J Psychosoc Nurs Men
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J Psychosoc Nurs Men · Jan 2010
Evaluating the bioavailability and bioequivalence of generic medications.
By law, the U. S. Food and Drug Administration (FDA) is permitted to approve generic versions of brand-name medications without necessarily requiring that research be conducted to prove them safe and effective, provided that a number of criteria are met. ⋯ Bioequivalence means that there is an equivalent rate and extent of absorption of the same active ingredient from two or more drug products. For a generic drug to be approved, both Cmax and AUC must vary only within a certain limited range compared with those for the brand name medication. Information about generic and pharmaceutical alternative drugs can be found in the Orange Book and via Drugs@FDA.
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Compared with younger patients, the use of various psychotropic drugs is typically associated with expected, but exaggerated adverse effects in elderly patients. Falls are the single most important serious complication associated with all types of prescription and nonprescription drug use in older adults; psychotropic drugs contribute to or cause falls by various direct and indirect mechanisms, including sedation, confusion, vision changes, blood pressure changes, cardiac rhythm changes, balance problems, and neuromuscular incoordination. This article discusses dosage titration for elderly patients, laboratory testing for monitoring pharmacotherapy, and the importance of careful clinical assessment. In their role of providing, monitoring, and coordinating treatment, nurses should be knowledgeable about the appropriate use of medication in elderly patients.
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J Psychosoc Nurs Men · Sep 2009
Comparative StudyMental health needs in a post-disaster environment.
Maintenance of a daily routine, which includes scheduled medications, access to a health care provider, and a stable environment, forms an anchor point in the lives of people diagnosed with mental illness. When a disaster, either man made or natural, interferes with these, patients often experience an acute exacerbation of their illness. ⋯ A review of the literature indicates that the impact on survivors' mental well-being is directly related to the level of exposure to a disaster. Mental health professionals must include crisis management, planning, and communication in pre- and post-disaster interventions with people who have mental illness.
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J Psychosoc Nurs Men · Aug 2009
ReviewClinical implications of chirality and stereochemistry in psychopharmacology.
Chirality, the concept of nonsuperimposable mirror images, is a fundamental property of biological systems and can be observed on a molecular, cellular, or organism level. Stereoisomer compounds possess the same molecular and structural formula, but they differ in their three-dimensional configurations. ⋯ Racemates and their individual enantiomers can have very different pharmacological properties that are relevant in clinical psychopharmacology. Various examples of drug therapies that show the clinical importance of chirality and stereochemistry are described.
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J Psychosoc Nurs Men · Jun 2009
Clinical practice guideline: 1-hour face-to-face assessment of a patient in a mechanical restraint.
Face-to-face assessment within 1 hour after placing a patient in a restraint has been the standard of care following regulatory requirements set forth by the federal government in 1999. This rule, although widely followed and applauded as optimum patient care, has little evidence of a standardized format for what constitutes the examination. Health care providers agree that a face-to-face assessment is warranted; however, no set parameters exist for what constitutes the key elements of such an assessment. This clinical practice guideline offers a specific outline to follow that emphasizes the safety of the patient being placed in a mechanical restraint for a behavioral health emergency.