Clinical geriatric psychopharmacology:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Baltimore [u.a.]
Williams & Wilkins
1998
|
| Ausgabe: | 3. ed. |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XXI, 592 S. graph. Darst. |
| ISBN: | 0683300210 |
Internformat
MARC
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| 245 | 1 | 0 | |a Clinical geriatric psychopharmacology |c Carl Salzman |
| 250 | |a 3. ed. | ||
| 264 | 1 | |a Baltimore [u.a.] |b Williams & Wilkins |c 1998 | |
| 300 | |a XXI, 592 S. |b graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
| 337 | |b n |2 rdamedia | ||
| 338 | |b nc |2 rdacarrier | ||
| 650 | 7 | |a Bejaarden |2 gtt | |
| 650 | 7 | |a Psychofarmaca |2 gtt | |
| 650 | 4 | |a Aged | |
| 650 | 4 | |a Geriatric psychopharmacology | |
| 650 | 4 | |a Mental Disorders | |
| 650 | 4 | |a Mental Disorders |x drug therapy | |
| 650 | 4 | |a Psychotropic Drugs |x therapeutic use | |
| 700 | 1 | |a Salzman, Carl |e Sonstige |4 oth | |
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Datensatz im Suchindex
| _version_ | 1804126963291389952 |
|---|---|
| adam_text | Contents
Preface vii
Contributors ix
Part 1: Overview
1. Older Americans and Their Illnesses 3
Barry D. Lebowitz, Jane L. Pearson, Gene D. Cohen
Characteristics of the Elderly 3
Gender Differences 3
Racial and Ethnic Differences 4
Chronic Illness and Comorbidity 4
Normal Age Related Change 4
Benefits of Treatment 6
Rates of Mental Disorders 6
Problems Using Psychotropic Drugs 11
Nature of the Problem 11
Treatment Modalities 11
Risk versus Benefit Considerations 12
Treatment Settings 12
Managed Care 12
Primary Care 12
Nursing Homes 14
Clinician s Misperceptions in Use of Prescriptions 14
2. Drug Prescribing, Drug Taking, Adverse Reactions, and
Compliance in Elderly Patients 21
J err) Avorn
Prescription Drug Use Concerns 21
Concerns with Over die Counter Medications 23
Prevalence of Psychotropic Drug Use 24
Psychotropic Prescribing Practices in Selected Settings 25
Hospital Inpatients 25
Nursing Home Residents 26
Approaches to Improving Prescription Practices 27
Prescribing Regulation in Nursing Homes 27
Advantages of the Institutional Setting 28
xiii
Educational Approaches to Prescribing in Nursing Homes 29
Drug Use Review and Appropriateness Measures 29
Medication Withdrawal 29
Common Side Effects of Psychotropic Drugs 31
Sedation 32
Confusion 32
Orthostatic Hypotension 32
Cardiac Side Effects 32
Extrapyramidal Symptoms 33
Ageism, Polypharmacy, Drug Interactions, and Adverse Reactions 33
Nutritional Status and Drug Effects 36
Compliance 36
Overall Compliance and Older Patients 37
Types of Noncompliance 38
Techniques for Improving Compliance 39
Conclusion 42
Part 2: The Aging Process and Response
to Psychotropic Drugs
3. Neurotransmission in the Aging Central Nervous System 51
Trey Sunderland
The Neurotransmission Process 52
The Effect of Age on Neurotransmitters 53
Norepinephrine 54
Dopamine 54
Serotonin 57
Acetylcholine 58
The Benzodiazepine GABA Receptor Complex 59
Glutamate 61
Effect of Psychotropic Drugs on Neurotransmission 62
Age Related CNS Alterations in Receptor Sensitivity and Psychotropic
Drug Effects 63
4. Kinetics and Dynamics of Psychotropic Drugs in the Elderly 70
Lisa L. von Moltke, Darrell R. Abernethy, David J. Greenblatt
Basic Pharmacokinetic Principles and the Aging Process 70
Absorption 71
Distribution 71
Protein Binding 72
Hepatic Metabolism and Clearance 74
Renal Clearance 75
Steady State Plasma Levels and Drug Accumulation 76
Pharmacodynamics and Aging 77
Pharmacokinetics of Specific Drug Groups 77
Sedatives, Hypnotics, and Anxiolytics 77
Antidepressants 85
Lithium 86
Neuroleptics 86
Using Pharmacokinetic Information in Prescribing Psychotropic Drugs ... 86
Absorption 86
Clearance 87
Protein Binding 87
Comment 87
Part 3: Agitation and Behavior Disorders
5. Diagnosis of Disordered Behavior and Psychosis 97
Dilip V. Jeste, John H. Eastham, James B. Lohr, Carl Salzman
