New Monitoring Guidelines for Atypical Antispychotics

Contributed by: Joe Hotujac, Pharm.D. Candidate

KU School of Pharmacy

Text Box: Atypical antipsychotics are among the newer class of antipsychotics and are considered to be far superior to that of their predecessors, the typical or conventional antipsychotics. They’re superior in the fact that they have lower adverse effects. Like with all new drugs time will eventually bring new information to the forefront in terms of adverse effects and ways we can monitor for them. Atypical antipsychotics are specifically used in people who suffer from schizophrenia, and can also be used in people who suffer from bipolar disorder. What medications are classified as atypical antipsychotics? 1. Risperidal ® (Risperidone) 2. Zyprexa ® (Olanzapine) 3. Seroquel ® (Quetiapine) 4. Clozaril ® (Clozapine) 5. Geodon ® (Ziprasidon) 6. Abilify ® (Aripiprazole) What type of adverse effects could be seen while on these medications? 1. Obesity 2. Diabetes 3. High cholesterol

Text Box: What are the New Guidelines for Atypical monitoring? The American Diabetes Association and other organizations recommend strict monitoring for patients on any of the atypicals. 1. Weight should be checked at baseline, then 4, 8, and 12 weeks after starting or changing therapy, and then every 3 months. 2. Fasting Glucose and blood pressure should be checked at baseline, 12 weeks, and then at least annually. 3. Lipids should be checked at baseline, 12 weeks, and then every 5 years if normal. Zyprexa and Clozaril are most frequently associated with weight gain and diabetes. Abilify and Geodon are probably the least associated with adverse effects, but they are also the newest, so it’s too soon to tell. What alternatives do you have? If you are one of the many people on one of these medications and are ex

Text Box: periencing 1 or more of these adverse affects your physician might try a different antipsychotic especially if glucose or lipids worsen, or more than 5 % weight increase is seen. If your physician recommends starting a different antipsychotic it is important to slowly lower your current dosage, while slowly increasing the dose of the new one. It is important to remember not to discontinue these medications abruptly. Overview It is important that your prescribing physician keep a close watch throughout the course of these medications. Let your physician know of any changes that you experience such as increased weight gain, as this could be a sign for therapy intervention. For additional information visit www.uspharmacist.com/index.asp?show=article&page=8_1161.htm.

Huntington’s Disease—An Uncommon Disease with Common Symptoms (continued)

Contributed by: Christina Mears, Pharm.D. Candidate

UMKC School of Pharmacy

Text Box: How is Huntington’s disease treated? There is no medication to prevent or reverse the course of Huntington’s disease. Medications are used for symptoms and as supportive therapy. · Antipsychotic drugs such as haloperidol may be used to minimize uncontrolled movements and hallucinations · Antidepressants may be used for the emotional struggles experienced with Huntington’s disease

Text Box: · Medications may be prescribed for anxiety · Mood stabilizers can be helpful in patients suffering from frequent mood swings · Botulinum toxin (Botox) is still in experimental trials to provide relaxation in patients who experience muscle stiffness or spasms These medications all have side effects, which should be evaluated with a physician or pharmacists before starting therapy. It is most important to

Text Box: keep in mind these medications are only to help with symptoms, but not reverse disease progression. For more information: Visit the National Institute of Neurological Disorders and Stroke www.ninds.nih.gov/disorders/huntington/huntington.htm