Use Of Aripiprazole For Acute Mani Critiquing A Systematic Research Review

Human health and theIR quality of life have been improving in the past 100 due to changes in medicine and in public health (Mattes et al., 2013). Patients are placed on multiple medications at the same time and it important to understand their safety, efficacy, drug interaction, and toxicity (Mattes et al., 2013). As Mr. Cynthia Nurse practitioner, my job is to understand what affect her prescribing medication is having on her body. I have place Mrs. Cynthia on Lisinopril for her hypertension and metformin for her type II diabetes.

The disorder is usually treated using two common drugs known as Aripiprazole and risperidone. The disorder can also be treated using therapy and some therapy drugs. The research below is to deduce what will be the outcome of combining risperidone to adjuvant drug therapy. This is done through analysis of conclusions drawn and effects observed from credible research articles previously conducted by other researchers. From the analysis of the research by the other researchers, conclusions drawn are that when compared, use of risperidone alone and the use of risperidone together with an adjunctive drug such as Riluzole and N-acetylcysteine the results prove that combination of risperidone with an adjuvant drug is more effective and helpful to patients suffering from autism.

They’re used to rebalance dopamine and serotonin to improve thinking, mood, and behavior, which can help you think clearly and take part in everyday activities. Aripiprazole can decrease hallucinations and improve concentration. It can also help with nervousness, severe mood swings and decrease how often they occur. Risperdal will help with hallucinations, delusions, disorganized thinking and speech, and social isolation. Both medications may cause sensitivity to extreme temperatures which can lead to dehydration. It may impair your thinking or reactions, lower blood pressure, dizziness and increase heart rate. Fatigue, sleepiness, headache, constipation, sexual dysfunction, and appetite increases are also common. Aripiprazole and Risperdal may increase the blood levels of a hormone called prolactin. Side effects of these increased levels include females losing their period, production of breast milk and males losing their sex drive or erectile complications. Long term elevated prolactin can lead to osteoporosis or increased risk of bone fractures. Some people may develop muscle-related side effects such as restlessness, tremors, and stiffness. Antipsychotics increase the risk of weight gain, high blood sugar, and high cholesterol. These serious side effects can lead to depression, lethargy, and

Evaluating the eight papers for quality evidence was critical when selecting the two papers to utilise. The evidence hierarchy was considered, aiming to use the highest evidence possible, such as systematic reviews and meta-analyses; and randomized, controlled, double-blind studies, to ensure the most accurate evidence informed the clinical decision for the patient (Bloom, Olinzock, Radjenoic & Trice, 2013). When sorting the results, other various factors were also taken into consideration; credibility, reputability, reasonability and support. With these factors taken into account, the two papers selected are highly esteemed in regards to evidence, and are most relevant to the patient (Stichler, 2010).

It is with no doubt that proper and correct prescription fosters positive patient outcomes, especially among patients with chronic conditions due to their long-term use of medications. Lack of proper communication between the pharmacist and the care-provider can potentially compromise outcomes due to improper prescription and medication use. In this regard, the choice of the clinical question (PICOT question) is primarily intended to promote quality and safety for the chosen population. As DiCenso, Guyatt & Ciliska (2014) assert, when it comes to answering a clinical question, it is usually prudent to use studies that have high levels of evidence that can be used to influence practice. As such, I may term your choice of the study article as prudent and quite promising in as far as answering this clinical question is concerned. The choice of an experimental study is agreeably wise since it shows causal relationships between different variables-hence making it easy to draw accurate conclusions that can be used to inform evidence-based practice.

Benzodiazepines include anticonvulsant drugs (tested in the study) and antidepression and anxiety drugs (medications my patient was on- specifically Xanax)- However to perfectly match the study to the clinical problem, Cerebral Palsy patients taking Xanax could be measured against Cerebral Palsy patient not taking any medication plus a control group of normal individuals.

Benzodiazepines are also commonly used adjunctively with SSRIs, and many clinicians believe that they provide benefits in terms of both speed of response as well as an overall response (Lader, 2011). In large part, the problem is that at a 3 to 4-week point, the patient typically feels better, has improved sleep, and attributes. The improvement to the benzodiazepines and not the SSRI (Lader, 2011). The chronic use of Benzodiazepines has become a problem in different countries such as Europe for the way they were being used. According to Bernardy (2012), the research noted that the number of Veterans being treated for PTSD in the

The primary goal of Phase II of the study is comprised of patients with a specific disease and what needs to be done to recognize the best dosage. The third phase of the process is set up to look at effectiveness while reducing toxicity. These studies have generated an open data process on the value and pigeonhole for most common short-term critical effects. Phase III is based on the huge, essential experiments that are regularly used for the FDA authorization of a drug. This phase by and large consist of a huge sample size (hundreds to thousands of patients) are use to estimate

Benzodiazepine is among the class of an Antianxiety agent used to treat a range of conditions, including anxiety and insomnia. It is suitable for intermittent or short-term use. On the other hand, Benzodiazepines may produce tolerance with long-term use and have the potential for psychological or physical dependence. Furthermore, if a person is dependent on a benzodiazepine it is imperative or crucial that they do not quite the therapy abruptly of taking benzodiazepine. This is because the withdrawal symptoms of Benzodiazepine may include trouble sleeping, feelings of depression and sweating. Moreover, it can result in a life-threatening situation, tremors, and even muscle cramps. Nonetheless, according to David’s Drug “Benzodiazepine is one

