Safety and Tolerability of Antipsychotics

Jann, Michael W.; Kennedy, W. Klugh

doi:10.1007/978-3-319-24741-0_9

Cited by 2 publications

(1 citation statement)

References 97 publications

(130 reference statements)

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“…Furthermore, certain clinical complications are associated with high systemic concentration which include respiratory disturbance (bronchospasm and increased depth of respiration), dermatological reactions (maculopapular and acneiform skin reactions), nausea, vomiting, and musculoskeletal disorder ( (Budhian, Siegel, Winey, 2007). It may also induce a rare idiosyncratic reaction known as "neuroleptic malignant syndrome" which leads to severe symptoms such as hyperthermia, muscle rigidity, altered consciousness, hypertension, rhabdomyolysis, tachypnea, and tachycardia (Jann, Kennedy, 2016).…”

Section: Introductionmentioning

confidence: 99%

Glyceryl behenate-based solid lipid nanoparticles as a carrier of haloperidol for nose to brain delivery: formulation development, in-vitro, and in-vivo evaluation

Yasir¹,

Chauhan²,

Zafar

et al. 2022

Braz. J. Pharm. Sci.

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This study was aimed to develop the haloperidol (HPL) loaded solid lipid nanoparticles (SLNs) for brain targeting through the intranasal route. SLNs were fabricated by the emulsification diffusion technique using glyceryl behenate as lipid and tween 80 as a surfactant. SLNs were evaluated for particle size, zeta potential, structure, entrapment efficiency, solid state characterization by differential scanning calorimetry (DSC), and in-vitro release. In-vivo biological evaluation was performed on albino Wistar rats for the determination of pharmacokinetic as well as brain targeting parameters. Particle size, PDI, zeta potential, and entrapment efficiency of optimized formulation (HPL-SLNs 6) were found to be 103±09 nm, 0.190±0.029, -23.5±1.07 mV, and 79.46±1.97% respectively. In-vitro drug release studies exhibited that 87.21± 3.63% of the entrapped drug was released from the SLNs within 24 h. DSC curves confirmed that during entrapment in SLNs, the drug was solubilized in the lipid matrix and converted into the amorphous form. Enhanced HPL targeting to the brain was observed from HPL-SLNs as compared to HPL-Sol when administered intranasally. The value of AUC 0-∞ in the brain for HPL-SLNs i.n. was found to be nearly 2.7 times higher than that of HPL-Sol i.v., whereas 3.66 times superior to HPL-Sol administered i.n. Stability studies revealed that the formulation remains unchanged when stored at 4±2 °C (refrigerator) and 25±2 °C /60 ±5% RH up to six months. Finally, it could be concluded that SLN is a suitable carrier for HPL with enhanced brain targeting through i.n administration, as compared to the HPL-Sol, administered i.n. and i.v.

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Section: Introductionmentioning

confidence: 99%

Glyceryl behenate-based solid lipid nanoparticles as a carrier of haloperidol for nose to brain delivery: formulation development, in-vitro, and in-vivo evaluation

Yasir¹,

Chauhan²,

Zafar

et al. 2022

Braz. J. Pharm. Sci.

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A Review of Adverse Outcomes Associated with Psychoactive Drug Use in Nursing Home Residents with Dementia

Lapeyre‐Mestre

2016

Drugs Aging

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Treatment guidelines generally recommend careful assessment and non-pharmacological treatment approaches for behavioural and psychological symptoms of dementia. However, the inappropriate use of psychoactive drugs in patients with dementia in nursing homes is still prevalent. The aim of this narrative review is to summarise and criticize the most recent data investigating the adverse outcomes related to psychoactive drug use, specifically antipsychotics, antidepressants and benzodiazepines, in patients with dementia living in nursing homes. Searches of PubMed and Web of Science identified 790 potentially relevant articles, 23 of which were retained in this review. All studies investigated adverse outcomes of antipsychotics compared with non-use, or with antidepressants and/or benzodiazepine anxiolytic or hypnotic drugs. Several studies focused on the comparison between atypical and conventional antipsychotics, risperidone often being the reference. The most frequently reported outcomes were mortality (all-cause or cardiovascular), falls and/or fractures, and cardiovascular or cerebrovascular events. Overall, for mortality or falls, the highest risk is for benzodiazepines, followed by conventional antipsychotics, antidepressants and atypical antipsychotics. Whatever the drug, the patient must be carefully monitored during the first days of treatment, which needs to be initiated at the lowest possible dose and for the shortest duration. In light of the high risk of adverse outcomes (falls, cardiovascular events, infections, mortality) for patients with dementia living in nursing homes, all drugs must be carefully prescribed. However, further studies comparing pharmacological with non-pharmacological interventions, with a realistic consideration of the structural nursing home organisation, would be welcome.

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Safety and Tolerability of Antipsychotics

Cited by 2 publications

References 97 publications

Glyceryl behenate-based solid lipid nanoparticles as a carrier of haloperidol for nose to brain delivery: formulation development, in-vitro, and in-vivo evaluation

Glyceryl behenate-based solid lipid nanoparticles as a carrier of haloperidol for nose to brain delivery: formulation development, in-vitro, and in-vivo evaluation

A Review of Adverse Outcomes Associated with Psychoactive Drug Use in Nursing Home Residents with Dementia

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