Opare-Addo Mercy N A, Mensah Josephine, Aboagye Grace Owusu
Department of Pharmacy Practice, Kwame Nkrumah University of Science and Technology (KNUST), PMB, U.P.O., Kumasi, Ghana.
Department of Surgery, Pharmacy Unit, Korle Bu Teaching Hospital, P.O. Box 77, Accra, Ghana.
Case Rep Psychiatry. 2020 Feb 15;2020:3419609. doi: 10.1155/2020/3419609. eCollection 2020.
Schizophrenia is a chronic and severe mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behaviour. This report presents the role of clinical pharmacists in the management of a patient diagnosed with schizophrenia with symptoms of paranoia. A gainfully employed young African male adult reported to be roaming around town moving from one bank to another was arrested. The patient was referred to the psychiatric unit of a hospital and diagnosed with schizophrenia. Key interventions offered included rapid tranquilization, electroconvulsive therapy, and psychotherapy. Medications administered to the patient while on admission included IV diazepam, IM haloperidol, IV Ketamine, IM flupentixol, olanzapine tablets, and trihexyphenidyl tablets. Issues raised by clinical pharmacists during the patient's admission included need for alternative medication for rapid tranquilization, need for initial investigations and documentation of the patient's vitals, initiation of antipsychotic therapy without initial monitoring and screening for substance abuse, inappropriate dose at initiation of antipsychotic medications, untreated indication, and incidence of missed doses. Interventions by the clinical pharmacists contributed to improvement in the patient's symptoms prior to hospital discharge. The case proves that it is critical for clinical pharmacists to be involved in the multidisciplinary team during management of patients with psychosis.
精神分裂症是一种慢性严重精神障碍,其特征是思维、感知、情绪、语言、自我意识和行为出现扭曲。本报告介绍了临床药师在管理一名被诊断为患有伴有妄想症状的精神分裂症患者中的作用。一名有工作的年轻非洲成年男性,据报道在镇上四处游荡,从一家银行转到另一家银行,随后被逮捕。该患者被转至一家医院的精神科病房,并被诊断为精神分裂症。提供的关键干预措施包括快速镇静、电休克治疗和心理治疗。患者住院期间使用的药物包括静脉注射地西泮、肌肉注射氟哌啶醇、静脉注射氯胺酮、肌肉注射三氟噻吨、奥氮平片和苯海索片。临床药师在患者住院期间提出的问题包括需要替代快速镇静药物、需要对患者生命体征进行初步检查和记录、在未对药物滥用进行初始监测和筛查的情况下启动抗精神病治疗、抗精神病药物起始剂量不当、未治疗的指征以及漏服药物的发生率。临床药师的干预有助于患者在出院前症状得到改善。该病例证明,在精神病患者的管理过程中,临床药师参与多学科团队至关重要。