The benzodiazepines, with their anxiolytic, sedative, anticonvulsant and myorelaxant properties are commonly used in the fields of psychiatry and neurology. They were originally introduced as an alternative to meprobamate and the barbiturates, as their lethal dosage was only slightly higher than their therapeutic dose. With the rise in the prescription of benzodiazepines for short-term insomnia and anxiety relief, and the subsequent rise of cases featuring benzodiazepine abuse, it seems ever more important that an alternative devoid of abuse and dependence potential is found, without compromising effectiveness. Dependence is much more likely when used long-term, as tolerance is built up and the dosage escalates. Several alternatives exist for

Following my Assessment, I brought to the team for discussion and planning and was agreed by the team that Brian has deteriorated in his mental health. Our team consultant has recommended starting him on Amisulpride 50mg in addition to Mirtazapine 30mg in the process of titration, determining the medication dose to reduce symptoms to the greatest possible degree while avoiding possible side effects). (Low, 2017). Amisulpride is an antipsychotic medication for the treatments of schizophrenic disorders such as delusions, hallucinations, thought disorders, blunted affects. Mirtazapine is an antidepressant used to treat major depressive disorder, Legal categories POM. (medicines.org.uk/me/medicine). Brian to be given the medication leaflet and also check any allergies. Brian to consult his GP for his physical health issue.

It looked at data regarding first-line pharmacotherapy for treatment for patients with panic disorders (Batelaan, Van Balkom & Stein, 2012). After reviewing evidence-based pharmacotherapy for panic disorders, they concluded that SSRIs along with SNRIs venlafaxine and Benzodiazepines should be the primary medications for panic disorders (Batelaan et al., 2012). When analyzing the efficacy of these drugs, it showed that these medications stayed effective in both short-term and long-term treatment (Batelaan et al., 2012). The three aspects researchers looked at to determine the effectiveness of the drugs were side-effects, drop out rates and time of onset (Batelaan et al., 2012). When looking at the panic disorder clinical trials, drop out rates for SSRIs and Benzodiazepines were 18% and 15% respectively. TCAs and MAOIs on the other hand showed a 30% dropout rate among patients with panic disorders (Batelaan et al., 2012). When looking at onset of action, antidepressants (SSRIs and SNRIs venlafaxine) are relatively slow, however TCAs showed a slower onset than SSRIs, SNRIs venlafaxine and Benzodiazepines (Batelaan et al., 2012). Researchers concluded that both SSRIs and SNRIs venlafaxine should be considered as first-line agents for treatment along with Benzodiazepines. The study did mention however, that there have not been one to one comparisons between SSRIs and SNRIs

The efficacy and safety of the drug in patients under the age of 18 years is not established. With renal / hepatic insufficiency and long-term treatment, control over the picture of peripheral blood and liver enzymes is necessary. Patients who did not take previously psychoactive drugs respond to the drug at lower doses compared to patients taking antidepressants, anxiolytics or alcohol. With endogenous depression, alprazolam can be used in combination with antidepressants. With the use of alprazolam, patients with depression have seen cases of hypomanic and manic development. Like other benzodiazepines, alprazolam has the ability to induce drug dependence in long-term admission in large doses (more than 4 mg / day). With a sudden discontinuation of alprazolam, there may be comeback syndromes, such as depression, irritability, insomnia, increased sweating, especially with prolonged admission (more than 8-12 weeks). When patients develop such unusual reactions as increased aggressiveness, acute excitations, feelings of fear, thoughts of suicide, hallucinations, increased muscle cramps, difficult sleep, superficial sleep, treatment should be discontinued. During pregnancy Xanax is very dangerous due to its toxic effect on the fetus and increases the risk of congenital malformations when applied in the first trimester of pregnancy. Admission of therapeutic doses in later periods

The patient presented with persistent symptoms of depression, anxiety, and stress-related medical complaints. Alprazolam was recommended for anxiety. The patient has been taking Alprazolam for an extended period of time however, that exact duration of medication use in unclear. Dr. Curtis appealed a previously denied Alprazolam on 12/30/15. Dr. Curtis indicated that benzodiazepines could be used long-term for the treatment of severe persistent panic anxiety. However, the CA MTUS and ODG guidelines do not support the long-term use of this medication. Per ODG, antidepressants are more appropriate treatment for anxiety disorders. Medical necessity of Alprazolam 0.5 mg # 60 has not been established. Recommend non-certification. Non-certification

There were various clinical trials completed and revived, only made possible by the preclinical work. These were done under various conditions at differing dosages and times of infusion and under different conditions. The ECLIPSE trials were made up of 3 studies to test clevidipine against 3 common perioperative antihypertensives which were nitro-glycerine, sodium nitroprusside, and nicardipine (which is usually a postoperative drug due to long half-life) in 1:1 ratio of clevidipine patients to other drug patients. Necessary ethics and control methods were implemented among the patients, 579 patients who were in the sodium nitroprusside vs. clevidipine study; 546 in the nitro-glycerine study and 381 in the nicardipine study (total 1506 patients only 1410 were eligible for analysis). [1] [2]