Formulations in Mental health

Question 1

What is a depot preparation

Answer 1

It is a drug that is suspended in oil

Oily injection

Question 2

What types of medicines are given in depot preparations

Answer 2

Anti-psychotic medicine that require long term treatment

Question 3

How are these depots administered

Answer 3

via IM

Question 4

Why are depots given

Answer 4

-By the patient’s choice
-In order to support adherence
-As they are Long Acting

Question 5

What are some disadvantages of depots

Answer 5

-Less people trained in administration
-Not as monitored as oral preparations

Question 6

What site are the depots administered to

Answer 6

Ventrogluteal

Dorsolateral

Deltoid: upper arm

Vastus lateralis: the thigh muscle

Question 7

What technique is used to administer the depot

Answer 7

Z track
> The skin in pulled 2.5-3.75 cm
>Then injected to prevent the it from leaking

Question 8

Which 4 typical anti-psychotics are given as depot

Answer 8

Flupentixol

Fluphenazine

Haloperidol

Zuclopenthixol

Question 9

List the 4 atypical anti-psychotics that are administered as depos

Answer 9

Aripiprazole

Olanzapine

Paliperidone

Risperidone

Question 10

What are the benefits of depots

Answer 10

Lowest therapeutic dose can be given to minimise the side effects

Question 11

How often is flupentixol depots administered

Answer 11

2-4 weekly

Question 12

How often is Haloperidol depots administered

Answer 12

4 weekly

Question 13

How often is fluphenazine depots administered

Answer 13

2-5 weekly

Question 14

How often is Zuclopenthixol depots administered

Answer 14

1-4 weekly

Question 15

How often is Azipiprazole depots administered

Answer 15

Monthly

Question 16

How often is Olanzapine depots administered

Answer 16

2 or 4 weekly at higher doses

Question 17

How often is Paliperidone depots administered

Answer 17

4 or 12 weekly depending on the brand.

Question 18

How often is Risperidone depots administered

Answer 18

2 weekly

Question 19

What are some point to consider when considering depots

Answer 19

-Consent
-Test dose : for tolerance and safety
-Good practice
>Allergies
>5Rs
>Medicine preparation
>Infection prevention
>Sharps

Question 20

What are the 5R of medicine administration

Answer 20

Right person

Right medicine

Right Time

Right route

Right dose

Question 21

What are the advantages of depots

Answer 21

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

Question 22

Disadvantages of depot injections

Answer 22

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

Question 23

Side effect of Olanzapine depots

Answer 23

Post=injection delirium syndrome