduction: Researchers have found anandamide (an endocannabinoid) and cannabinoid type 1 receptor activation encourages extinction of aversive memories. Some theorize cannabinoids such as those in cannabis may provide a new treatment approach for PTSD, while others suggest it may worsen symptomology. The objective of the current study was to determine if cannabis use impacts the success of evidence-based intensive outpatient PTSD treatment in a veteran population.Methods: A list of veterans enrolled in the Battle Creek Veterans' Affairs Medical Center outpatient PTSD Clinical Team Clinic between October 1st, 2008 and October 1st, 2016 was obtained, and a random sample was identified. Study participants were veterans aged 18 to 85 years, with at least 2 PTSD Checklist scores, and a diagnosis of PTSD. Data collected included mental health medications, type and number of evidence-based psychotherapy used, and presence of co-occurring behavioral health diagnoses. The cannabis use group was compared to the no-cannabis-use group, and differences in variables pertaining to the relative number of treatment successes and failures was evaluated for statistical and clinical significance.Results: The majority of patients were white (87.1%) and male (95%). The success rate was similar between the cannabis and no-cannabis-use groups (51.9% and 51.4%, respectively).Discussion: The current study did not show that a predominantly white male veteran sample diagnosed with PTSD differed in intensive PTSD treatment success or failure based on cannabis use.","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"11 4","pages":"238-242"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/25/3e/i2168-9709-11-4-238.PMC8287864.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39227523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Hyperammonemia in patients receiving valproic acid in the hospital setting: A retrospective review. 在医院接受丙戊酸治疗的患者的高氨血症:一项回顾性回顾。

The Mental Health Clinician Pub Date : 2021-07-16 eCollection Date: 2021-07-01 DOI: 10.9740/mhc.2021.07.243

Tressa McMorris, Angela Chu, Lynn Vu, Amanda Bernardini

{"title":"Hyperammonemia in patients receiving valproic acid in the hospital setting: A retrospective review.","authors":"Tressa McMorris, Angela Chu, Lynn Vu, Amanda Bernardini","doi":"10.9740/mhc.2021.07.243","DOIUrl":"https://doi.org/10.9740/mhc.2021.07.243","url":null,"abstract":"Introduction: Valproic acid (VPA) is widely used for the treatment of epilepsy, migraine, and a variety of psychiatric conditions. The reported incidences of hyperammonemia induced by VPA use is variable. The purpose of this study is to evaluate the incidence of VPA-induced hyperammonemia in the general adult inpatient population.Methods: Adult patients who received at least 1 dose of VPA and derivatives between June 1, 2017 to December 31, 2017 were included. Patients were excluded if they did not have VPA administered during their inpatient stay or if they had elevated ammonia levels (>33 μmol/L) prior to initiation of VPA. Patients with a confirmed diagnosis of liver cirrhosis were also excluded. The primary endpoint was the incidence of hyperammonemia. Secondary outcomes included symptoms of hyperammonemia, diagnosis of VPA-induced hyperammonemia, and treatment of VPA-induced hyperammonemia.Results: A total of 162 patients were included in this study. A total of 33 (20.4%) patients were identified as having the primary outcome of hyperammonemia; 26 (16.0%) patients had symptoms of hyperammonemia, and 13 (8.0%) patients were diagnosed with VPA-induced hyperammonemia. Treatment modalities included administration of lactulose, levocarnitine, discontinuing VPA, or decreasing the VPA dose.Discussion: The administration of VPA in the general adult inpatient population resulted in a 20.4% incidence of hyperammonemia, with a lower rate of diagnosed VPA-induced hyperammonemia. Clinicians should be encouraged to obtain ammonia levels in patients receiving VPA if symptoms of altered mental status or encephalopathy develop.","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"11 4","pages":"243-247"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/69/cf/i2168-9709-11-4-243.PMC8287865.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39227524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 4

Impact of a pharmacist-driven tardive dyskinesia screening service. 药剂师驱动的迟发性运动障碍筛查服务的影响。

The Mental Health Clinician Pub Date : 2021-07-16 eCollection Date: 2021-07-01 DOI: 10.9740/mhc.2021.07.248

Niyati Butala, Andrew Williams, Jamie Kneebusch, Melissa Mitchell

{"title":"Impact of a pharmacist-driven tardive dyskinesia screening service.","authors":"Niyati Butala, Andrew Williams, Jamie Kneebusch, Melissa Mitchell","doi":"10.9740/mhc.2021.07.248","DOIUrl":"https://doi.org/10.9740/mhc.2021.07.248","url":null,"abstract":"Introduction: Tardive dyskinesia (TD) is defined as involuntary movements that can develop with prolonged antipsychotic use. Regular monitoring using the Abnormal Involuntary Movement Scale (AIMS) is recommended to be conducted every 3 to 6 months for early recognition, although the AIMS is underused. Several studies have investigated risk factors that may be associated with TD, including age, sex, and long-term antipsychotic use. This study aimed to increase the monitoring and treatment of TD for those assessed to be at higher risk.Methods: This was a prospective quality improvement study on the effectiveness of a psychiatric pharmacist-driven TD screening service (PPDTSS) in an inpatient psychiatric facility. Participants were composed of adult patients admitted between May and November 2018. Patients were screened daily by a clinical pharmacist and, if determined to be high risk based on studied risk factors, prioritized to receive a formal TD screening via the AIMS. The primary objective was to optimize standard of care by increasing the number of AIMS screenings conducted. The secondary objective was to increase the treatment of TD.Results: A total of 402 patients were assessed prior to implementation of the PPDTSS, and 390 patients were screened following implementation. The PPDTSS increased the number of AIMS screenings attempted by 85.1% for high-risk individuals. Of the 75 patients who had an AIMS screening attempted in the postintervention group, 46 (61.3%) had an AIMS screening completed, of which 3 (6.5%) were positive.Discussion: The results of this study demonstrate that psychiatric pharmacists can be used to improve the regular monitoring of patients at high risk for TD.","PeriodicalId":22710,"journal":{"name":"The Mental Health Clinician","volume":"11 4","pages":"248-253"},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/d8/i2168-9709-11-4-248.PMC8287863.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39227525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 1

Loxapine in patient with clozapine-resistant psychosis. 氯氮平抵抗性精神病患者的洛沙平治疗。

The Mental Health Clinician Pub Date : 2021-07-16 eCollection Date: 2021-07-01 DOI: 10.9740/mhc.2021.07.263

Jennifer Erley, Sarah Goldsborough, Amy VandenBerg, Alexandra Audu

引用次数: 3

2020 MHC Awards and Recognition. 2020年MHC奖项和认可。

The Mental Health Clinician Pub Date : 2021-05-12 eCollection Date: 2021-05-01 DOI: 10.9740/mhc.2021.05.173

Amy VandenBerg, Erica A K Davis

引用次数: 1