Appropriate Dosage of Psychotropic Medications

A significant number of people worldwide is reported to develop serious psychiatric diseases such as depression, mania, or schizophrenia at some point in their lives (Rappaport, 2013). Disease medication can be delivered effectively (Tanzi, 2012). For the majority of these illnesses, drug treatment is an essential component of treatment. For comprehensive and effective treatment, medications must be administered for the most beneficial time period. Psychotropic medicines serve numerous medical purposes in the treatment of psychiatric diseases (Tanzi, 2012). Modern brain imaging tools have provided a better knowledge of how psychiatric medicines work. These modern methods have resulted in the formation of compounds that have been modeled to operate at chosen neurotransmitter receptors at determined anatomical sites (Desmarais, 2010). In spite of this objective, the majority of psychotropic drugs, especially those made in the past, are not location-specific and cause effects to other regions of the brain. Hence the great impact during an overdose, some of which is unpleasant side-effects (Tanzi, 2012).

Case Study

Cases were handled for psychotropic drugs overdose at a center of emergency in a Tokyo hospital for more than two years (Rappaport, 2013). Medical records and database for patients were kept. Diagnostic standard for cases of psychotropic overdose was determined by on the worldwide statistical categorization of diseases and other health issues. Clinical information was obtained from database and clinical records of all cases on admission which included laboratory data, critical symptoms, gender, and age. A team of medics comprising of pharmacists and emergency physicians carried out all the first medical analyses and treatment within the emergency section. Following the completion of natural treatment and upon regaining consciousness by all patients, psychotropic consultation was done to determine the causes of attempted suicide. The cause is critical aspects when considering future cases of overdose (Rappaport, 2013). Members of the medical team held a meeting with the patients every day to discuss all recent cases at the facility. Members of the medical team used clinical data to deduce and debate pre-hospital care such as first aid as well as inside information such as chest X-ray, blood sample, previous history and patient's etiology. To ascertain the symptoms of overdose, cases that got the first treatment in the ICU emergency section were targeted (Rappaport, 2013). Drug quality related to drug overdose or side effects were not approximated due to the quality of drug per tablet was different even for similar drugs. Therefore, cases were included when the type of drug was ascertained, however, were omitted in case the number of tables for the drug was unknown.

Discussion

Cases of an overdose of psychotropic drugs usually occur as a result of swallowing two or more kinds of medicinal products including benzodiazepine (Tanzi, 2012). Until today, the mixture of many drugs influencing medical difficulties among overdose cases is not clear (Desmarais, 2010). Cases of an overdose on psychotropic medicine including barbiturates and antipsychotics ought to be observed carefully because of greater chances of medical complications. In these cases, managing respiratory organs and the airway is an important chemical intention due to the remarkably increased risk of endotracheal intubation in addition to other medical problems like aspiration pneumonia. In the case study, it was revealed that respiratory disorder makes malformation in first symptoms complex (Rappaport, 2013). Significantly it was demonstrated that approximation of the central nervous and respiratory systems at primary care in patients with drug overdose including barbiturates and antipsychotics is crucial. Some case needed endotracheal intubation because of obstructed disturbance of consciousness following hospitalization. This situation demonstrates the significance of managing airways by respiratory conditions or observation not only during emergencies but also in hospitalization (Tanzi, 2012). In most particular, extended stay in ICU was also linked to barbiturate ingestion. Aspiration pneumonitis, airway management, and possible endotracheal intubation were also related to ingested barbiturates as components of many overdoses on drugs (Rappaport, 2013). Barbiturates are used to treat conditions like depression, anxiety, and insomnia (Desmarais, 2010). Barbiturates are characterized by delayed movement through the barrier in the brain and extended time of elimination because of being very soluble into adipose tissue. The joint range of therapy is narrow and hence there is a greater chance of side effects related to overdose (Tanzi, 2012). Consequently, arbitrates are typically replaced by secure drugs like the benzodiazepine. Benzodiazepine is comparatively harmless for an overdose case of respiratory depression. Even when consumed in high doses, benzodiazepine has minimum lethality. However, clinical problems of benzodiazepines include a higher chance of suicide attempts caused by the disinhibition impact of benzodiazepine (Desmarais, 2010). Whereas an overdose in benzodiazepine was seen in about 94% of cases in the case study, it is still not clear whether benzodiazepine is directly associated with suicide attempts (Rappaport, 2013). The hospital recorded a mortality rate of 0.4% due to situations of an overdose while a quarter of all cases needed additional care while in the hospital such as the management of airways because of unconsciousness. An estimated 25 % of all cases required further extra care while in the hospital .An estimated 25% of the cases needed new kinds of a certain instance while in the hospital such as oxygenation, arterial pressure measurement, and central nervous-line bradycardia and hypotension did not appear to depend on the type of rug and there was recovery among cases while in ICU. Bradycardia was notably seen in cases of anti-psychosis overdose. According to a report by Treatment of Chronic Pain With Psychotropic Medications. (2014), antipsychotics produce ant cholinergic impacts as a result of sympathetic stimulation also, anti psychotropic drugs side effects of comprising extra pyramidal signs and it s said that deglutition and mastication functions are influenced . Tanzi (2012) asserts that anti-psycho tropics reduce the discharge of a cough from the cervical ganglion thereby reducing the cough reflex. In the case study, a remarkable correlation was seen between the emergence of two conditions namely aspiration pneumonitis and intubation n and endotracheal intubation, and drug overdose (Rappaport, 2013). The period of intragastric retention for medication may delay in case of the prescription of an anti-cholinergic drug for decreasing the simultaneous psychotropic drug's side effect (Desmarais, 2010). This anti-cholinergic impact can improve the sedative influence of the drug resulting in a greater occurrence of disturbance of consciousness among cases in need of medication for aspiration pneumonitis. Due to this situation, psychotropic drugs are believed to cause side effects like aspiration pneumonitis and endotracheal intubation. Almost 5.8% of all cases indicated thoughts of suicide even after overdose treatment (Rappaport, 2013).All cases of an overdose on psychotropic drugs did not register thoughts of suicide following a stay in ICU. However, almost 1% of cases are reported to have subsequently tried and committed suicide. Reports on drug overdose in some countries, an estimated 70% of cases do not get a medical review from a psychiatric expert. Because this is a crucial element of clinical observation in overdose cases facing a greater risk of suicide, a medical review for a specialist ought to be considered following intensive care.

