Use of psychoactive medication and the quality of care in rest homes. Findings and policy implications of a statewide study

Therapeutic Drug Monitoring: Psychotropic Drugs

The therapeutic monitoring of patients who take antipsychotic drugs can be both challenging and rewarding. Antipsychotics have been in clinical use for over 30 years; yet, their complex pharmacology is not fully understood and parallels our infant knowledge of human brain chemistry. The art of successful therapeutic drug monitoring depends on the clinician's knowledge of basic pharmacology, an understanding of psychiatric disorders, and a sensitivity for careful patient observation. In addition, a thorough history, well thought out goals, and reasonable recovery expectations are essential. Antipsychotic drugs are never curative and should be used judiciously for indications where positive results outweigh the risks of adverse effects. This article will provide the reader with sound, practical knowledge of how to monitor these drugs in any clinical setting. © 1989 by W.B. Saunders Company.

Haloperidol prescribing practices in the general hospital

This study investigates the clinical use of haloperidol within a general hospital. Patients who were prescribed haloperidol were often elderly, seriously ill, and stayed in the hospital longer than average. Only 23% received a psychiatric consultation. Of the patients under study, 80% were prescribed haloperidol on a PRN basis. The most common reason for neuroleptic treatment was to symptomatically manage severe agitation. Organic mental syndromes were rarely documented. Mental status exams were generally absent; the neuroleptic's effect was often omitted, and its use was rarely noted in the discharge summary. It is recommended that more education regarding the use of neuroleptic medication is indicated.