Characteristics of Disordered Behavior 97
Causes of Behavioral Symptoms 97
Dementia 97
Delirium 99
Delusional Disorder 100
Early Onset Schizophrenia 101
Late Onset Schizophrenia 101
Mood Disorder 102
Conclusion 103
6. Treatment of Disordered Behavior and Psychosis 106
Dilip V. Jeste, John H. Eastham, James B. Lohr, Carl Salzman
General Principles for Neuroleptic Treatment 106
Clinical Pharmacology 106
Pretreatment Evaluation 107
Dosage and Administration 108
Side Effects of Neuroleptics 109
Sedation 109
Hypotension 110
Anticholinergic Reactions 110
Cardiovascular Side Effects 110
Neuroleptic Induced Movement Disorders I: Extrapyramidal Reactions 111
Neuroleptic Induced Movement Disorders II: Tardive Dyskinesia (TD) 113
Other Tardive Syndromes 116
Neurological Side Effects 117
Miscellaneous Side Effects 117
Ophthalmological Side Effects 118
Syndrome of Inappropriate Secretion of Antidiuretic Hormone
(SIADH) 118
Choice of Neuroleptics 119
Typical Neuroleptics 119
Atypical Neuroleptics 125
Treatment of Agitation widi Nonneuroleptic Drugs 127
Drugs Affecting Serotonin Neurotransmission 128
Anticonvulsants 128
Other Nonneuroleptics 129
Use of Neuroleptics in Difficult Clinical Situations 134
Tardive Dyskinesia, Parkinsonism, and the Elderly Patient 134
Agitation and Extrapyramidal Side Effects 134
i Dopa Induced Psychosis in Parkinson s Disease 134
Clinical Vignettes 135
Part 4: Affective Disorders
7. Diagnosis of Late Life Depression 153
Ira R. Katz, David Miller, David Oslin
Diagnosis as a Process 154
Case Recognition 154
Pathways to Diagnosis and Diagnostic Distinctions 156
Major Depressive Episode 160
Subtypes of Major Depression 162
Common Contexts of Major Depression 163
Other Depressive Disorders 164
Dysthymic Disorder 164
Adjustment Disorder 165
Depression (Not Otherwise Specified) 165
Depression and Dementia 165
lifetime Diagnosis 167
Biological Correlates of Depression 168
Neuroimaging 168
Biological Markers 168
Conclusions 169
Consequences of Depression 171
Suicide 171
Exacerbation of Medical Morbidity 172
8. Treatment of Depression with Heterocyclic Antidepressants,
Monoamine Oxidase Inhibitors, and Psychomotor Stimulants 184
George S. Alexopoulos, Carl Salzman
Heterocyclic Antidepressants 184
Clinical Pharmacology 185
Choice of Heterocyclic Antidepressants 188
Dosage and Administration 208
Side Effects 208
Treatment of Milder Depressive States 212
Treatment of Elderly Patients with Neurological or Medical Illness 212
Antidepressants and the Hypertensive Elderly Patient 213
Treatment of Bereavement Related Depression 214
Monoamine Oxidase Inhibitors 214
Clinical Pharmacology 217
Side Effects 218
Choice of MAOIs 220
Psychomotor Stimulants 221
Treatment of Delusional Depression 222
Augmenting Strategies 223
Outcomes and Maintenance Treatment 224
Clinical Vignettes 226
9. Treatment of Depression with New and Atypical
Antidepressants 245
Gary W. Small, Carl Salzman
Selective Serotonin Reuptake Inhibitors (SSRIs) 246
Clinical Pharmacology 247
Side Effects 248
Choice of SSRI 249
Dosage and Administration 249
Other Atypical Antidepressants 251
Bupropion 251
Trazodone 252
Venlafaxine 252
Nefazodone 253
Mirtazepine 253
Treatment Duration 253
Polypharmacy and Drug Interactions 254
Clinical Vignettes 255
10. Electroconvulsive Therapy In Late Life Depression 262
Harold A. Sackeim
Use and Indications 262
When to Consider ECT 264
Efficacy of ECT 265
Aging and Efficacy 267
Psychotic Depression 272
Medical Complications and Relative Contraindications 274
Cognitive Side Effects 276
Description 276
Treatment Technique 278
Individual Differences in Cognitive Effects 282
Patient Attitudes 283
Treatment Following ECT 284
Continuation Pharmacotherapy 284
Continuation/Maintenance ECT 286
Administration of ECT 287
Pre ECT Workup 287
Informed Consent 288
Concomitant Medications 288
Anesthesia 289
Choice of Electrode Placement 289
Stimulus Dosing 290
Physiological Monitoring 291
Seizure Adequacy 292