Conclusion

The majority of newly developed compounds of psychotropic drugs have remarkable benefits over previous psychotropic medications based on the greater safety and high tolerability (Tanzi, 2012). Regrettably, they do not function quickly and are usually not very effective. However well-tolerated and selective the drug is, for optimal usage the drug requires to be administered properly. The use of drugs ought to be confined to the settings for which clinical effectiveness is already ascertained by controlled medical trials (Tanzi, 2012). Dosage must be kept in the recommended range for the prescribed indications. While lower doses are usually not effective, higher doses can result in undesirable toxic reactions or side-effects. Desmarais (2010), notes that dosage requirements for the elderly individuals are lower as compared to other ages. For treatment of a drug to function, Desmarais (2010) recommends that the medicine be ingested as directed. The lack of consistency interferes with the judgment of its effectiveness. Before recommending for multiple drugs, it is suggested to examine if the recommended combination of medications is therapeutically safe and rational. In a provided clinical context, a mixture of various psychotropic medications may well be proper. However, this does not always imply that it is true. A complete explanation of the possible side effects and open discussion regarding the chance of severe occurrences typically assists in preventing the concern for drug overdose. Individuals getting medication have all the rights to receive relevant information regarding the prescribed medication. The best treatment duration should be reviewed carefully at the beginning and discussed ((Desmarais, 2010).

References

Desmarais, J., Beauclair, L., & Margolese, H. (2010). Switching from Brand-Name to Generic Psychotropic Medications: A Literature Review. CNS Neuroscience & Therapeutics, 17(6), 750-760. http://dx.doi.org/10.1111/j.1755-5949.2010.00210.x retrieved on 14/7/2017

Rappaport, N., Kulick, D., & Phelps, L. (2013). PSYCHOTROPIC MEDICATIONS: AN UPDATE FOR SCHOOL PSYCHOLOGISTS. Psychology In The Schools, 50(6), 589-600. http://dx.doi.org/10.1002/pits.21696 retrieved on 14/7/2017

Tanzi, M. (2012). Overuse of psychotropic medications. Pharmacy Today, 18(5), 47-48. http://dx.doi.org/10.1016/s1042-0991(15)31857-0 retrieved on 16/2017

Treatment of Chronic Pain With Psychotropic Medications. (2014). Psychopharm Review, 49(1), 7-8. http://dx.doi.org/10.1097/01.psyphr.0000442518.21818.8e retrieved on 16/2017