Contemporary Neuropsychiatric Medication Selection

Author: Zhao Zhigang
Publisher:
Publish Date: 2003-11-01
Features: With the advancement of pharmaceutical technology, the market has seen a significant increase in the variety of treatments for neurological and psychiatric diseases in recent years, expanding the options available to clinicians and pharmacists. However, all medications have two sides: used appropriately, they prevent and treat diseases; used inappropriately, they can cause harm. Therefore, rational drug use is crucial. When prescribing and dispensing medications, clinicians and pharmacists must consider the following issues:
(1) Whether the name of the prescribed medication is correct (including the international nonproprietary name, trade name, and synonyms).
(2) Whether there are interactions between two or more prescribed medications.
(3) Understanding the pharmacokinetic parameters of the medication (to determine the dosage and administration interval).
(4) Understanding the safety of the medication (e.g., the size of the therapeutic window, the difference between the therapeutic dose and toxic dose, and whether blood drug concentration monitoring is necessary).
(5) Determining the optimal route of administration and the time of taking the medication (e.g., before or after meals, swallowing, or sublingual administration).
(6) Understanding the common and rare adverse reactions of the medication, knowing how to avoid or reduce them, and how to handle adverse reactions if they occur.
(7) Understanding whether food, beverages, or exercise affect the prescribed medication.
(8) Whether the patient is elderly or a child (if so, consider switching medications or adjusting the dosage).
(9) Whether the patient is pregnant or breastfeeding (if so, consider the safety for the fetus or infant).
(10) The patient's history of allergies to the prescribed medication and other medications.
(11) Other diseases the patient currently has, and whether the prescribed medication could worsen them.
(12) Other medications the patient is currently taking (whether they interact with the prescribed medication).
(13) The patient's liver and kidney function (if impaired, whether the dosage needs to be adjusted).
(14) Understanding the dosage form of the medication and informing the patient of the correct method of administration (oral) or use (topical).
(15) Whether the medication affects laboratory test results (to help distinguish false positives or false negatives).
(16) Whether the medication affects the color of stool or urine (explain clearly to reduce the patient's psychological burden).
(17) Incompatibilities in the external preparation of injectable medications (selecting appropriate solvents, administering medications separately if they cannot be mixed, etc.).
(18) Clarifying the duration of treatment required for the medication, i.e., the treatment course, which can also be considered the optimal time to stop taking the medication.