Number and Rate of Treatments 292
Evaluation of Efficacy 293
Evaluation of Cognition 293
Conclusion 294
Clinical Vignettes 295
11. Diagnosis and Treatment of Mania 310
Andrew Satlin, Benjamin Liptzin
Diagnostic Characteristics of Mania in Late Life 310
General Treatment Principles 312
Treatment with Lithium 312
Clinical Pharmacology 313
Pretreatment Evaluation 313
Dosage and Administration 314
Side Effects 315
Maintenance Treatment 318
Other Somatic Therapies 319
Valproic Acid 319
Carbamazepine 320
Clonazepam 321
Calcium Channel Blockers 321
Neuroleptics 321
Electroconvulsive Therapy 322
Clinical Vignettes 322
Part 5: Anxiety and Anxiety Related Disorders
(Panic, OCD, Phobias)
12. Diagnosis Of Anxiety and Anxiety Related Disorders 333
Carl Salzman, Javaid I. Sheikh
Characteristics of Late life Anxiety 334
Differential Diagnosis 334
Physical Illness 334
Drugs 336
Depression 336
Delirium and Dementia 338
Diagnostic Evaluation 338
Neurobiological Mechanisms of Anxiety in the Elderly 339
Panic Anxiety, Obsessive Compulsive Disorders, and Phobias 339
Panic Disorder (with and without Agoraphobia) 339
Obsessive Compulsive Disorder 339
Phobias 340
Posttraumatic Stress Disorder (PTSD) 340
Brief Conclusions 341
13. Treatment of Anxiety and Anxiety Related Disorders 343
Carl Salzman
Treatment of Anxiety States with Benzodiazepines 343
Pharmacokinetics of Benzodiazepines 345
Pharmacodynamics of Benzodiazepines 347
Selection of Benzodiazepines 348
Side Effects of Benzodiazepines 350
Prescribing Guidelines for Benzodiazepines 354
Treatment with Nonbenzodiazepine Medications 355
Barbiturates and Meprobamate 355
Buspirone 356
3 Blockers 356
Antidepressants 357
Antihistamines 357
Neuroleptics 357
Treatment of Spectrum Disorders 357
Benzodiazepines 357
Antidepressants 357
Selective Serotonin Reuptake Inhibitors 358
Clinical Vignettes 358
Part 6: Sleep Disorders
14. The Impact of Age on Sleep and Sleep Disorders 371
J. Christian Gillin, Sonia Ancoli Israel
Neurobiology and Chronobiology of Normal Sleep 371
Normal Age Related Changes in Sleep and Wakefulness 373
Napping Behaviors and Excessive Daytime Sleepiness 374
Formal Evaluation of Sleep Disorders 375
Types of Sleep Wake Disorders 377
Dyssomnias: Intrinsic Sleep Disorders 379
Dyssomnias: Extrinsic Sleep Disorders 381
Dyssomnias: Circadian Rhythm Sleep Disorders 381
Parasomnias 381
Sleep Disorders Associated with Mental Disorders 382
Sleep Disorders Associated with Neurological Disorders 383
Sleep Disorders Associated with Other Medical Disorders 383
Special Issues and Elderly Sleep Wake Patterns 384
Sleep Apnea 384
Periodic Limb Movements 385
Advanced Sleep Phase Syndrome 385
Falls, Fractures, and Napping 385
Dementia and Sleep 386
Conclusion 386
Clinical Vignettes 386
15. Treatment of Insomnia in the Elderly 395
Charles F. Reynolds III, Quentin Regestein, Peter D. Nowell,
Thomas C. Neylan
Insomnia Complaints and Use of Medications 396
Treatment of Insomnia in Later Life 396
Treatment of Underlying Illness 396
Drugs That Can Disrupt Sleep 398
Pharmacological Treatment of Late Life Insomnia 399
Principles/Recommendations for Treatment 400
Benzodiazepines and Related Compounds 400
Side Effects of Benzodiazepine Hypnotics 404
Pharmacotherapy of Insomnia for Patients with Dementia 405
Pharmacotherapy of Sleep Impairment in Late Life Depression 406
Antidepressants in the Treatment of Chronic Insomnia 407
Behavioral Treatments of Chronic Primary Insomnia 407
Conclusion 408
Clinical Vignettes 408
Part 7: Dementia And Memory Disorders
16. The Diagnosis of Dementia 419
Marilyn S. Albert
Clinical Presentation 419
Mental Status Testing 419
Mini Mental State Examination (MMSE) 420
Blessed Dementia Scale (BDS) 421
Short Portable Mental Status Questionnaire (SPMSQ) 421
History and Examination 422
Cognitive History 422
Medications and Medical History 423
Psychiatric History 423
Family History 423
Medical and Neurological Examination 423
