RESUMO
Primary care providers (PCPs) are frequently responsible for the pharmacologic management of mood disorders, and the PCP is often an important member of the clinical team in the management of bipolar disorder and schizophrenia. Not only is a good understanding of psychopharmacology important for the effective treatment of psychiatric disease, it is also necessary for patient safety. Clinicians should understand the side effects and the medication interactions associated with psychotropic medications. This article reviews mechanisms of action, indications, dosing, side effects, medication interactions, and general management considerations for common medications used to treat psychiatric conditions encountered in the primary care setting.
Assuntos
Transtornos Mentais/tratamento farmacológico , Psicotrópicos/administração & dosagem , Psicotrópicos/efeitos adversos , Anticonvulsivantes/administração & dosagem , Anticonvulsivantes/efeitos adversos , Sistema Enzimático do Citocromo P-450/metabolismo , Interações Medicamentosas , Overdose de Drogas , Humanos , Atenção Primária à Saúde , Inibidores Seletivos de Recaptação de Serotonina/administração & dosagem , Inibidores Seletivos de Recaptação de Serotonina/efeitos adversosRESUMO
Major depression is a common, disabling condition seen frequently in primary care practices. Non-psychiatrist ambulatory providers are increasingly responsible for diagnosing, and primarily managing patients suffering from major depressive disorder (MDD). The goal of this review is to help primary care providers to understand the natural history of MDD, identify practical tools for screening, and a thoughtful approach to management. Clinically challenging topics like co-morbid conditions, treatment resistant depression and pharmacotherapy selection with consideration to side effects and medication interactions, are also covered.
Assuntos
Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/terapia , Atenção Primária à Saúde , Transtornos de Adaptação/diagnóstico , Consumo de Bebidas Alcoólicas/efeitos adversos , Antidepressivos/uso terapêutico , Luto , Transtorno Depressivo Maior/epidemiologia , Diagnóstico Diferencial , Manual Diagnóstico e Estatístico de Transtornos Mentais , Dieta , Interações Medicamentosas , Resistência a Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Exercício Físico , Pesar , Humanos , Estilo de Vida , Programas de Rastreamento , Personalidade , Psicoterapia , Medição de Risco , Fatores de Risco , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Sono , Transtornos do Sono-Vigília/diagnóstico , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/psicologia , Ideação Suicida , Inquéritos e QuestionáriosRESUMO
Recipients of solid organ transplants (SOT) need primary care providers (PCPs) who are familiar with their unique needs and understand the lifelong infectious risks faced by SOT patients because of their need for lifelong immunosuppressive medications. SOT recipients can present with atypical and muted manifestations of infections, for which the knowledgable PCP will initiate a comprehensive evaluation. The goal of this article is to familiarize PCPs with the infectious challenges facing SOT patients. General concepts are reviewed, and a series of patient cases described that illustrate the specific learning points based on common presenting clinical symptoms.
