Psychiatric Hospital Medications and Treatment

baronzb

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    What psychiatric medications and treatments are common in a psych hospital? I assume lots of tapering and some blood levels. Can someone enlighten the forum on this important part of pharmacy, including what a day is like? Thank you for your support.
     

    ValeRx

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      What psychiatric medications and treatments are common in a psych hospital? I assume lots of tapering and some blood levels. Can someone enlighten the forum on this important part of pharmacy, including what a day is like? Thank you for your support.


      Let me guess... now you've applied to a mental health pharmacist position, yet another position you aren't qualified for?
       
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      zelman

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        What psychiatric medications and treatments are common in a psych hospital? I assume lots of tapering and some blood levels. Can someone enlighten the forum on this important part of pharmacy, including what a day is like? Thank you for your support.
        Freaking all of them. What kind of question is this? Most of your patients will be on at least 4 classes of psych meds.
         
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        baronzb

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          Freaking all of them. What kind of question is this? Most of your patients will be on at least 4 classes of psych meds.
          This is what I mean, what resources can I look up and which medications are important, etc. If you don't know, you don't have to reply. Thanks!

          Psych is mostly like rehab pharmacy, mostly tech work and some rounding, and procedural stuff; however, acute care usually doesn't handle psych meds and adjusting. This is an important, though obscure, part of pharmacy all of us could learn from.
           

          zelman

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            This is what I mean, what resources can I look up and which medications are important, etc. If you don't know, you don't have to reply. Thanks!

            Psych is mostly like rehab pharmacy, mostly tech work and some rounding, and procedural stuff; however, acute care usually doesn't handle psych meds and adjusting. This is an important, though obscure, part of pharmacy all of us could learn from.
            Everyone with substance abuse problems will be on Buspar. Everyone else will be on a benzodiazepine. About 15% will be on clozapine and at least half the remainder will be on a different neuroleptic (or two). Somewhere between 20 and 30% will be on lithium and double that number on Depakote. Including Depakote, 70% will be on at least one anticonvulsant. Many on 2 or more. You will have at least two patients on drugs you’ve never seen before (e.g. Loxapine - a first gen antipsychotic with a TCA metabolite). One person will be on an MAOI and they will constantly be prescribed interacting meds as though their doctor’s sole intent is to test pharmacists’ ability to spot them. Four or five will be on ungodly expensive meds for no good reason (e.g. Rozerem solely for the possible androgen suppression). About 90% will be on an SSRI, SNRI, TCA, or some combination thereof. You’ll have 5-10% on a stimulant and probably the same number on propranolol. Everyone will either have an order for a hypnotic or trazodone (or both). You’ll have a handful on acamprosate, too.

            I guess what I’m saying is, you might not have people on barbiturates. Maybe.
             
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            brbi

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              Everyone with substance abuse problems will be on Buspar. Everyone else will be on a benzodiazepine. About 15% will be on clozapine and at least half the remainder will be on a different neuroleptic (or two). Somewhere between 20 and 30% will be on lithium and double that number on Depakote. Including Depakote, 70% will be on at least one anticonvulsant. Many on 2 or more. You will have at least two patients on drugs you’ve never seen before (e.g. Loxapine - a first gen antipsychotic with a TCA metabolite). One person will be on an MAOI and they will constantly be prescribed interacting meds as though their doctor’s sole intent is to test pharmacists’ ability to spot them. Four or five will be on ungodly expensive meds for no good reason (e.g. Rozerem solely for the possible androgen suppression). About 90% will be on an SSRI, SNRI, TCA, or some combination thereof. You’ll have 5-10% on a stimulant and probably the same number on propranolol. Everyone will either have an order for a hypnotic or trazodone (or both). You’ll have a handful on acamprosate, too.

              I guess what I’m saying is, you might not have people on barbiturates. Maybe.

              Wow, that is such an incredibly accurate portrayal.
               

              baronzb

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                I have worked at The State Lunatic Hospital at Taunton.


                I did some reading about the subject and it seems that most patients in this venue for pharmacy practice stay for only 3 days or so, with large d/c and admit turnover with wide variations in dosing. Too much sedation seems to be an issue between pharmacists and MDs on how much of a cocktail to prescribe, e.g. a benzo, gabapentin and an opiate.
                 
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