Neuropsychological Assessment 424
Summary 426
Clinical Vignettes 426
17. Assessing the Progression of Dementia:
Diagnostic Considerations 432
Barry Reisberg, Alan Kluger
Age related Cognitive Decline 432
Mild Neurocognitive Disorder 436
Alzheimer s Disease 439
Mild Alzheimer s Disease 440
Moderate Alzheimer s Disease 445
Moderately Severe Alzheimer s Disease 446
Severe Alzheimer s Disease 449
Diagnostic Use of Functional Stages 452
Alzheimer s Disease and Other Dementias: Differential Diagnosis 455
Alzheimer s Disease and Geriatric Depression: Differential Diagnosis 456
Alzheimer s Disease and Geriatric Anxiety: Differential Diagnosis 457
Conclusion 458
18. Neurobiology of Alzheimer s Disease 463
George S. Zubenko
Neuropathology 463
Constituents of Senile Plaques and Neurofibrillary Tangles 467
Biology of Amyloid 468
Neurotransmitters and Their Receptors 470
Afferent Neurons 470
Intrinsic Neurons 474
Energy Metabolism 476
Cell Membranes 477
Brain Cell Membranes 477
Peripheral Cells 478
Inflammation and Immune Mechanisms 480
Infectious Agents and Toxins 480
Genetics of Alzheimer s Disease 482
Etiological Model 486
Conclusions and Future Directions 489
19. Treatment of Dementia 510
Lon Schneider, Pierre Tariot
Treatment Implications of Alzheimer s Disease Pathology 511
Cholinergic Restitutive Therapies 512
Cholinergic Precursors 512
Cholinesterase Inhibitors I 512
Cholinesterase Inhibitors II 516
Factors Affecting Response to Cholinesterase Inhibitors 517
Muscarinic and Nicotinic Agonists 519
Long Term Effects of Cholinergic Agents 520
Summary of Cholinergic Therapies 520
Other Neurotransmitter based Approaches 521
Catecholamines 521
Excitatory Amino Acids 522
Peptides 522
Nonneurotransmitter Treatment Strategies 522
Antioxidant Agents 523
Anti inflammatory Medications 523
Hydergine 523
Calcium Channel Blockers 524
Antiamyloid Treatment 525
Neurotrophic Factors 525
Acetyl L Carnitine 525
Propentophylline 525
Membrane Enhancers 525
Chelating Agents 525
Transplant Strategies 526
Estrogens 526
Therapy Affecting the Circulatory System 526
Nootropics 527
Combination Treatments 527
Current Clinical Considerations 527
Appendix A. Prescribing Information 543
Carl Salzman
Appendix B. Enzyme Metabolism and Drug Interaction 547
Jayendra Patel, Carl Salzman
Appendix C. Drug Interactions with Psychotropic Medications ..553
Jayendra Patel, Carl Salzman
Index 579
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| spelling | Clinical geriatric psychopharmacology Carl Salzman 3. ed. Baltimore [u.a.] Williams & Wilkins 1998 XXI, 592 S. graph. Darst. txt rdacontent n rdamedia nc rdacarrier Bejaarden gtt Psychofarmaca gtt Aged Geriatric psychopharmacology Mental Disorders Mental Disorders drug therapy Psychotropic Drugs therapeutic use Salzman, Carl Sonstige oth HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008365122&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Clinical geriatric psychopharmacology Bejaarden gtt Psychofarmaca gtt Aged Geriatric psychopharmacology Mental Disorders Mental Disorders drug therapy Psychotropic Drugs therapeutic use |
| title | Clinical geriatric psychopharmacology |
| title_auth | Clinical geriatric psychopharmacology |
| title_exact_search | Clinical geriatric psychopharmacology |
| title_full | Clinical geriatric psychopharmacology Carl Salzman |
| title_fullStr | Clinical geriatric psychopharmacology Carl Salzman |
| title_full_unstemmed | Clinical geriatric psychopharmacology Carl Salzman |
| title_short | Clinical geriatric psychopharmacology |
| title_sort | clinical geriatric psychopharmacology |
| topic | Bejaarden gtt Psychofarmaca gtt Aged Geriatric psychopharmacology Mental Disorders Mental Disorders drug therapy Psychotropic Drugs therapeutic use |
| topic_facet | Bejaarden Psychofarmaca Aged Geriatric psychopharmacology Mental Disorders Mental Disorders drug therapy Psychotropic Drugs therapeutic use |
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