Author/Editor		Bačar, Cvetka
Title		Zmanjševanje individualnega in populacijskega tveganja pri zdravljenju duševnih bolezni
Translated title		Individual and population risk reduction in the treatment of mental illness
Type		članek
Source		Farm Vestn
Vol. and No.		Letnik 51, št. Spec issue
Publication year		2000
Volume		str. 229-36
Language		slo
Abstract		The article opens with a brief historic outline of the treatment of mental diseases prior to the invention of chlorpromazine. Principal adverse effects of antipsychotic therapy are discussed, along with the guidelines for their management, and the most frequent therapeutic mistakes incurred in pycho-pharmacotherapy are shown. The most important issue in the risk reduction in the drug treatment of mental diseases is dependable diagnosis. Its impact is evident especially in the maintenance therapy of chronic psychoses. An uninterrupted therapist-patient relationship is necessary in which clinical pharmacist can play a supportive role, taking part in the continuous review of the therapeutic decisions taken in the past. Posology is vital for the outcome of the therapy, mainly due to the fact that inappropriate dosing (including underdosing) can result in therapeutic failure. The patients differ to a large extent in their sensitivity to the antipsychotic drugs, their variability reaching up to tenfold among individuals. The responsibility of the pharmacist is on the increase, because the therapeutic trends are directed towards the increase of outpatient treatment and reintegration of the patient in his/her social circle.
Summary		V članku je zajet kratek pregled zgodovine zdravljenja duševnih bolezni pred odkritjem klorpromazina. Opisani so pomembnejši neželjeni učinki antipsihotične terapije, ustrezne obravnave teh učinkov in najpogostejše napake pri izvajanju farmakoterapije duševnih bolezni. Prvi pogoj za zmanjšanje tveganja pri zdravljenju duševnih bolezni je zanesljiva diagnoza. Njen pomen je zlasti očiten pri vzdrževalnem zdravljenju kroničnih psihoz. Za to je potreben stalen kontak bolnika in zdravnika (ter kliničnega farmacevta), kakor tudi nenehna revizija v preteklosti sprejetih odločitev. Odmerek je važen za uspeh terapije, saj se je izkazalo, da je neustrezno odmerjanje (tudi prenizko!) lahko razlog za neuspeh terapije, saj se bolniki med seboj zelo, tudi desetkratno razlikujejo glede na individualno občutljivost za antipsihotične učinke. Odgovornost farmacevta bo vedno večja, saj so trendi razvoja zdravljenja duševnih bolezni usmerjeni v ambulantno zdravljenje in v vključevanje duševnih bolnikov v socialno okolje.
Descriptors		MENTAL DISORDERS ANTIPSYCHOTIC AGENTS