Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-25T15:14:03.998Z Has data issue: false hasContentIssue false

Development of a hospice formulary for psychotropic medications

Published online by Cambridge University Press:  19 February 2008

Amy Barnhorst
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, California
James A. Bourgeois*
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, California
Jack Macmillan
Affiliation:
Department of Internal Medicine, University of California, Davis Medical Center, Sacramento, California
*
Address correspondence and reprint requests to: James A. Bourgeois, University of California, Davis Medical Center, Department of Psychiatry and Behavioral Sciences, 2230 Stockton Boulevard, Sacramento, CA 95817. E-mail: [email protected]

Abstract

Objective:

The authors describe the concept of hospice formulary as is utilized at the hospice service of a university medical center.

Method:

A periodic review of hospice formulary, focusing on psychotropic medications and delirium prevention, was accomplished in 2006. This effort represents a multidisciplinary effort among hospice nursing, internal medicine, and psychiatry.

Results:

An updated formulary adopting contemporary psychopharmacologic best practices was produced and implemented along with targeted in-service training to nurse clinicians.

Significance of results:

The modern hospice formulary offers opportunities to offer state-of-the-art psychopharmacological care and minimization of delirium through judicious use of psychopharmacological treatments for the psychiatric comorbidities common in terminally ill patients.

Type
Review Articles
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Akechi, T., Okuyama, T., Sugawara, Y., et al. (2004). Major depression, adjustment disorders, and post-traumatic stress disorder in terminally ill cancer patients: Associated and predictive features. Journal of Clinical Oncology, 15, 19571965.CrossRefGoogle Scholar
Boettger, S. & Breitbart, W. (2005). Atypical antipsychotics in the management of delirium: A review of the empirical literature. Palliative and Supportive Care, 3, 227237.CrossRefGoogle ScholarPubMed
Friedlander, M.M., Brayman, Y., & Breitbart, W.S. (2004). Delirium in palliative care. Oncology, 18, 15411550.Google ScholarPubMed
Gaudreau, J.-D. & Gagnon, P. (2005). Psychogenic drugs and delirium pathogenesis: The central role of the thalamus. Medical Hypotheses, 64, 471475.CrossRefGoogle Scholar
Glassman, A.H. & Bigger, J.T. (2001). Antipsychotic drugs: Prolonged QTc interval, torsades de pointes, and sudden death. American Journal of Psychiatry, 158, 17741782.CrossRefGoogle ScholarPubMed
Kehl, K.A. (2004). Treatment of terminal restlessness: A review of the evidence. Journal of Pain & Palliative Care Pharmacotherapy, 18, 530.Google ScholarPubMed
Macleod, A.D. (1998). Methylphenidate in terminal depression. Journal of Pain and Symptom Management, 16, 193198.Google ScholarPubMed
Meagher, D.J. (2001). Delirium: optimizing management. British Medical Journal, 322, 144149.CrossRefGoogle Scholar
Morita, T., Tei, Y., & Inoue, S. (2003). Impaired communication capacity and agitated delirium in the final week of terminally ill cancer patients: Prevalence and identification of research focus. Journal of Pain and Symptom Management, 26, 827834.CrossRefGoogle ScholarPubMed
Newcomer, J.W. & Haupt, D.W. (2006). The metabolic effects of antipsychotic medications. Canadian Journal of Psychiatry, 51, 480491.CrossRefGoogle ScholarPubMed
Newcomer, J.W., Haupt, D.W., Fucetola, R., et al. (2002). Abnormalities in glucose regulation during antipsychotic treatment of schizophrenia. Archives of General Psychiatry, 59, 337345.CrossRefGoogle ScholarPubMed
Portenoy, R.K., Thaler, H.T., Kornblith, A.B., et al. (1994). Symptom prevalence, characteristics and distress in a cancer population. Quality of Life Research, 3, 183189.CrossRefGoogle Scholar
Rozans, M., Dreisbach, A., Lertora, J.J. et al. (2002). Palliative uses of methylphenidate in patients with cancer: A review. Journal of Clinical Oncology, 20, 335339.CrossRefGoogle ScholarPubMed
Samuels, S.C. & Evers, M.M. (2002). Delirium: Pragmatic guidance for managing a common, confounding, and sometimes fatal condition. Geriatrics, 57, 3338.Google Scholar
Skrobik, Y.K., Bergeron, N., Dumont, M., et al. (2004). Olanzapine vs. haloperidol: Treating delirium in a critical care setting. Intensive Care Medicine, 30, 444449.CrossRefGoogle Scholar
Tune, L. (2001). Anticholinergic effects of medication in elderly patients. Journal of Clinical Psychiatry, 62 (suppl. 21), 1114.Google ScholarPubMed
Tune, L. (2002). The role of antipsychotics in treating delirium. Current Psychiatry Reports, 4, 209212.CrossRefGoogle ScholarPubMed
Vogl, D., Rosenfeld, B., Breitbart, W., et al. (1999). Symptom prevalence, characteristics, and distress in AIDS outpatients. Journal of Pain and Symptom Management, 18, 253262.CrossRefGoogle ScholarPubMed