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三级护理医院中紧急精神疾病的用药模式:一项前瞻性观察研究。

Drug use pattern for emergency psychiatric conditions in a tertiary care hospital: A prospective observational study.

作者信息

Jalgaonkar Sharmila V, Mapara Tausif I, Parmar Urwashi I, Patil Mahesh L, Adarkar Shilpa, Parkar Shubhangi

机构信息

Department of Pharmacology and Therapeutics, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India.

Department of Psychiatry, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India.

出版信息

Perspect Clin Res. 2021 Oct-Dec;12(4):203-208. doi: 10.4103/picr.PICR_158_19. Epub 2020 May 7.

Abstract

PURPOSE

Psychiatric emergencies (PEs) are defined as acute disturbances of thought, mood, behavior, or social relationships requiring immediate interventions. The common emergency psychiatrics are attempted suicide, severe anxiety, schizophrenia, acute psychosis, substance abuse, acute panic attacks, drug toxicities, and extrapyramidal reactions. Emergency physicians in the general hospital may face the challenge of assessing and managing patients in PEs. This study was conducted to evaluate the clinical pattern and drug use pattern for PEs at a tertiary care hospital.

MATERIALS AND METHODS

This was a cross-sectional, observational study where patients presenting to emergency medical services of a tertiary care hospital were recruited after approval from Institutional Ethics Committee and written informed consent. Demographic details, diagnosis, medication details, cost of the treatment, and adherence to guidelines in the management of emergency psychiatric conditions were assessed using a validated questionnaire. Descriptive statistics was applied to analyze the data.

RESULTS

In 110 patients, a total number of drugs prescribed were 463 (mean: 4.21 drugs/prescription). The most commonly used psychotropic drug in emergency setting was found to be risperidone (19.39%), followed by lorazepam (13.60%) and clonazepam (4.28%). The most common diagnoses were substance abuse (32.72%) and schizophrenia (21.81%). About 74.5% of the physicians prescribed drugs abiding by the standard guidelines. The average total cost incurred by patients was about Rs. 366.

CONCLUSION

The most commonly used drugs in emergency treatment found in this study are risperidone, followed by lorazepam and haloperidol.

摘要

目的

精神科急诊(PEs)被定义为需要立即干预的思维、情绪、行为或社会关系的急性紊乱。常见的急诊精神科疾病包括自杀未遂、严重焦虑、精神分裂症、急性精神病、药物滥用、急性惊恐发作、药物毒性和锥体外系反应。综合医院的急诊医生可能面临评估和管理精神科急诊患者的挑战。本研究旨在评估一家三级护理医院精神科急诊的临床模式和药物使用模式。

材料与方法

这是一项横断面观察性研究,经机构伦理委员会批准并获得书面知情同意后,招募到一家三级护理医院急诊医疗服务部门就诊的患者。使用经过验证的问卷评估人口统计学细节、诊断、用药细节、治疗费用以及急诊精神科疾病管理中的指南遵循情况。应用描述性统计分析数据。

结果

110例患者共开具了463种药物(平均:4.21种药物/处方)。在急诊环境中最常用的精神药物是利培酮(19.39%),其次是劳拉西泮(13.60%)和氯硝西泮(4.28%)。最常见的诊断是药物滥用(32.72%)和精神分裂症(21.81%)。约74.5%的医生按照标准指南开药。患者的平均总费用约为366卢比。

结论

本研究中发现的急诊治疗最常用药物是利培酮,其次是劳拉西泮和氟哌啶醇。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7f7a/8525784/1720e441090c/PCR-12-203-g001.jpg

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