Formulations in Mental health Flashcards
What is a depot preparation
It is a drug that is suspended in oil
Oily injection
What types of medicines are given in depot preparations
Anti-psychotic medicine that require long term treatment
How are these depots administered
via IM
Why are depots given
-By the patient’s choice
-In order to support adherence
-As they are Long Acting
What are some disadvantages of depots
-Less people trained in administration
-Not as monitored as oral preparations
What site are the depots administered to
Ventrogluteal
Dorsolateral
Deltoid: upper arm
Vastus lateralis: the thigh muscle
What technique is used to administer the depot
Z track
> The skin in pulled 2.5-3.75 cm
>Then injected to prevent the it from leaking
Which 4 typical anti-psychotics are given as depot
Flupentixol
Fluphenazine
Haloperidol
Zuclopenthixol
List the 4 atypical anti-psychotics that are administered as depos
Aripiprazole
Olanzapine
Paliperidone
Risperidone
What are the benefits of depots
Lowest therapeutic dose can be given to minimise the side effects
How often is flupentixol depots administered
2-4 weekly
How often is Haloperidol depots administered
4 weekly
How often is fluphenazine depots administered
2-5 weekly
How often is Zuclopenthixol depots administered
1-4 weekly
How often is Azipiprazole depots administered
Monthly
How often is Olanzapine depots administered
2 or 4 weekly at higher doses
How often is Paliperidone depots administered
4 or 12 weekly depending on the brand.
How often is Risperidone depots administered
2 weekly
What are some point to consider when considering depots
-Consent
-Test dose : for tolerance and safety
-Good practice
>Allergies
>5Rs
>Medicine preparation
>Infection prevention
>Sharps
What are the 5R of medicine administration
Right person
Right medicine
Right Time
Right route
Right dose
What are the advantages of depots
Adherence - Unintentional and intentional
Consistent are reliable release of dose
Improved prevention of relapse and easier to detect relapse
Confirmation of administration
More predictable and stable serum concentration
Bypass gastric absorption
Decreased risk of accidental self-poising
Disadvantages of depot injections
There is a perception of coerciveness
Side effects which can last till the medicine is depleted/ Accumulation/Interactions
Training for administration
Monitoring
Risk that are associated with injections
Lack of flexibility around administrations
Availability
Costs
Atypical injections can give cause more EPS than the oral doses.
sciatic nerve damage if dorsogluteal muscle used
Side effect of Olanzapine depots
Post=injection delirium syndrome
